Maharashtra, the state affected worst by the coronavirus pandemic, may see a third wave of infections by July or August, Health Minister Rajesh Tope said on Thursday, PTI reported.

“Maharashtra is trying to be self-sufficient in terms of availability of medical oxygen by then,” he said, adding that the state was trying to set up 125 Pressure Swing Adsorption plants for generating medical oxygen and arrange for oxygen concentrators. The government would also provide medical equipment such as CT scan and MRI machines to districts where these facilities are not available, he added.

“Crises of oxygen should not happen in future, we have informed all officials. Huge oxygen plants are being set up,” he said following a review meeting with Chief Minister Uddhav Thackeray as well as district collectors and divisional commissioners. Collectors were told not to complain about oxygen shortages when the next wave hits the state, he said.

Tope’s statement came on a day the state reported 66,159 new cases and 771 deaths. State capital Mumbai logged 4,192 new cases and 82 deaths. On Thursday, the Maharashtra government also extended the lockdown-like restrictions in the state till May 15.

The health minister also said that the state was facing a shortage of 10,000 to 15,000 vials of antiviral drug remdesivir. He added that doctors have been advised to use remdesivir judiciously as extra doses could lead to grave side effects.

Remdesivir is being used to treat coronavirus patients in critical condition, though medical opinion about its effectiveness has been mixed. Experts have warned that it’s no “silver bullet”. In November, the World Health Organization had issued a conditional recommendation against the use of remdesivir in hospitalised patients, saying there was no evidence that the drug improved survival and other outcomes.

Thackeray has told business house and corporates that any money they spend on Covid facilities would be considered Corporate Social Responsibility expenditure. “They can avail all benefits related to CSR spendings and this will also ease financial burden on the state,” Tope said.

Vaccination paused in Mumbai

“For two-three days, the inoculation drive will be paused in Mumbai because vaccines are not available,” Tope said. “We have seen large crowd at vaccination centres and people have to go back due to non-availability of vaccines. We have full infrastructure to speed up the drive but vaccines are not available.”

The health minister added that vaccinations for the 18-44 age group cannot begin on May 1 in Maharashtra. His comments came a day after registrations were opened for inoculating citizens in the age group of 18-44 and two days before the third phase of vaccination is scheduled to roll out.

“The Serum Institute of India has given purchase order for just three lakh doses. It is not enough. We need at least 20 lakh doses, only then vaccination can be started,” Tope said, according to News18.

“For 18 to 44 age group, Chief Minister Uddhav Thackeray clearly said that we are ready to pay full cost in one go, but vaccines are not available,” Tope reiterated. “We are continuously having conversation with vaccine providers. We have written so many times to the prime minister. We have informed all that we need 12 crores doses of vaccines in Maharashtra.”

While admitting that there were other vaccine options, Top said: “Pfizer is costly. It costs Rs 1,400 per dose. The Chinese vaccine costs Rs 750 per jab. We are in touch with Zydus Cadila and Johnson & Johnson.”

He also welcomed the moves by the Serum Institute and Bharat Biotech to reduce the price of their vaccines to Rs 400 per shot from the earlier Rs 600.

Vaccine shortage

The scarcity of vaccines ahead of the third phase of vaccination that makes all adults eligible for the shot from May 1, is not a concern in Maharashtra alone. On Wednesday, 1.33 crore people registered themselves for the vaccine. However, most of them could not book a slot for vaccination, as they were open only for those above 45.

While Uttar Pradesh is expected to do a token drive on May 1, Madhya Pradesh will put off vaccinations for the 60+ and the 45+ age groups for two days to concentrate on the new age bracket on May 1. States such as Delhi, Bihar, Odisha, Assam, Jharkhand, Andhra Pradesh, Telangana, Kerala, Goa, Rajasthan and Himachal Pradesh have placed orders for vaccines. But, they are not sure if they will get the stocks in time. Gujarat has said it will announce vaccination schedules only once stocks arrive.

Earlier this month too, at least seven states – Rajasthan, Andhra Pradesh, Chhattisgarh, Haryana, Maharashtra, Odisha and Telangana – had reported shortage of vaccines. The burden is likely to increase with around 60 crore more citizens in the 18 to 45 age group becoming eligible for the shots in the third phase.

Under the new vaccination policy that will come into effect on May 1, 50% of the shots manufactured will be earmarked for the Centre. This quota will be used to inoculate priority groups who were already eligible for the shots. So, only half of the vaccines manufactured from May 1 will have to be used to accommodate the 60 crore new beneficiaries.

Even if the projected ramped up capacity of manufacturers is taken into account, Serum Institute is expected to produce 10 crore doses of Covishield, Bharat Biotech will churn out one crore doses of Covaxin and Dr Reddy’s will make 40 lakh vials of Sputnik V by the month of June. This would not even cover the 40 crore people in the priority groups that the government had hoped to cover by August. The figure does not take into account the new beneficiaries.

So far, more than 14.92 crore shots have been administered, while 2.54 crore beneficiaries have received both their doses, according to government data.