2020: A public health nightmare that had some silver linings

It was the worst of times, it was the best of times (to misquote Charles Dickens), in healthcare.

The world witnessed a crisis like no other in recent times, where flights were grounded and cities went silent. Where the streets were empty, but hospitals filled up, as patient and healthcare worker battled a hitherto unknown virus.

Last December, the world began hearing reports from Wuhan, China, of “pneumonia of an unknown cause”. In January, the World Health Organization called the outbreak a Public Health Emergency of International Concern, the highest level of alarm. And as the spread was reported across geographies, it was labelled a pandemic caused by the novel coronavirus (SARS-CoV-2).

A year on, the world grapples with variants of this virus reported from countries including the UK, South Africa, and The Netherlands among others. And the now familiar rigmarole of night curfews and flight bans, for instance, returns. But with a difference.

The global scientific community has helped ready an arsenal of vaccines, in an unprecedented show of cross-country solidarity. And it’s not just the big pharmaceutical drugs and vaccine makers and universities that are putting their might behind the world’s fight against Covid-19.

Many ancillaries play a supporting role, chipping away, without the attention and applause given to the drug and vaccine makers.

Indo-German venture SCHOTT KAISHA made an “immediate investment” of ₹122 crore in November in existing facilities to increase vial production by 300 million pieces “in a record time of one year”. The investment increased their vial production capacity to 1.5 billion pieces by end-2021.

“We are working with 10 vaccine candidates,” says Rishad Dadachanji, Director with SCHOTT KAISHA. The company provides vials to vaccine developers in India and to producers overseas. The additional investment in production added to the three billion-plus pieces of ampoules, vials, syringes, and cartridges it was already producing annually.

In the last three years, the company invested about ₹450 crore to set up two new plants at Umarsadi in Gujarat and Baddi in Himachal Pradesh. “Fortunately for us, the infrastructure is ready,” Dadachanji said, adding they were familiar with manufacturing high volumes and scaling up production at short notice.

In August, Hindustan Syringes & Medical Devices Ltd (HMD), the largest maker of auto-disable (AD) syringes in the world, said it was scaling up production to one billion (from 700 million) in the first half of 2021.

In October, they shipped the first lot of 56 million KOJAK auto-disable syringes to the Covax facility — a WHO-supported, international effort to ensure equitable access to the vaccines. The order was for supply of 140 million HMD products by December 2020.

The company has ongoing supply commitments with Unicef for its immunisation programmes, and the recent reports of yellow fever in Africa have further increased the requirement for syringes, explains Rajiv Nath, HMD Managing Director, adding that they have been able to keep pace with the demand.

“There’s also my packaging material suppliers etc who provide the ‘just in time’ inventory,” he says.

Home appliances maker Godrej Appliances contributes with medical refrigerators and freezers needed to store and transport vaccines at 2–8°C and -20°C respectively.

Many such supporting roles are played by hordes of unsung heroes who contribute to the successful rollout of the Covid-19 treatment and vaccine juggernaut.

The sentiment is best summed up by WHO. “2020 saw the world unite against the virus, from small personal gestures to protect others, to international collaboration on research and innovation. The year ends with Covid-19 vaccines rolling out — an extraordinary feat,” it said of the silver linings to a year that had turned out to be everything that the public health community had dreaded for decades.

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