Oxygen, Removing Vaccine Patent Barriers Seen as Key Needs in India COVID Crisis

Members of the Bay Area's Indian communities are mobilizing relief efforts to support India as one of the world's worst COVID-19 crises unfolds in the country, where more than 21 million cases and 230,000 deaths have been reported, and only 2% of the population has been fully vaccinated.

KQED's Brian Watt spoke about the crisis this week with Dr. Anurag Mairal, a professor of medicine at Stanford University and president of the Bay Area chapter of Sewa International, a Hindu humanitarian nonprofit.

The following is edited for length and clarity.

What are you hearing from your family and friends in India?

Mairal: The situation is really grim, with these really horrendous numbers, hundreds of thousands infected, thousands of people dying per day. And those are just the numbers that the country is able to capture. But the real numbers are expected to be much higher. Millions of people are probably getting infected. And there's not a single diaspora member of the Bay Area community, their family members, loved ones or friends, who have not been touched by this crisis. It's a pretty dire situation.

Is it simply a question of being overwhelmed, of people showing up with dire symptoms and not having a bed for them?

It's availability of beds for sure, but it's a number of things, like availability of oxygen in places that are real hotspots, which is something we dealt with last year in the U.S. But this is many orders of magnitude greater given the population and resource constraints in India. Not only in hospitals, but also in settings like homes, where many patients with mild and moderate symptoms could benefit from just having access to oxygen. But the supply chain has broken down, and demands just far exceed what India was ready for.

Your Stanford colleague Dr. Manu Prakash is helping to scale up devices that conserve the oxygen that typically gets wasted when using a nasal tube. What would it take to manufacture this kind of technology at the level needed to help the millions of people with COVID?

It requires quite a bit of coordination among different stakeholders. Manu is leading this coalition of 100-plus scientists, engineers, policymakers, epidemiologists, manufacturing experts, supply-chain folks, policy folks. It really does take an entire global village to come together to make these seemingly simple technologies that are so impactful, and to get them manufactured at scale and get them to the last mile.

India's health care system is pretty diverse. It's got high-end settings and bigger cities, which are also under major strain right now. But imagine being in rural areas where barely adequate primary care facilities exist. How do you get these to all of those patients, all of those facilities? It takes all of us coming together to test these things and get them to the places where they need it.

Should India be able to get past patent law and manufacture COVID vaccines itself?

It's the need of the hour. It's something that we need to do as a global community. We have to find a way to eliminate all barriers that we can. The only real solution we have for this pandemic globally is vaccination. Even that's not completely sufficient, but it's the only real impactful or viable solution that we have right now. And the more we can do to make that accessible to the rest of the world, the better it would be. So, yes, I would recommend that we find a way to take away the intellectual property barriers, and it'll take some time to produce these things. But at least we'll get there.