Only 44% of rural India willing to pay for COVID-19 vaccine doses

As the country waits anxiously for the official launch of the coronavirus vaccine including those from Indian pharmaceutical companies, a survey of Rural India by Gaon Connection (GC) reveals that 44% of the respondent households were willing to pay for the vaccine. While 36% said they wouldn’t and 20% said they were not sure.

Of those willing to pay for the vaccine in rural India, two-third were open to shelling out less than Rs 500 for two doses and just 8% were comfortable paying Rs 1,000 more. Also, over than 33% respondents said their elderly parents would be the first to get vaccinated.

The findings are a part GC’s third rural survey titled the ‘COVID-19 Vaccine and Rural India’. Conducted across 60 districts in 16 states and one union territory, the face-to-face rapid survey comprised a sample size of 6,040 households and was conducted between December 1 and December 10, 2020.

The survey also asked rural citizens if the government had to prioritise vaccination, who should be given the top priority to which 43.5% respondents said it should be the doctors and nurses.

The GC survey also showed that over 51% respondents believe the COVID-19 disease was a “conspiracy by China”, 22% said it was due to failure of people to take precautions and 18% felt the government failed to contain the spread.

While jobs and incomes were impacted, half of the survey respondents said spend on buying / consuming packaged immunity boosting products viz. Chyawanprash, Giloy, Kaadah, Vitamin tablets, etc. has increased during the pandemic. That’s not all, the coronavirus outbreak altered the food habits of rural citizens. Almost 70% stopped eating outside food, over 33% were consuming more vegetables and 30% were having more fruits in their daily diet.

Around one-fourth of the total respondent households reported that samples from at least one member of their household was taken for the testing of COVID-19. The proportion of such households was the highest (42.6%) in the east-and-northeast zone, whereas it was the lowest in the north zone (10.9%).

Of the 25.9% respondent households who reported their family member(s) getting tested for COVID-19, more than half, that is 59%, said at least one person in their household had tested positive for the coronavirus. Overall, 15% of the total 6,040 respondent households reported at least one person in their household/friend circle testing positive for COVID 19.

Overall, some 15% rural households reported at least one person in their household / friend circle testing positive for COVID 19.

Those keen for more details on the survey can download the full report published under the title ‘The Rural Report 3: COVID-19 Vaccine and Rural India’ from www.ruraldata.in.

(The writer is a Mumbai-based independent business journalist and has extensively covered diversified consumer businesses over the last two decades. He can be reached at hello@ashishktiwari.com)

“Pod hospitals can significantly enhance quality of healthcare infrastructure and delivery in India”

The COVID-19 pandemic has created havoc across the globe especially countries lacking specialised and quality healthcare infrastructure to treat those infected with the coronavirus. The pandemic also exposed the fact that the gap between demand and supply of healthcare infrastructure and delivery is only widening by the day and that there is an urgent need to come up with solutions that will help bridge this gap timely, effectively and efficiently. The pod smart hospitals concept, according to Mahesh Krishnachari, director and founder of the design and build firm “Vevra”, is one such game changing solution to the problem at hand. Read on for more details.

What led to conceptualising the pod hospitals? Is this something you’ve been working on for some time now?

It all started after the lockdown was implemented earlier in March. We all watched the chaos this pandemic has brought upon the healthcare infrastructure and delivery space. We also realised how helpless we were in addressing this situation. Being a design and build firm we began brainstorming for possible solution(s) to deal with airborne diseases like COVID. That was the starting point for this pod hospital concept.

We wanted to devise a futuristic solution that would prove beneficial in the effective treatment of such diseases that may surprise us going forward. The idea was to come up with a concept that can be easily scalable and ensures timely delivery of quality healthcare services.

A lot of efforts have gone into understanding/ identifying the pain points, taking feedback and interacting with healthcare professionals from the United Kingdom as well as doctors from private and government hospitals in Bengaluru. Additionally, feedback was also sought from nurses and other hospital support staff including the Class IV employees. This exercise revealed that lack of quality infrastructure was and continues to be the key issue in the treatment of diseases like COVID-19.

All the data and intelligence gathered were studied and brainstormed by the Vevra team to come up with possible solutions that will help overcome the hurdles in the overall healthcare delivery process. A fully-furnished prefabricated pod hospital concept was the outcome of this exercise.

Could you tell us about some of the key pain points being addressed?

Sure. I think one of the crucial issues was that doctors, nurses and hospital support staff were getting infected from coronavirus while performing their duties. So designing a safe “PPE” donning and doffing area for doctors and nurses who were getting exposed to this airborne virus while overseeing the treatments was critical to minimise the spread of this infection.

Most doctors were getting infected in the doffing area, basically at the time of removing their personal protective equipment (PPE). That’s because doctors and nurses are moving in an open area with 100 to 150 COVID positive patients and there is a huge viral load in the treatment area. Being airborne the viral load settles on the PPEs worn by the doctors and nurses. And these viral particles were infecting healthcare professionals at the time of removing the PPEs in the doffing area.

So irrespective of how many COVID patients a hospital is treating, if the healthcare staff including class IV workers are at a greater risk of contracting the virus due to lack of proper facilities, then we are not really fighting COVID effectively.

And the Vevra pods hospitals are capable of addressing this issue?

The ideal solution to address this problem, in my view, is to control the air quality inside the COVID treatment area(s) thereby curtailing the spread of this virus. That’s one of the key features of the pod hospital concept we’ve designed. The air getting circulated inside the premises is getting exhausted and fresh air (filtered using HEPA filters) is being pumped into the pod.

Eighty per cent fresh air and 100% suction ensures negative pressure in these pods. This is very important especially for patients in intensive critical units (ICUs) requiring oxygen, are on a ventilator and so on. You cannot have the same air circulating or split/ centralised air conditioning and that was the reason for the government to issue an advisory on use of ACs in such areas.

Apparently, the ICU section in most hospitals have a maximum of 15 to 20 beds. Besides, no hospital in India has got negative pressure ICU’s to treat any airborne disease. Pumping fresh air and exhaust the air at regular intervals brings down the load of viral particles inside the pod. As a result the possibility of these viral particles settling down on the PPEs worn by healthcare professionals, nurses and support staff is very low. This in turn helps reduce the spread of virus and related infections.

The fully furnished and prefabricated ICU and operation theatre pods designed by us can thus come very handy in such situations. This apart there are other variants like the general pod, doctors stay pod and scanning room pod that ensure patients being treated for such pandemics apart from other ailments can be properly isolated while ensuring there is no compromise on the quality of healthcare delivery. These pods are not just the regular mobile isolation rooms but a completely functional, fully furnished, internet of things (IoT) and artificial intelligence (AI) integrated smart hospital setup. (More details about the features of these pods can be found here)

What was the reason for partnering InnoWave group?

That was mainly for technology required to monitor the patients’ health records as well as the medical equipment inside the pod. We couldn’t find a local technology partner who could meet our requirements. I reached out to a former colleague from a Portugal-based company who was working with an internet of things (IoT) firm. We exchanged notes and figured out the synergies. It was a coincidence and a good one too. Interestingly, InnoWave was already doing this in hospitals across Europe and the Unites States of America (USA). However, it would be the first time this will be done in a movable pod hospital set up in India.

How far have you reached with this concept?

The conceptualising part was completed in May and its designing was finalised in June. Thereafter we got into sourcing the raw materials required for making the pod. Incorporating the negative pressure aspect was challenging because we couldn’t find a company who could do it in a movable pod. We were fortunate to find a company based out in Bengaluru, sourced the systems/AHU’s from Luxembourg based company that had the expertise and agreed to take up the project.

The prototype is currently in very advanced stages and we are testing the functionality, efficacy and mobility of the pods in our manufacturing facility. After thorough testing at our end, we will test the healthcare delivery through these pods on hospital premises to see if there are any final tweaks required. The pods will then be delivered to the healthcare facilities for treating patients. This will take a few more weeks. The pod hospitals will go live on hospital premises that have expressed interest in having them for specialised healthcare delivery.

Are these pods made used shipping containers by any chance?

These can be made using shipping containers. However, our pods are built using other durable and recyclable materials. Every care is taken to ensure we are meeting the required guidelines and standards of building a hospital premise. Our pods are made of a prefabricated structure and its surface, walls and roof is completely antibacterial. The power requirement is up to 20-25 kilowatts resulting in a monthly electricity bill of around Rs 25,000 or so. There is a three-and-a-half feet gap between each bed which is enclosed by thick PVC curtains that acts as a barricade for additional safety of patients.

While its designs are owned by Vevra, I don’t mind opening it to someone who’d like to do this on a large scale. As for the size of these pods is concerned, it is similar to that of shipping containers because it’s been done keeping the mobility aspect in mind. These pods can be transported anywhere by loading it on a low-bed trailer and it can be shipped to other countries as well.

Can these be used to construct modular hospitals?

Definitely. The pods can be annexed to existing hospital premises depending on the kind of open space they have. This ensures there is no cross contamination in the main hospital building when treating COVID patients. In fact, if the structural design of the hospital is good enough to take another five to six tonnes of load, we can easily place these pods on the hospital terrace (after analysing the building structure).

Another advantage is that the hospital can scale it up from four beds to 100 beds depending on the requirement. It can be done in a small space of 400 square feet to 100,000 square feet. We can also stack it one above the other to make a ground plus one hospital structure. The pods can be built in two weeks and shipped to the hospital/ healthcare service provider. The reusable, easy to maintain structure can be used for 20 years without much hassles.

There is a dearth of healthcare infrastructure facilities in Tier II, III, IV locations and rural India.

This concept can make a huge difference across such locations. This set up is also very appropriate for companies looking to set up or upgrade healthcare facilities at their manufacturing units located in the interiors or for that matter undertake healthcare related corporate social responsibility (CSR) activities in these areas. Overall, I think pod hospitals have great potential to significantly enhance the quality of healthcare infrastructure and delivery in India and across emerging markets.

Will these help in bringing down the cost of COVID-19 or healthcare treatments in general that’s going through the roof?

I cannot really comment on that because pricing the healthcare delivery will be decided by the healthcare service provider. As for the costing of our pods is concerned, we haven’t yet arrived at the final pricing either since final testing of the prototype is still underway. Besides, I am also working on various permutations and combinations of this pod hospital concept so that it can be made available across price points depending on the hospital’s requirement. The IoT and AI features will be offered on a subscription basis allowing hospitals to switch on/off depending on the requirement. All I can say is that pod hospitals are way too economical as compared to the conventional structure. And the best part is that it comes as a fully furnished unit.

How much have you invested in this concept so far? How are you funding this development?

It’s been done through internal sources so far. We will be looking at external funding in terms of bringing in a financial partner or even a strategic investor. We haven’t yet decided on the quantum of funding to be raised as all the focus currently is on getting the pod hospitals up and running.

Will you be looking at a leasing model for the pod hospital infrastructure?

Yes. A lot of hospitals may not have financial resources to acquire it upfront. In such cases leasing the pod hospitals for a certain number of years or maybe even renting it for a predefined period makes more sense. The lease model can certainly be explored on a case to case basis.

(The writer is a Mumbai-based independent business journalist and has extensively covered diversified consumer businesses over the last two decades. He can be reached at hello@ashishktiwari.com)

Titan cuts H2 FY’20 growth guidance to 11-13% from over 20% earlier

A version of this story first appeared in The Free Press Journal on Wednesday, November 6, 2019.

Stressed consumer sentiments coupled with growing tendency for conserving cash in hand is likely to impact growth targets for consumer companies in the remaining quarters of the current fiscal. And as demand environment continues to be sluggish, consumer companies could be looking to revise their growth guidance for the second half (H2) of fiscal 2019-20 (FY’20).

Taking a lead in this direction is Tata Group’s jewellery, watches, eyewear and fashion accessories business vertical, Titan Company Ltd (TCL). The company management said in an earnings call on Tuesday evening that it has revised jewellery business growth guidance for the period between October 2019 to March 2020. Taking a cautious approach Titan Co. management had in August 2019, said that it was targeting over 20% revenue growth keeping the wedding and festive season in mind.

C K Venkataraman, managing director, Titan, said, “The guidance has been revised to between 11% and 13% now from the earlier over 20% growth levels.” The downward revision has been done after taking into account that overall market situation and consumer buying behaviour, said the top company executive.

Analysts tracking Titan are of the view that the premise of over 20% growth talked about earlier was based on company’s execution of business and not necessarily relying on overall macro market conditions. However, the change in the guidance now is an indication of concerns in this industry as a result of which Titan management has made a significant correction in its growth numbers going forward.

Abneesh Roy, executive vice president - institutional equities (research), Edelweiss Securities, said that the brokerage has been pointing that achieving 20% guidance in H2FY20 is very difficult in jewellery business given weak sentiments, high base of 36% in Q3FY20 and 21% in Q4FY20. “For FY21, the company is yet to change guidance from current 20%. By next quarter, Titan said they will have more clarity,” said Roy.

 
While Edelweiss expects Titan to correct 5-6% in near term, from longer term perspective, the brokerage maintains a BUY on dips given huge retail expansion, struggling competitors and increasing formalisation of jewellery sector.

Elucidating the reasons that led to revising the guidance, Venkataraman said, the company had set out a growth table for five years based on positive sentiments in the business environment. Growth may have been sluggish, in single-digits or flat during the fiscals 2018 and 2019 owing to certain migration that started happening as a result of a lot of structural changes, demonetisation, Nirav Modi scam and so on.

”The trust factor started kicking in, in favour of Tanishq and we were able to deliver a 20% plus growth rate with a certain set of initiatives and certain level of excellence in our execution. Our internal research with consumers done earlier in January and February 2019, indicated positive sentiments. However, what’s appearing now after six - seven months, is that the sentiment is actually worse than what we had measured then.

“As a result, the overall industry has witnessed 70% decline in imports, every single jeweller that we are aware of, is talking about a decline, vendors are talking about big drop in supplies. Regional jewellers are talking about a 12% and 22% decline in business during the festive period as opposed to 10% positive growth that has been achieved by Tanishq. So, obviously the strategies and standards of excellence in our execution are happening in a circumstance that’s less in our favour than a year ago,” he said.

Taking into account the market conditions, the company had to go back to the drawing board, expand the number of weapons that required (to deal the market conditions) or create fresh ones. That, as per Venkataraman, will take a little more than a few months and hence the change in guidance for October 2019 to March 2020 period.

“It is our intent to keep gunning for the over 20% growth number for fiscal 2021. For the moment though, it can only be about tweaking of the arsenal that we already have. And we are going by the more recent growth performance over the last three to four months,” he said.

While companies like Hindustan Unilever Ltd (HUL) operating in the fast moving consumer goods (FMCG) sector are optimistic about overall business, the company management had earlier said that near-term demand outlook, especially in the rural markets, remains challenging.

Among India's leading Ayurvedic and natural health care companies, Dabur said that it is working on achieving its annual growth target of mid to high single digits for the full year.

On the possibilities of revising the guidance for the second half of current fiscal, Mohit Malhotra, chief executive officer, Dabur Ltd, said, there was no need to do it. “We will work to achieve the targeted growth rates for the fiscal 2020,” he said in the earnings call on Tuesday.

(The writer is an independent business journalist and can be reached at ashishktiwari.1976@gmail.com)