India will need oxygen again in Covid third wave: Stanford professor


India, one of the world’s worst hit countries in the pandemic, may be able to manage a third wave of Covid-19 but it must not get complacent, feels Anurag Mairal, adjunct professor of medicine and director, Global Outreach Programs at Stanford Byers Center for Biodesign, Stanford University.

Half of India’s population now has been given one vaccine shot which is remarkable for a country of 1.3 billion people, Mairal pointed out in a wide-ranging conversation with indica News.

So, my feeling is, if the government stays on it and the state governments also go along with that and people continue to see the importance of it, my feeling is that India will be able to at least manage the pandemic,” he said.

Asked about when the third wave would hit and how deadly it would be in a country that was ravaged by the second wave, Mairal said: “I think October- November timeframe it might be there, but my hope and my expectation is that it won’t be as deadly as a second wave.

I don’t think we’ll ever return to that, but there are a lot of lessons that we have learned from second wave that need to be incorporated. So, that it prevents deaths.”

He said there was also a huge vaccine hesitancy in the rural population in India, and in India the vaccine is not mandated like China.

To make it mandated India needs to have enough vaccines,” he admitted. “And it will take a few months before we get to a scene where a mandate would be useful… So, what you want to do is you want to vaccinate the most vulnerable parts of the population first.”

Mairal was one of the brains behind Stanford-India Biodesign, which was launched in 2007 and is now called the School of International Biodesign. As associate director of the school meant to promote biotechnology innovation, Mairal with Indian medical device companies during the pandemic.

India has to look out for its own public health policies,” he said. “India’s public health policy must be based in what India needs economically, people’s health perspective, and the education level.”

He stressed that India needed a vaccine awareness campaign and tell people how it will save their lives.

Asked if India’s coronavirus data was believable, he admitted: “ I am not willing to believe in the data because we know in India, the numbers were not correct, the numbers

were not coming right, we all know that…. It’s very hard to know the exact numbers, and you can only guess,” he said.

He said biotechnology has become a big movement in India and the SIB had mentored many projects.

We basically lit the fire and we are just at the right place at the right time with the right tools and knowledge base,” he said.

He said in nine years Stanford-India Biodesign has trained 32 innovators who developed 14 technologies.

The program expanded and a lot of people started coming up but the big challenge in India was how do you take these technologies and bring them to the patients, and it was a huge issue. So, in 2016- 17, a few professors decided to help our innovators who are coming up with these amazing technologies to help them with the implementation phase in India,” he said.

So, when pandemic hit last year, we basically asked them, do you want to continue to work on the technologies that you’re working on or you we see which of your technologies can be helpful for Covid-19 in India… and many of them did that many of them took their existing technologies and pivoted during Covid-19.”

Mairal said even though officially the collaboration has ended so students, those innovators, they don’t come here, but professors at the SIB still advise them informally.

Citing an example, he said India-based company Biosense ramped up supplying swabs needed for the Covid-19 test.

Most of their staff was not able to come to the factory so they had to bring local teams, put the team together locally, and at one point they were supplying swabs to half of entire India,” Mairal said.

He also cited the example of the India Covid SOS [(,) an international non-profit volunteer group of scientists, clinicians, engineers, policy-makers, community organizers.

Stanford bio-engineering Professor Manu Prakash played an important role in some of the areas, mainly [addressing the] oxygen shortage.”

Mairal, who is also part of the coalition, said they had around 500 researchers, scientists, public health policy folks that came together and created a set of guidelines and a set of protocols.

During the second wave of Covid-19 in India, hospital beds were mostly full and it is common knowledge and well documented how people died because of lack of oxygen and because they could not get hospital care. Part of the problem was also that people who may not have needed hospitals were occupying beds because they were scared.

Prakash, Mairal said, designed a safety monitor for Covid situations at home, and with some help from local clinicians, rather than going to hospitals.

Asked if India was ready for a third wave, Mairal, who also serves as Sewa International president Bay Area and has worked in smaller cities in India, said:  Not completely ready.”

I think we still have a lot to do. So, my advice to anybody who’s involved in healthcare in India is not to take it easy. Again, we’ll be needing oxygen and I’m working with a coalition to training cities in rural areas teaching about ventilators, oxygen concentrators, how do you maintain them how to fix them if they break down,” Mairal said.

I think, it would take at least 10 years to really fix everything that’s gone wrong [with healthcare in India],” he said.