Despite last week’s turn of events where the Allahabad High Court’s order directing lockdown in five cities of Uttar Pradesh was stayed by the Supreme Court, the High Court continues to hear the suo moto case giving directions to the government for better management of the crisis.
The bench of Justice Ajit Kumar and Justice Siddhartha Varma refused to accept the submissions made by the government painting a rosy picture that everything was under control in the state. The bench observed that nothing remarkable seems to have been achieved on the front of public health care to the satisfaction of the people.
During the hearing on April 27, the Home Department informed the court that the government has been allotted about 857 metric tons of the liquid medical oxygen, and that a control room has been set up so that the gap between demand and supply of the oxygen is removed. It is also stated that a district level ICCC is working 24×7 and complete guidance is given to a Covid patient, and those who are in home isolation are being provided with medicine kits and a tele consultation platform is opened for treatment of non-covid patients.
Situation on ground
On the other hand, Adv. Amrendra Nath Singh, informed the court that one of the Level-1 centres in Kalindipuram had issues of availability of power, potable water and non-availability of mosquito repellents. Adv AP Paul informed the court that people are not getting admission in hospitals easily and those who are tested negative in antigen tests are being discharged even though their oxygen levels are below 90. Also those who tested negative on RT-PCR test but there are signs of Covid through CT scan of lungs are not being admitted to private hospitals because of the tedious process of getting referral letters from the Chief Medical Officer or District Magistrate.
Adv. Anuj Singh through a letter petition has questioned the wisdom of the Government in bringing the idea of referral letters for admission of patients to government and private hospitals. The struggle to first arrange medicine followed by oxygen, and then finishing the arduous task of registration process at CMO office, for receiving a basic human right such as medical aid, is only adding misery to the lives of innocent residents of the state, he said. Another counsel, Adv. Shushi informed the court that patients in private hospitals are being told to bring their own oxygen cylinders and they have to stand in queue for over 12 hrs to refill them.
Advocates Amrendra Nath Singh and A.P. Paul also submitted that the government is only giving a very rosy picture but the situation on ground has gone from bad to worse and the lockdown of all commercial activities and the public movements except in cases of health emergency, could be the only solution. They have submitted that merely creating a portal and announcing helpline numbers would not help. They stated that the health care system has completely collapsed and the government is covering up its failure in the name of guidelines. What is worse, as submitted, is that it is showing the attitude of “My way or no way”.
“Those who are resource full will survive and the rest as histories of past pandemics tell us may die for want of proper healthcare,” the counsel said.
Further, Adv AP Paul told the court that around 135 persons including teachers, shiksha mitra and investigators who were on an election duty in the recent phases of Panchayat elections have succumbed to Covid.
The court observed that nothing remarkable seems to have been achieved on the front of public health care to the satisfaction of the people. The court found that two issues needed to be addressed:
A) the management of public health infrastructure; and
B) raising or enhancing the infrastructure to at least meet 1% of the city’s population in every district of the state.
The court proposed that following steps be followed in cities of Lucknow, Prayagraj, Varanasi, Agra, Kanpur Nagar, Gorakhpur and Jhansi:
1. Major govt hospitals in these cities to have health bulletin system twice a day apprising people of health updates of the patients to avoid visiting attendants to hospitals
2. The government is also directed to declare on its district portal of the above cities the occupied and vacant positions of beds in covid wards and ICUs of all government hospitals and covid assigned private hospitals
3. Mere antigen negative report should not be a ground to throw a patient out of the hospital. They needed to be shifted to non-Covid wards for at least a week and for this government needs to gear up to set up makeshift wards
4. Every bed in Level 2 hospitals must be supported with a BiPAP machine and High Flow Cannula Mask at the rate of one per two beds and ventilator available in ICUs at the rate of one per three beds
5. Government hospital should be provided with sufficient medicines and injections including Remdesivir for patients to be treated, oxygen supply to hospitals should remain uninterrupted. Despite rules regulations framed for transporting and disposal of industrial oxygen, it should be immediately diverted to the use of people making it Medical Oxygen and its immediate uninterrupted supply for the said purpose be ensured.
6. Effort should be to rotate the Doctors, medical and paramedical staff six hourly to give them the required rest
7. Government and district administration is directed to study viability of setting up more and more Level- 1 covid centres with all requisite facilities so that people voluntarily approach there and stay to curb further spread
8. Number of ambulances must be increased and well equipped
9. Government must ensure that every covid death is reported to a Judicial Officer to be appointed by District Judge at the end of the day. It is also directed that the police station Incharge officer, shall ensure that cremation in Covid death cases is strictly followed as per the guidelines and that the details of every covid death is entered in the register maintained at the crematorium
10. Food, sanitation and other budgetary aspects should not come in the way of treatment of those admitted and patients must be supplied with good quality food and potable water and paper napkins at every meal which should be served at least 4 times a day in all levels of covid hospitals and covid centres.
The court made it clear that it will “not tolerate any paperwork or public announcements to show account of the steps taken and its sufficiency as it is now an open secret that government had gone complacent due to weakening of virus impact by the end of 2020”. The court said that those is power, must shun the attitude of ‘My Way or no way’ and should welcome suggestions from all quarters. The court held that it does not doubt the bonafides of the government but plans must be translated into action with the spirit with which they have been made.
The court also directed that a blue-print for raising the existing infrastructure should be prepared and submitted to the court on the next date and a compliance affidavit should also be filed of the directions which are to be followed in letter and spirit.
The court further directed that Additional Advocate General should give following details with respect to cities of Prayagraj, Lucknow, Varanasi, Agra, Kanpur Nagar, Meerut, Ghaziabad, Gautam Buddha Nagar, Gorakhpur and Jhansi:
existing total number of beds (including ICU beds) in the government hospitals in the level two and level three wards and their current occupancy as on 2nd of May 2021 as also the per day demand.
Government shall also inform as to why the various community health centres are not being converted into level 2 hospitals.
Total number of BiPAP machines and high flow Cannula masks and ventilators as well as ambulances
Statistical details of the oxygen supply to the hospitals where there are no oxygen producing plants
The exact number of supply of life-saving drugs including Remdesivir in government hospitals;
Details of meals that are given to the patients. The number of times, quality of meals and vitamin and calorie value and the source of such meals
Modalities adopted for admission to level 3 and private hospitals
Exact number of covid deaths reported between 19th April 2021 to 2nd May 2021
Viability to use LPG Cylinders for filling Liquid Medical Oxygen to meet the demand of cylinders.
Fee structure of private hospitals and status of oxygen supply to them
The court has directed District Judges of Lucknow, Allahabad, Varanasi, Kanpur Nagar, Agra, Gorakhpur, Ghaziabad, Gautam Budh Nagar, Jhansi to nominate a judicial officer who will act as nodal officer and report to the Registrar General of the court every weekend on number of deaths reported to them.
The matter will be taken up on May 3.
The complete order may be read here:
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