Thread by @barandbench

Nagpur Bench of #BombayHighCourt will continue hearing the suo motu Public Interest Litigation (PIL) registered to consider issues concerning COVID-19 management in the city of Nagpur.

Hearing before Bench led by Justice SB Shukre.

#Nagpur #COVID19 #CovidResources #COVID19India

Bench has assembled.

Hearing begins.

Adv Prateek Sharma tries to mention his intervention application.

Court asks him the reason for intervening.

Sharma: This is for shortage of beds.

Court: Ok you submit your submissions and suggestions to the amicus as this plea is already burdened and voluminous.

#Nagpur

Court: We also make it clear that who so ever wants to bring forth facts to the Court, they are free to bring those on record, and must do so through the amicus curiae.

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Court: First we will focus on Remdesivir and oxygen. And now will deal with the Nagpur division entirely.

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Court asks if the order is obeyed or not. The Central Drug Controller has revised quota for Remdesivir throughout because there are vials available.

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Court asks State what are the instructions from Mumbai.

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Advocates submit documents which give statistics showing the vials acquired.

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Court however points out that these are only on paper but is this actually available to citizens.

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Court asks them whether the vials are received as per the revised allocation, and the government advocates state they need to take more instructions.

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Court: How do we take decisions, when we and even the state has no instructions?

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Advocate Kulkarni appearing for a petitioner submits a list of companies who are providing Remdesivir for 10 days.

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Court says that the State should have sat down with the officers and made a war room which will have a dedicated group for Remdesivir, for oxygen and for beds. If there is a centralised allocation for Mumbai, why can’t similar system be adopted here?

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Court: WE are receiving information not only from Advocates, but also from anonymous letters considering the sensitivity of this issue. We have letters telling us about the pilferage of Remdesivir. Then on allocation of cylinders.

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Court: Some hospitals who do not know refiners received less oxygen, ones who know get more.

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Court: We may take a decision, but the person who is executing it is faulty, what do we do?

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Court (to State): If you do not have data on the shortfall, on what you are supposed to receive? How will you work? It will be a futile hearing, if there is no solution.

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Amicus Curiae SP Bhandarkar submits that there is no clarity on the allocation.

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Court: But there has to be a reserved allocation.
The State is playing a hapless victim. How can you say you are not aware at all? Have you taken any steps to find out?

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State tries to inform the Court that they are still trying to find out the figures of allocation.

Court is shown a document showing allocation.

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Court: Ma’am this document shows the number (of drug allocation), division of allocation; this shows the company wise allocation.
You could have done some forward thinking. How can you just wait for some information to you?

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State tries to inform that without confirmation, State could not have promised to anyone.

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Court: Maybe not promise, but you could have made provisions for distribution.
The Central government has done its job of allocating. Now the ball is in the State’s court on how they are allocating based on the figures they have been allocated.

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Court (to State): Based on this order of the Centre, have you taken any revised allocation order?
How much will Bhandara get? Nagpur? Let us know our entitlement..

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Court asks for the State to submit any document where they have calculated the distribution of vials in each district.

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State showed the distribution formula.

Court noticed that the formula was not as per the requirement of each district.

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Court: We are only asking what is the allotment of the vials for the next 10 days?

State is not able to give proper response.

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Court: Anyway there is no point in asking you.
You do not care about the citizens. You are parens patriae, yet you do not care. You will rather let the citizens die, than help them.

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State responds that they have not allocated district wise, there is formula. They have received over 1 lakh vials in 5 days.

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Court: Then you require 2 lakhs, you received 1 lakh, have you done anything to make do the difference? What are you doing about it?
How can the State plead helplessness?

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Stat submits that the Central allocation for Maharashtra is over 4 lakhs.

Court asks what has the State done to ensure that the stock comes to them?

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Court asks Aurangabadkar what can the State do when they have applied to the companies for vials and they have not received?

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ASG UM Aurangabadkar submits that State can directly place order with the individual company.

Court asks State if they have placed orders?

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Before State can answer, Court states: Before anything you need to be clear on what steps has State taken for procuring.
Without having taken the steps, the State cannot approach the Centre saying we are not getting supplies. You will have to show your steps.

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Court: If the State cannot help itself, then who is to help? Don’t hide behind Centre orders.

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Court asks Adv Vaibhav Bhure appearing for an intervenor in Bhandara what he is seeking.

Bhure points out that he needs supply of 2000 vials of Remdesivir injections urgently.

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Bhure submits that Bhandara has received only 200 vials which is atrociously low.

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Court asks the State for the distribution figures in this district.

Court names three other drugs which are used along with Remdesivir for treating COVID. Enquires with the State what are they doing about the supply of these drugs?

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An intervenor submits that there is shortage of these medicines in Akola.

Court asks State what is their plan of action for maintaining this supply in not just Akola but the other districts as well.

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Court asks a State officer present in Court to submit what was his assessment on the requirement of drugs in Nagpur district for the next 15 days?

They also ask for Buldhana, Amravati etc. Those districts cannot be ignore now.

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Court records: There has been a positive development which has taken place after the order. One of the important directions is of the state reviewing its requirement of Remdesivir injections and placing a request with the Central Government committee.

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Court: for increasing the allocation for Remdesivir injection for 10 days. After an order was placed, a revised allocation order was issued by the Central Level Committee signed on April 24, 2021.

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@MoHFW_INDIA

Court records: For the said period of 10 days, State of Maharashtra will be received 4 lakhs vials.

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Court records: Order of April 24, 2021, requires state govt to take certain steps. It requires that state to place supply order with manufacturers if not already done, within the aforestated allocation of 4.35 lakh and based upon ‘manufacturer wise mapping’.

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Court records: The order dated April 24, 2021, also states quota allocated to each manufacturer to each state against their names. The state of Maharashtra is required to place the supply order based on revise allocation order with the limitation of total allocation.

Court: and within limitation allowed to individual manufacturer in Maharashtra. This order requires State of Maharashtra to appoint district nodal officer for Remdesivir and the state nodal officer will be responsible for timely movement of Remdesivir in Maharashtra.

Court: There would be a WhatsApp group consisting of officers responsible for movement of Remdesivir. This machinery is set up to ensure there is no gap in Remdesivir injection sought for and actual supply.

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Court: Thus the Centre’s rider is specific and ought to be followed in letter and spirit by Maharashtra. In this regard we like to have specific information. State govt though its nodal officer be required to place on record a detailed affidavit.

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Court: We are not aware of a revised allocation order, if such a revised allocation order is issued by the State, it would not for any district to ascertain to each district whether or not the supply is proportionate to the number allocated. State to place on record info in that.

Court: In case such revised order has not been issued, we would direct State to do so forthwith without wasting any time. During the course of hearing, it transpired that the State government is still following three methods for procuring.

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Court: There are some directs where the private pharmacies to directly place orders with companies for supply of Remdesivir. We do not understand the reason for this when the procurement and supply is centralised now.

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Court: There is no reason why some of the districts on an individual level, be permitted to procure this drugs to private Chanels. This must be stopped forthwith.

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Court: Having received instruction from Jt Commissioner FDA, that no private pharmacy is allowed to directly place orders with pharmaceutical companies. If this is the truth, then it must be placed on record.

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Court: However, if today there is an affidavit by Division Commissioner Nagpur which throws light on this aspect. It has been mentioned that certain number of vials are available and same have been qualified by two words which is “private purchase”.

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Court: These statements indicate that vials of this injection are permitted to be obtained through private purchase. Govt. Pleader submits that there is no such methods in Maharashtra. As stated earlier an affidavit will be placed on record.

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Court: Even otherwise by order of April 24 the purchase of Remdesivir within the quota has to be and must be done by the State through its central agency.

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Court: If the state government does so, much of the problem arising out of unfair distribution and also black-marketing of this drug will be solved.
The detailed affidavit to be filed latest by tomorrow.

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Court: During the course of the hearing, it was pointed out that drugs like Hybervectin, Favipiravir, almost every district is facing shortage.

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Court: Jt Director submits that there is sufficient stock of these drugs however he is not aware about the assessment of requirement of each district.

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Court: and the present stock which is available would last till May 31 as per estimated requirement. Jt Commissioner to place on record the requirement of the drug.

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Court: His estimate of probably requirement in each of the district of Vidarbha region until May 31 and the stock available for thr present and if the stock is not sufficient then the required tot this drug till May 31 for producing these drugs. Details affidavit by tomorrow.

Court: We have in the earlier para referred to three methods, one appears to be private purchase although there appears to be confusion, and that issue will be clear by tomorrow after detailed affidavit is filed.

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Court: Second method pears to be of procuring vials through tender notice. On April 21, this court was informed by Divisional Commissioner Nagpur that bids are received from bidders and CIPLA as lowest bidder was considered for being issued the order of supply of Remdesivir.

Court: Till date no further info is received. The state to include this in affidavit.

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Court: Court: Third method is placing of orders directly by the State with the manufacturers. State is requested to enlighten on this through Affidavit.

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Court: In order to boost the supply in Maharashtra as informed by GP, state is also planning to import this drug from Bangladesh, Singapore and Hong Kong. In support, she places on record a letter.

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Court: According to GP, response of Centre is still awaited. We would request ASG to seek instructions from Govt on this subject and let this court know if Centre has granted permissions for procuring this drug.

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Court: We had required that there was to be a central agency for distributing drugs as observed form hospitals.

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Court: There are some complaints about COVID care centres, not having stock of Remdesivir vials for some of the needy patients and this resulting in some kind of pilferage at COVID care hospitals.

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Court: We direct Commissioner Nagpur and Municipal Corporation to carry out individual checks at hospitals and ensure that the vials of Remdesivir are actually put to use for treating COVID patients and in their full measure without any tampering of these vials.

#Nagpur

Court: The Commissioner Nagpur may think of centralising the distribution and requisition by its office.
In the sense that there would be centralised agency which would be having in its hand all the stock of Remdesivir.

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Court: and which would be responsible for its distribution for the minute to minute and hour to hour distribution to hospital as per requisition of Central agency.

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Court: We would request Commissioner to set up a control room with team of 30-40 officers working on 8 hourly basis. These may include not only experienced administrators, officials from FDA and doctors from govt hospital and private hospitals.

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Court: This team could also be over seeing allocation of beds and oxygen liner of hospital within district.

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Court: Oxygen consultant has advised Government Medical hospital at Nagpur to decrease the oxygen beds by 20% as there is overload and possibility of an untoward incident. Hence at present 600 oxygen beds are occupied to full capacity.

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Court: Directions are issued to GMC, AIIMS hospital and other government hospitals in Nagpur to take immediate steps for oxygen generation plants.

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Court: The requisite permissions to be given within 48 hours. Western Coalfield Ltd in Nagpur is directed set up oxygen generation plants at these hospitals at their own costs within 24 hours. No MPCB permission required.

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Court: Collector of Nagpur submits to us that from tomorrow Bhilai plant will be supplying 110 MT of liquid oxygen.

#Nagpur #COVID19 #CovidResources #OxygenEmergency #OxygenShortage #OxygenCylinders

Lawyer appearing from Akola submits that there is disruption of oxygen supply to their district. Only 10 MT of oxygen is given every alternate day.

#Nagpur #COVID19 #CovidResources #OxygenEmergency #OxygenShortage #OxygenCylinders

On the issue of availability of doctors, the Court states that IMA Nagpur must consider a “clarion call” for their services at AIIMS Nagpur. IMA members to volunteer their services as specialists for AIIMS.

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Court: Till we don’t know the entitlement of Nagpur, we cannot issue directions to manufacturers.

Hearing ends.

Matter adjourned to April 29.

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