Thread by @barandbench

Delhi High Court will today continue hearing petitions concerning #COVID19 in the national capital.

Hearing to take place before Justices Vipin Sanghi and Rekha Palli.

#Oxygen #DelhiCOVID19 #DelhiHighCourt

@CMODelhi

Senior Adv Ramesh Gupta for Bar Council of Delhi : Notification was issued yesterday appointing a nodal officer.

Give the notification on record: Court

Bar council of Delhi's plea concerns medical needs of lawyers suffering from #COVID19.

We'll keep after ten days for report on progress : Court

DM south is interacting with Mr Manoj Singh for attaching a Hospital: Gupta

Justice Sanghi faces connectivity issues.

Justice Sanghi joins with his video off.

We direct Respondent to act in terms of the office order forthwith: Court

The office order says we have to coordinate with the Bar Council. They have to come to us. There is no compliance required. They have to get doctors, put a facility, engaging with everyone..we have to help them tide over problems: Senior Adv Rahul Mehra for Delhi govt

If they require any clearance.. it attachment.. : Court

They are aware of everything. Meeting with Deputy CM has happened.. everybody is conscious : Mehra

I can't hear you, Mr Mehra : Justice Sanghi

Why is it taking so long to activate? : Justice Palli

It's not in my hand. Mr Gupta can share : Mehra

Mr Gupta said they don't want the Rockland attachment.. that issue is gone : Adv Stayakam for Delhi govt

Justice Sanghi's connection is weak. He's trying with the hotspot.. we all have to innovate now. We've to learn whatever we've not learnt : Justice Palli

Justice Sanghi joins.

Mehra shares the notification on screen.

One officer at the rank ot IAS has been deployed to only look into coordination issue.. they don't want to be now linked with Rockland Hospital: Mehra

The court may just dispose it of now : Mehra

This should not be a lolipop.. : Court

If we don't coordinate, they can come back: Mehra

If they don't set it up, it's thier problem: Court

Their *

Another ten days may be given. There is no harm. We had doctors, nurses but now they have some other (employment).. in the meantime we will see.. : Gupta

We are keeping it : Court

If Rockland Hospital which was opened for this purpose, if it is given up.. the court may look into the issue that the hospital is not opened under the garb of this arrangement : Amicus Senior Adv Rajshekar Rao

We've not desealed any premises.. : Court

There is not a single admission in the Dwarka Hospital (Indira Gandhi): Adv YP Singh

250 bed facility is there. Admission process may not have started by now.. : Mehra

Once it opens, it will open for everyone.. we are trying to operationalise with the oxygen concentrators and cylinders...we are putting the mechanism in place. 150 bed are available. Next 100 we will augment tomorrow: Mehra

Mehra says it will become operational by tomorrow.

Saturday it was in the press that it is operational and Tuesday you say it is not : Court

I've already placed the anxiety (before the officers) in now less terms...the next time the court may refuse to take us on face value : Mehra

Govt is telling something and not doing anything.. they have not filed reply also : YP Singh

Better is to make it operationalise.. : Mehra

Mehra says the Principal Secretary, Health's statement on time line be recorded.

It was a problem we didn't anticipate. We were not aware that we required testing certificate for the cylinders: Secretary

Cylinder were from donation.. Now we have succeeded.. we are open for admission since yesterday.. : Secretary

Not a single admission is there: YP Singh

Court records submissions.

Let an affidavit be filed today itself during the course of the day by Principal Secretary on no of beds category wise.. : Court

We direct the officers of GNCTD to maintain caution and not make statements inaccurately..it erodes the confidence of the court in officers of govt : Court

Once again my sincere apologies: Mehra

Court is hearing other matters.

To take up #COVID19 petitions in a while.

Matter resumes.

Amicus Rao makes submissions. Refers to the issue of children orphaned amid #COVID19

Says sensitization on the issue should not just be in English. Court says in Delhi at least, it should be in Hindi and English

Mehra says all forms of media are being used

Rao: There are a lot of children, from all over the spectrum, not only from well-off backgrounds.

Adv Prabhsahay Kaur makes submissions with respect to helpines.

Rao: There about 15-16,000 anganwadi workers.. 72 child care insitutions.. they can also be roped in.

Adv Prabhsahay Kaur : Our suggestion was if some of these homes can be designated for children, especially for street children.. who may not have anywhere to go for testing, no homes..

Adv Kaur on angwanwadi workers: These are volunteers, have special training, whether they were activated to help in COVID-19 pandemic - there is nothing available... can be activated

Court: All this is contained in your note?

Kaur: Yes

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Kaur: Problem that we have seen on ground.. CWC is working online.. people, because they dont know that there are CWC officers also on ground, they dont know how to approach

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#COVID19India

Kaur: While ads are being made for people orphaned on account of COVID-19.. there are also children who are in hospitals, whose parents are not able to help ...

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#COVID19India

Court says that advertisement has to be properly worded. Adv Kaur says advertisement can be prepared in English and Hindi today, Court asks that it be shared with the court also.

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#COVID19India

Ms Kaur, you prepare the advertisement. Share it with amicus... tomorrow we will.. : Court

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Rao: One category which almost always gets left behind is children with special needs ... by next week, if they can given indication of what all has happened ..on the ground.. most of these should have had an action plan.. these are statutory functions...

Rao: We have put together a chart on compliances by GNCTD and the Union of India. Your Lordship can look at this and give timelines.

Rao: My Lordship may see the Union of India compliance list, it is a shorter list ... Issue of tankers from Rajasthan... I am not sure if there is relevant anymore... flagged it because there is a court order.

Mehra: For now, may leave it Milords... we are a relatively better.. we are better placed.

Justice Sanghi: The only thing is, Mr Mehra. We would like to bring closure to this

Court: These tankers that were allocated for use in Delhi, now allocation no longer there... that statement should come.. now official status is that there is for Delhi.

Adv Nidhi Mohan Parasaran: GNCTD was asked to give a list of tankers... this issue has in fact been resolved

Court: We were told that in the war room also, this issue was flagged... there should be something coming from Central govt also, that this issue has been resolved.

Parasaran: Last status was that we have written to Rajasthan to return it and Rajasthan refused to ...

Court says that a statement should be made so the issue does not remain pending

Parasaran says the statement can be filed in the afternoon.

Court: Let there be no more quarrel about this, we want to put an end to it.

Mehra making submissions on oxygen, incl ad hoc supplies from Reliance, Linde.

There was some leakage from Linde, that has been accounted for, 20 MT, Mehra adds.

623 MT for yesterday, Mehra informs

Our tanks are coming in the next week or so. Have ordered from different suppliers. Till our tanks come, we are using this: Mehra

Are you using the services of the military?: Court

We have requested, but so far not using, Mehra informs

Adv Nidhi Mohan Parasaran says not in terms of storage: But they are extensively helping in distribution... decanting and taking to hospitals

On augmentation of resources, Rao says effort has to be co-joint between State and Centre.

Court: Our endeavour is to sensitise all the depts that these are the aspects you need to look at, if not already looked at.

Correction: Please read Adv Nidhi Mohan Parasaran as Adv Nidhi Mohan ** Parashar

Adv Nidhi Parashar says that production of #Remdesivir has been ramped up

Court: Also what is the timeline...?

Parashar: So far as Remdesivir is concerned, increased up to 1 crore a month. They think that is sufficient to meet the demand that has arisen and likely to arise

Court: Point is, you must see in what case scenario.. keeping in mind the present rate of infection... the situation is it may have been tapering off in last few days, still it is so much, you cant find a bed

Court: What we are seeing today is only going to show its impact only 10-12 days later... nature of the disease is that it is showing serious symptoms after 7 days, 10 days...

Adv Parashar: Atleast so far as augmentation of drugs.. we have exact details on how experts predict the demand and how we are going to meet it...

Court asks about allocation of beds. Notes they were supposed to be increased, but this has not been done.

Parashar says updated chart is awaited.

Court told by Rao that this was supposed to be taken up on May 13

Submissions made on foreign aid.

Rao: If aid is coming to Central govt hospitals, it could be for covid or not covid. Clarification can come on record that it is for covid.

Parashar: Lordships may direct us, we will clarify..

Court: Please clarify

Jivesh Kumar Tiwari seeks to make submissions for UOI, refers to SOP dated May 2, and criteria for distribution of resources.

Tiwari says distribution is based on the urgent needs of States.

Rao: Question was when allocation was through organisations... either they should have a mechanism where hospitals tell what their needs are or where they ask before sending equipment if hospitals needs them

Parashar: We can ask Ministry to tell whether they are getting written requests before sending.. Amicus is pointing out distribution through institutions... we will look into distribution through institutions specifically ...

240 oxygen beds have been allocated to Lady Hardinge, Court informed

Bench breaks for lunch. Will re-assemble after 3 pm.

Court: 3 o clock, we have a full bench. We'll do that and then connect.

#DelhiHighCourt
#CovidIndia

Hearing resumes.

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#CovidIndia

Rao: Coming back to the chart. 6 and 7 is with respect to sharing registration of numbers with GNCTD... this is the tankers allotted to specific States.. so States can also ensure follow up

Court: Stand of Centre has been tankers they do not want to touch...

Mehra: Subsequently, after the 700 MT order, which was upheld by SC, now there is no issue of tanker. Oxygen is being delivered at the border. Regarding quantity, there is no issue.

Mehra: Issue flagged by amicus still persists, but we are not pressing from now.

Since SC is looking it, let it be. I am not pressing

On buffer stock, Mehra: By next week we will have R1 facilities.. will transfer.

Mehra: Things are much better than they were. May have noticed number of calls to milords has reduced, to me Satyakam, to me... There are quite a substantive number of beds that are empty

Court: Oxygen beds?

Mehra: Yes

Court: That is surprising

Mehra: I will place on record

Mehra: 500 more (beds) have been added yesterday. Opp GTB hospital, there is a huge facility... another 500 ICU beds are being added today.

Mehra: Crisis of beds we are going to tide over in a few days... every ordinary citizen will have bed

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#CovidIndia

Justice Rekha Palli: You should have doctors also... I have very clear reservations on doctors also, I am telling you ... Please speeden up the increase in doctors and staff also

Mehra:... Please take it from me, we will abide. We are taking it up very seriously.

Rao: There is a category of patients in 70+ bracket incapable of taking care of themselves... we had a lady on a ... couldn't feed herself. She had no attendant. Staff said we don't have an attendant to deal with this... there was a blip in electricity, ventilator stopped working

Rao says because of Mahajan's intervention, someone was able to attend for some time.

Justice Rekha Palli notes this issue, says increase in number of beds alone is not enough.

Justice Sanghi says that patients cannot be left unattended this way, suggests that some family member or attendant be allowed with such patients subject to compliance of wearing of PPE kits etc.

ASG Chetan Sharma says the situation is that even if nurses and medics are there, they can be found to be lacking in attending. Notes that people within hospitals such as sweepers and other staff may also be scared to approach COVID patients

In the old lady's case, a brigadier Malik stepped in to help, court told. The lady had to be put on drip in the evening, she did not eat dinner, court told.

Rao says some mechanism has to be in place for such COVID patients in sealed wards

Rao: I have heard horror stories, diapers of senior citizens not being changed for two days.

Adv Aditya N Prasad: NHRC today has come out with an advisory that there has to be clear indication what is the status of patients..

Justice Palli: You can't blame doctors.. it depends on numbers...

Will doctors spend time answering queries or treating patients?, Sanghi J.

Justice Palli: Only point I was making, Mr. Mehra, is please increase the numbers (doctors)

Justice Sanghi suggests that family members who are willing to attend may be allowed to do so.

ASG Chetan Sharma: As a first baby step, like protocol in ICU - from 10-11 pm or 5-6 in the morning, it is totally sanitized, in total PPE kits - they can at least know what their loved ones are going through... subject to what the doctors say...

Rao: Even if ratio is 1:10 (doctor to patient), so some semblance of attention is there... ideally, it should be 1:3

Justice Palli: If you have the numbers, probably you would be able to save more lives

DG, Health Services makes submissions: Shortcomings are there, we do try to take care of every patient in every possible way but there might be gaps... a lot of trust has been placed on the medical fraternity.

Adv Satyakam asks if attendants can be permitted in some form.

DGHS: We do. If there is a small child, mother is allowed in the ward.. on specific request, risk is explained to the attendant, with proper PPE kit, they are allowed... specific wards in which we put those people..

DGHS: Till 12 years of age, the mother is allowed as an attendant to the child...If the patient is bedridden, we will allow attendants

Court: What about the old lady mentioned by Rao... in a situation where not even able to pick up a water bottle...

DGHS: This is a DRDO facility managed by the army.. will ask what happened... will agree that number (of patients is high)

DGHS: We will look at it and allow attendants for some time, on case to case basis

On communication gap concerns, DGHS adds: There are helplines, managers floor-wise and ward-wise to give information.

DGHS: Patients in some places are allowed video calls. In Lok Nayak and Rajiv Gandhi at least...If the public feels there is gap in communication, will see what needs to be done.

On augmenting number of doctors etc.

DGHS: Recruitment being conducted, walk-in interviews being conducted. .. there are ad hoc appointments ... ensuring human resource augmentation ... we are not getting many applications... there is a limitation

Rao makes submission on issue of plasma, says Centre's response is awaited.

Rao: There is a body of medical opinion that plasma is not a magic pill or may not serve any purpose... there are others. ... availability is a huge problem

Rao adds: There are instances where it is working... Union and State have to work together...Plasma is a problem

Says calls for Remdesivir are also less now.

Random people call, either calls are either fake or one has to travel long places. That is a problem, Rao.

Mehra: On plasma, can I draw Lordship's attention to latest status report. Plasma works like a blood bank.. usually, unless and until we have a donor, the concept is you have to have a donor so the blood bank does not deplete in numbers

Mehra: What is happening, could be for various reasons, not trying to shift blame - there is the large number where people have COVID yet numbers of plasma donors are minuscule

Mehra: Time and again, requests made at the highest level, press conferences, that as good citizens, we should also come forward once we have contracted COVID and have antibodies, donate plasma... have not been able to enthuse citizens of that spirit...

Mehra: There are quite a few... but not the numbers in terms of numbers actually getting treated.

Court says audio-visual media can be utilized for making appeals for plasma donation.

Mehra says media is being used as well.

Adv Aditya N Prasad: People do want to come (to donate plasma)...but they are scared that they will be exposed.

Adds that ILBS (plasma bank) appears to be a closed space

Mehra reads submission on Delhi Plasma Bank (ILBS).

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Mehra: There could be 2-3 things. The waiting period could be more.... 1031 can be called to raise a requisition.. can be raised on the website

Dr Neenu is saying there cannot be online requisition, only form to be downloaded online, Adv Satyakam informs

Court: Even a person like Rao is being misled into thinking it can be done online..

Mehra says that issue to be fixed right away

Court: Another aspect, you should on the website, have a link where the plasma donor can also register

Rao: That is there. Both forms are there. You click and submit the form, it says "thank you your request has been accepted."

Mehra says that process is there, the issue is taking it to a logical end. Says such issue of implementation is a primary issue, will be looked into.

Mehra says what needs to be looked into is also what can be done to reduce the waiting time period at plasma banks, so confidence can be there in public that they don't have to wait the whole day.

Rao says he agrees with Mehra that there should be a quid pro quo in plasma donation so plasma donated is replaced.

The patient who receives plasma should undertake that they will also be plasma donors or that they will arrange for plasma to replace, Rao suggests.

Mehra notes that society today is such that each person does not care once they have received what they need.

Court notes what happens at times is that even after recovery, people may donate plasma only if some family member requires it.

Mehra agrees.

Mehra: The majority of them are there because they were driven by some relative requiring plasma.

Need to take steps to augment plasma donation, Court says.

Need to look at how the hospital system can be streamlined, how to make it more donor friendly, how people may be assured they can donate without catching COVID, Court observes.

There is a need to sensitize the people, can only happen through media, Court says

Mehra adds that celebrity endorsements may also make an impact.

Justice Sanghi: So go and chase some of the celebrities... go and chase them for the nation...

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#COVID19India

Mehra says that when celebrities endorse, a media event is created.

Cricketers, Politicians and Bollywood may be roped in, he suggests

Lawyers also, on the lighter side: ASG

Dr Meenu Bajpai makes submissions on the process of plasma donation.

Court has asked why it takes 4-5 hours for plasma donation

Dr Bajpai: When the donor comes... we ask questions (under Drugs and Cosmetics rules), tests are done (Hep A, B, HIV, Malaria, Syphilis, screening for COVID antibodies, blood tests, serum protein, blood grouping, etc.) All these tests take between 1.5-2 hours.

Dr Bajpai: May take more time if there is backlog.... without test results, we cannot proceed with the donation, required under the Rules. It takes about 35 mins thereafter for donation, depending on the thickness of the vein.

Dr Bajpai: .... (then we ) do a reverse group check, then issue (plasma) to the patient if compatible - takes about 90 mins ... It is a tiresome, long process, it is not easy. Most hospitals do it the next day. But we are trying to do it within 4-6 hours

Court: You are working round the clock?

Dr Bajpai: Yes, getting about 220 donors a day.. not able to do on regular working hours.. so we decided to have it in shifts. .. we have been working 24 hours

Justice Sanghi: Is it possible to make the system a little better... for example the forms .. they had to physically bring... is it possible to upload it...

Dr Bajpai: It is a legal document. Needs the sign and stamp of (doctor)...

Dr Bajpai: Plus there is a lot of chance of corruption.. so we have to take an undertaking that it will be used for patient and will not be misused

Court: Mr Mehra these signatures can be digital signatures...digital signatures is not rocket science, it is something anyone can..

This can be explored, will come back, Mehra submits

Court: Another thought which comes to mind is, when people go for blood donation camp, these tests are not done. They take the blood and then tests are done... similarly, is it not possible to collect the blood and let them go?

Dr Bajpai says this may entail in the wastage of money.
Each kit for plasma donation costs around 4000-6k rupees, only a few donors are eligible.

The amount of money we waste per day, would be unsustainable. Blood bank costs very little - 780 rs. It takes 10 minutes: Dr Bajpai

Regarding digital signatures, have to go back to drug dept: Dr Bajpai

Adv Satyakam: That, we will take up. on the technical aspect, you can speak

Court: Can you not take the sample, examine whether potent or not. Do people have to wait for the entire process?

Dr Bajpai responds as to why this is not possible

Court informed that in usual blood donation, it is a small quantity. In plasma donation, blood gets separated from plasma, blood goes back to donor. Plasma & blood separate.

You can't take that much blood from donor, HC told.

Till last year, plasma not even considered as treatment... : Mehra notes

Adds that some are still divided over whether it should be used.

Now that debate should have survive since doctors recommend, since it is ICMR approved, Court notes.

Court decides to adjourn for the day.

Mehra: Can we have it on alternative dates? Unless petitions come, all my colleagues are available (if any petition comes)

For this week we will continue (hearing case daily)... we don't want to lose momentum.. maybe from next date we can take it up from alternative days: Justice Sanghi

Friday is also a holiday: Justice Palli

While speaking on the recent trend of COVID numbers, Mehra observes that he cannot say what it would be like when restrictions are lifted and Delhi goes back to normal.

Court: It will go back to the same, it is so highly contagious...

Justice Sanghi: ... have to make it a very controlled opening so State should be able to deal with the numbers that are coming in.

Gautam Narayan: We let our guard down, we are also to blame

Court adds govt also played a role

We have had elections, we have had melas: Court

ASG: There are still things around, I don't want to make comments

Justice Palli: So many young people have gone, such a tragedy

Mehra notes that small children are being left to fend for themselves

Recounts an incident where children at a park were prevented from taking the "extreme step" just in the nick of time.

Mehra: There are stories where entire families, within 24-48 hrs are turned on its head

Court: Alright, we will continue tomorrow.

Hearing over. To continue tomorrow.

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