#BombayHighCourt to hear plea alleging improper management of #COVID19 medical treatment in #Maharashtra.

Hearing before Bench of Chief Justice Dipankar Datta and Justice GS Kulkarni.

#CovidIndia #maharastralockdown #COVIDEmergency2021

Adv General Ashutosh Kumbhakoni appears for State, ASG Anil Singh appears for Centre, Sr Adv Anil Sakhare appears for BMC.

Advocates Simil Purohit, Arshil Shah, Rajesh Inamdar, Ajinkya Udane appear for petitioners.

In the previous hearing, the Court had suggested that municipal corporations in State consider adopting the model followed by #BMC while handling the #COVID19 situation in Mumbai.

Hearing begins.
Adv Akshay Shinde, B’ Panel counsel is appearing for State.

#CovidIndia #maharashtralockdown #COVIDEmergency2021
State has submitted a note to the Court.

#CovidIndia #COVIDEmergency2021 #maharashtralockdown
Court: From next time, such comprehensive notes should be circulated in advance. Because we have to hear other counsels too.

Court points out from the note that mentions Dexamethasone is an alternate drug for Remdesivir.
Court: You have attacked our order in your note. We never said this. We have drawn from the Central government’s affidavit in #SupremeCourt and we are no experts in the field. We have only said alterIatives are present and should be considered.
Court: As it is foreign drugs, there is a shortage. We have not misunderstood anything, you have misunderstood our order.

And what about the oxygen supply?

Shinde submits there is a stock of 1700 MT.
Court (referring to the note): Your note again misunderstands our order. Everything has been taken care of in our order. We do not appreciate this note of today’s.
Court was referring to the para in the note where the State submits that “only because the no. of fresh patients is reported to be on decline does not necessarily mean that State ought to give up its claim for certain quantity of oxygen.
Court’s order stated that the having regard to the current situation, where HC of other states have been proactive and issuing directions to GoI for restoring supply, we have moral obligation to ensure that oxygen reaches those states that have high demand.
Court: We also stated that it would not be wise to give any positive direction to the GoI at this stage but we keep the option open to so direct if there is any deterioration.
Court: We have gone through your note.
Why did we lower our guard? Why did we not procure sufficient Remdesivir?

Ministry of Health as far back as July 2020 had stated that it was useful drug as per the Clinical Protocol of the Ministry of Health. This was sent to all states.
Court: Why have we not procured enough stock then? Why was there a shortage in all states? Presently what is the position? You have received 2 lakh vials more.
Shinde: There is a demand for 70000 vials per day raised. We are receiving 45000 vials.

Court: Their note mentions about a global tender by the State and they have stated that the manufacturers have responded. And they want central government to respond to this.
Court: We need a decision of yours on this. The foreign manufacturers are ready.
Court: What is your basis for demanding 70000 per day?

Shinde: This is based on the active cases.

Court: But give some more particulars to this.
Court (to ASG): State’s note states that the Cabinet Secretary sought requisite permission from Centre to import Remdesivir drug from other countries.
Why is there no response on this?
Court (to Shinde): You have said that nodal officer are in place who will collect the information about supply, but then you have not informed us about the shortage if any.

We are saying this because there is difference in the active cases.
Court: On one hand you are saying there is reduction in active cases, and then you are saying there is need for Remdesivir. Then active cases are not reducing then.
Court asks Petitioners if there is any information they have on the status of Remdesivir supply.

Purohit submits that Cipla is the only manufacturer supplying Remdesivir.
He submits on the point of manner of prescribing the drug.

Court: This is subjective.
Court: ultimately the prescription will depend on the clinical examination of the patient.

Purohit: Yes but if prescribed, will they receive?
Court: Everyone is taking efforts, but we want to see the execution also. Only efforts is not going to work.

Court points out from Centre’s note that the allocation of Remdesivir till May 9 was 8,09,000 and thereafter till May 16 was 11,57,000.
Court: Why don’t two officers - one from Centre, one from State - speak on video conference and sort this issue?
Because it takes time between affidavit and rejoinders. Precious time is lost. Just sit together and sort it out.
Inamdar: As far as distribution of medicines is concerned, I have submitted in my affidavit that people are running from pillar to post for Remdesivir, despite order of this court.

Inamdar: Even for Tocilizumab, doctors are prescribing the medicine and are telling them to procure it somehow.
I had personally written to the Collector on this with examples.
The nodal officers are not aware, there is not enough publicity.
Court: The demand has to be placed on the nodal officers. What is the information on the stock with nodal officers? Is there a portal? Is there anything on the internet.
Court: Hospitals giving patients to get the medicines.. They know that there is no medicine available. They should place order before the nodal officer. Hospitals do not read our order, the state does. They should inform them.
Court: How can hospitals tell the patient to get the stock? Where is the patient supposed to get the medicine from? What is the data that at a particular place, it is surplus?
Court: Like in the case of BMC, where they have efficiently managed to reduce the no.of cases. There is rise in demand in Pune and Nashik, but what is happening to the excess stock in BMC?
Court has resumed after lunch break.

They ask the state to file an affidavit on the issue of demand of Remdesivir raised before lunch.

Court then asks ASG to respond on the permissions to be granted for the procurement from foreign manufacturers.
ASG informs that they have sought information from the officer and instructions are to be received shortly.

Court then asks Advocate Kulkarni appearing for PMC to respond on the questions asked in the previous hearing.
Kulkarni: Pune has 33732 active cases. On May 10 there are 1165 cases so far.
They have corona control rooms with 2 numbers in place.
Kulkarni: We have submitted a power point presentation to the District Collector.
Total beds are over 4000 and we have added 12000 beds since February 2021.
Kulkarni: We have established abut 6 jumbo facilities.

Court: What about testing?

Kulkarni: We have over 20000 tests everyday.

Court: You claim you are the highest in the state? But BMC tests 28000 per day.
Kulkarni: We are comparing ourself with the class B and C cities.

Court: So you are saying Pune has an excess of beds?
There are over 2351 beds in government hospitals and 2400 ICU beds.
Kulkarni: We have a jumbo COVID centre at TOEP Centre which is a college ground so social distancing and all is possible.

PMC hospitals have been generating oxygen on its own. We have 2 units, 4 more will be set up. Every govt hospital in PMC will have self generation of oxygen
Kulkarni: We have been generating oxygen with funds from the PMC, CSR and funds from people.
Court asks if anyone wants to comment on the submissions made by PMC.

Inamdar submits that there are actually no beds available in PMC. Hence the submission of excess beds is incorrect.
Court asks Inamdar to call on one of the emergency numbers.
He gets a reply from the officer that there are no beds available at the moment.

Court asks Kulkarni to respond.
Kulkarni: This is not the situation. Even I had called on this number. I got a different response. This is not the manner in which calls are placed. This was a more confrontational call. There is a manner in which such calls are to be made.
Court: So what is the manner in which one is supposed to talk?

Kulkarni: When I had called, they asked for details from me. They are not doctors, they cannot decide for the caller. They ask for details.
Court: So if someone calls in panic, then they wouldn’t know what details to give, then what?
And that is not what they even asked. They simply said no bed available.
Court asks Adv Nitin Deshpande to contact on the same number.

Deshpande asks his client who are doctors to contact.

The doctor also receives a response that there are no beds available.
Court deduces that in all probability the information of the dashboard is not informed to the officers who receive the call.
Court: Our concern now is only that the patients who call in distress will not get efficient assistance.
Kulkarni: Most calls are placed by doctors and relatives. The patient who needs ventilator is already on treatment.

Court: Doctors do not have time now. There has to be a better management.
Court asks Deshpande who appears for the Indian Medical Association in Pune to submit a reply to PMC’s affidavit.

The Court now proceeds to hear on the issue of cremation.
Sr Adv Sakhare makes submissions on the cremation issue in BMC.

He also submits a note to the court.

Sakhare submits details on the bed management of BMC.
He submits that a paediatric advisory task force is making an action plan for paediatric covid cases in Maharashtra.
Court: This is very important.

Sakhare submits that for oxygen supply and consumption they supply to private hospitals too and they have sufficient supply. As on May 10, they had supply of 116.42 MT and consumption of 91.93 MT.
Sakhare submits that crematorium details he has submitted.

Court: What is the number of bodies and what kind of furnace is used?

Sakhare submits that his affidavit of April 29 gives details.
Sakhare: Total number of crematoriums are over 200 crematoriums.
And total 80000 deaths.

He added that crematoriums are being shifted to CNG furnaces.
Sakhare: total number of deaths due to COVID as on May 9 is 13817.

Sakhare submits that the crematorium system is working properly.
Sakhare: Let me please point out for vaccination, because that we will be handling in near future.

Court (asks Shinde): What is the position in rural areas? We have seen Mumbai, Pune.
Court: One Pankaj Upadhyay from India Today reported from Palghar. No beds, no facilities, patients are lying on floor.
We have taken stock of situation in MMR, now we are moving to rural areas. We want State govt to issue some directions to the collectors in the rural areas.
Court: There is nothing on record for those areas. There were interviews of the patients and the relatives. That interview was sort of an eye opener.
Court: You must cut the pandemic at the thresh hold. In cities these issues can be managed, treatments can be given, but not the case with rural areas.
Your priority should be villages now. In the first wave villages were not affected, now they are.
Court: There is a village in Gujarat, which has zero cases. We must try and find out their model. We read in some magazine.
It is a big report.
Efficiency is possible, only if there is will. Will of the people and the stakeholders.
The Court states that they will pass a short order in the matter and then again keep the matter for hearing in the next hearing.

Before adjourning the matter Adv Inamdar requests the court to consider his application.

He submits that the issue pertains to private entities procuring Remdesivir after a single tweet is put out requesting for vials.

Inamdar: I am not objecting to the social work they are doing. But I just want to point out how the celebrities and politicians have managed to get.
Inamdar: In the previous hearings it was pointed out that private entities are not to be given stock of Remdesivir. But then when tweets are put out for request, then somehow they manage to get those vials.
Inamdar: And the response to their help is that they are working better than the government. People are struggling for vials and then these politicians and celebrities manage to get them.
Inamdar: I am not saying they have the stock. I am not questioning their social work. Just pointing out to the Court.
Inamdar: I am not discouraging the social work that is being done. We need more people helping. But if there is a legal procedure given by the government then that has to be followed.

Court (to Shinde): Why not have a nodal officer assigned to them?
He is saying this is the “tip of the iceberg”?
We do not want to come in the way of them doing this work. But then let this go to everyone not select few.
Court: Will this amount to hoarding? Will this be illegal procurement?
This is not one such case. There was a case in Aurangabad, and then the Bench took cognizance of it.
Court: We are here to do justice in accordance with law.
They are just pointing out to us, so we are considering them.
Petitioner in person Anjali Navle submits to the Court that her petition submits a need to form a nodal agency to supervise the implementation of the action plan to have effective result and have a government portal for incorporating every detail pertaining to COVID-19 treatment
The Court asks the State to look into the allegations made in the plea and respond accordingly.

ASG submits that the officers and the authorities will get in touch with the appropriate state authority and look into it.
Kulkarni appearing for PMC submits that he had a word with the Addl. Municipal Commissioner and informed him of what happened in open court and accordingly they will take steps to ensure that it is not repeated. He assures the court that this will not be treated adversarial.
Kulkarni: People who are sitting at the desk for calls are trained but they will be trained again for the assistance of citizens.

Court: This isn’t adversarial. We are looking at ways to help the citizens. What is required is intense sensitivity training on their part.
Corut: And just by filing an affidavit, the municipal commissioner cannot get over with his duties. He has to ensure it is properly executed. So that the purpose for which a municipal corporation exists is fulfilled.
Sr Adv Sakhare proceeds to make submissions on the paediatric cases in BMC. He gives statistics on the cases.
Hearing ends. Court will take up the matter next Wednesday.

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