Thread by @barandbench

#BombayHighCourt is hearing Suo Motu plea concerning #COVID19 situation in districts falling within the Aurangabad Bench jurisdiction.

Bench of Justices RV Ghuge and BU Debadwar are dealing with the issue of #mucormycosis.

Court is informed that till today in Aurangabad there have been 49 deaths, and in Nanded 35 deaths.
In Marathwada region, 124 deaths have taken place till date.

#COVID19 #BombayHighCourt

Court: And what is the stock of the #AmphotericinB with us?
Because the affidavit in the Principal seat says about 5-6 vials are required in a day, and we were told yesterday that only 1-2 vials in a day. SO what is it? Undertreatment?

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Chief Public Prosecutor DR Kale submits that it was 1-2 vials on the first day.

Court: On the first day the dose has to be higher doesn’t it! The doses will taper with passing days.

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Court: We were told by the doctor of the medical hospital that only 1-2 vials is required because he must have thought we will pull him up for being under-stocked.
He thought we will not study this matter.

#COVID #BombayHighCourt

Court: This affidavit (submitted in the COVID Management PIL before the Principal Bench) before us tells us otherwise.

Chief PP: This issue will be taken up by the Principal Bench on June 8, this matter may be heard on June 9 or 10..?

#COVID #BombayHighCourt

Court: So you are seeking an adjournment?
Just because principal seat adjourned the matter, we should also adjourn?
We have to be sensitive to the issue. About 124 people have died.

#COVID #BombayHighCourt

Court: We have perused the order on May 27, 2021. The AG had declared before the Court based on expert advice that #mucormycosis patient requires 3-4 vials per day for 3 to 4 weeks.

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Court (to ASG): What do you have to say in this issue?

ASG Talhar: Mr. Singh appears in this matter. Detailed affidavit is filed before the Principal Bench.

Court: You are ASGI for Aurangabad Bench, so who is to address us?

#COVID #BombayHighCourt

Court: Why should ASG Singh address us. We allowed him yesterday.

ASG Talhar: We have filed a detailed affidavit in the principal bench...

Court: Is that bench dealing with Marathwada issue?

#COVID #BombayHighCourt

ASG Talhar: We want to file a detailed affidavit here, some time maybe given.

Court: So what are you waiting for? Are you seeking adjournment?
How can you be so casual?

#COVID #BombayHighCourt

Court: This will be recorded in our order. You may hate the bench for doing this. But we do not care if it pleases you or not.

#COVID #BombayHighCourt

Court: What is the allocation to districts?

ASG Anil Singh: We allocate to the State, they allocate it internally within the state.

#COVID #BombayHighCourt

Court: What is the allocation to the Marathwada region?

ASG Singh: I can give for Maharashtra.
The total cases of Black fungus in Maharashtra are 3931.

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ASG Singh: #AmphotericinB and #liposomal and another alternate drug distribution is given.

We have given import license, there is some issues with the stock.

Out of 2.76 lakhs available with the Centre 68360 vials are allocated to Maharashtra.

#COVID #BombayHighCourt

ASG Singh: We have given license for production to Haffkeine in Mumbai and another company in Hyderabad.
The total allocation is made to the State, and they distribute it within the State.

#COVID #BombayHighCourt #mucormycosis

Court: The deaths have occurred here, 124 deaths, is because of the under-treatment given to them. They have been given 1 dose per day, instead of 5-6 doses as is prescribed.

#COVID #BombayHighCourt #mucormycosis

ASG Singh: We have been ramping up production with the distribution of the drugs.
I am told it takes 20-25 days to ramp of production.

#COVID #BombayHighCourt #mucormycosis

ASG Singh: It happened with Remdesivir, but we solved that problem.

#COVID #BombayHighCourt #mucormycosis

Court: But the stock which reaches here is of a minimum level. Which is causing the deaths.

#COVID #BombayHighCourt #mucormycosis

Court: There is disparity and imbalance in the allocation within the day.

ASG Singh: From 2.76 lakhs, about 68k has been allocated to Maharashtra because of the number of cases.
The allocation is based on the cases in this state.

#COVID #BombayHighCourt #mucormycosis

ASG Singh: The distribution within the district has to be considered by the State - considering the number of patients in the districts.

#COVID #BombayHighCourt #mucormycosis

Court: We are only passing a short order, recording a few facts. We will not making any observations, considering you are helpless due to unavailability of the stock. We also hope that this order is placed before the principal bench.

#COVID #BombayHighCourt #mucormycosis

ASG Singh: We will most definitely place it before the Court, so that they can also peruse this order.

#COVID #BombayHighCourt #mucormycosis

Chief PP: The Marathwada region has received 16k vials.
Since this new disease, production of the medicine will take its time.

#COVID #BombayHighCourt #mucormycosis

Chief PP says the situation will be normal in 2-3 weeks..

Court: No no no, you are not aware! There is a third wave. Do not go to sleep. Let us not get complacent. December 2020, we got complacent and the second wave happened.

#COVID #BombayHighCourt

Court dictates order:

Pursuant to our order seeking details on #Mucormycosis we have heard the counsels today on the situation.

Today the government pleader has placed before us, 4 charts, and they are taken on record.

#COVID #BombayHighCourt

Order:

The number of patients in the Marathwada region are 1178.
Patients who are being treated are 669. Patients who are cured are 385. And deaths that have occurred as on date are 124.

#COVID #BombayHighCourt #mucormycosis

Order:

We were informed in one of the earlier hearings before us, that a #mucormycosis patient requires one dose of medicine #AmphotericinB and sometimes a patient may require 2.

#COVID #BombayHighCourt

Order:

This treatment is normally for a period of 4 weeks. However, the affidavit placed before the principal seat by the learned advocate general refer to in its order dated May 27, 2021, indicates that the…

#COVID #BombayHighCourt #mucormycosis

Order:

medical dept of Maharashtra believes that a patient requires 4-5 vials for 3-4 weeks.

ASG Singh had informed the principal seat that the Union of India expects a supply of 2.5 vials in the month of June 2021.

#COVID #BombayHighCourt #mucormycosis

Order:

In so far asMarathwada region is concerned, as against the requirement of 50178 vials to treat active patients, 13428 vials was supplied. This is 30% of the required quantity.

#COVID #BombayHighCourt #mucormycosis

Order:

The amicus curiae submits that since there is a shortage in the number of vials, the patients in the Marathwada treatment are under treated. They are being administered 1-2 injections per patient per day.

#COVID #BombayHighCourt #mucormycosis

Order:

This is against requirement of 4-5 injections per patient per day.
As a consequence, 124 deaths have occurred.

#COVID #BombayHighCourt #mucormycosis

ORder:

Even today, there is shortage of 70% of the required quantity of the drug.

#COVID #BombayHighCourt #mucormycosis

Order:

ASG Singh submits on instructions, that between May 11 to May 31, Maharashtra was allocated 68660 vials. The number of patients in the Maharashtra, Karnataka and Gujarat are relatively higher than others.

#COVID #BombayHighCourt #mucormycosis

Order:

Those Pharma industries who were manufacturing the said drug, have been instructed to amp up the production. This would be fruitful after a period of 20-25 days.

#COVID #BombayHighCourt #mucormycosis

Order:

In addition to the existing companies, establishment Haffkeine and one pharmaceutical industry in Hyderabad have been granted license to manufacture the said drug. He adds that 6 more privately owned companies have been granted license.

#BombayHighCourt #mucormycosis

Order:

Alternative drugs like #liposomal..

ASG: Liposomal is not alternate. Alternate is Posacanozole and Isavucanozole. Import licenses are also granted.

#COVID #BombayHighCourt #mucormycosis

Order:

Amphotericin B is conventional drug, liposomal is non-conventional. The alternate drugs are also being sought to be included in the treatment.

#COVID #BombayHighCourt #mucormycosis

Order:

He further submits that the principal seat would be considering the issue of #mucormycosis treatment and the availability of the drugs on June 8, 2021.

#COVID #BombayHighCourt #mucormycosis

Order: Considering the fact situation, as recorded above, we find that Maharashtra may have to apprise the Union of India as regards the growing no of #mucormycosis patients and especially highlight the fact that in some parts of the state like Marathwada region

#BombayHighCourt

Order:

Patients are dying due to shortage in quantity of #AmphotericinB. As patients are being administered inadequate doses, the mortality rate is quite high as 669 active patients today and deaths being 124.

#COVID #BombayHighCourt #mucormycosis @CMOMaharashtra

Order:

We are directing the Chief PP to place before us a ready reference chart indicating the number of patients under treatment, the no of patients which are cured and no of deaths.

#COVID #BombayHighCourt #mucormycosis

Order:

Also a chart indicating supply of #AmphotericinB date wise between June 2 to June 9 2021 shall also be placed before us.

#COVID #BombayHighCourt #mucormycosis

Order: Stand over to June 10, 2021.

#COVID #BombayHighCourt #mucormycosis

Hearing ends.

Matter to be heard on June 10, 2021.

#COVID #BombayHighCourt #mucormycosis