Maintenance of covid facility centers in India have drawn a wide amount of attention and the authorities are forced to reevaluate the situation and provide a clear picture to the public about the same. With the ongoing covid pandemic, rising number of cases and to top it off the black, white and yellow fungus spreading around, things for the health department and the government has really taken a hit.

The following case was held online in pursual of the notice dated 20.5.21, which comprised of Mr. Amit Negi, the learned Secretary, Medical Health and Family Welfare, Mr. Dilip Jawalkar, the learned 2 Secretary, Tourism, Government of Uttarakhand, Mr. Ved Prakash Mishra, Director, Department of Pharmaceuticals, Mr. Manmohan Sachdeva, Chief Advisor in the National Pharmaceuticals Pricing Authority, and Dr. Sanjay Roy, the learned Director, Department of Health and Family Welfare, Government of India.

FACTS OF THE CASE

The Court had asked Mr. Amit Negi, the learned Secretary, Medical Health and Family Welfare, with regard to the steps being taken by the State Government for tackling the crisis of COVID-19 pandemic. He informed the Court that the State had taken certain substantial steps: firstly, for breaking the chain of infection of COVID-19, full curfew has been imposed on major cities and towns of the State. Secondly, the State Government had given sufficient discretionary power to all the District Magistrates to decide the extent and duration of the curfew to be imposed in their respective towns and cities. During the full curfew, only essential services and shops, which cater to the essential needs of the people, are permitted to operate; the rest of the shops and services are closed.

Mr. Amit Negi, the learned Secretary, further informs this Court that the State is trying to increase the number of beds available in the hospitals run by the Medical Colleges. For example, in the Doon Medical College, the number of beds is being increased by forty, in the Himalayan Institute of Medical Sciences (popularly known as the Jolly Grant Medical College), the number of beds is increased by hundred, in the All India Institute of Medical Sciences at Rishikesh, the number of beds is increased by 150. Moreover, the State Government was trying its level best to turn its stadium, located in Dehradun, into a 400 bed hospital. According to Mr. Amit Negi, the concern of the State is the lack of ICUs and ICU beds, and the lack of medical staff for monitoring and supervising the large number of patients, who are pouring in. In order to solve the problem of dearth of medical staff, the State Government had already requested the UPNL to ensure that even retired Army doctors, and nurses could be made available to the State Government in order to strengthen the medical staff. He further informed the Court that the state govt had already increased the number of Dedicated Covid Hospitals from five to twelve, and the number of Dedicated Covid Health Centres from twelve to sixteen. Therefore, according to him, the State Government was already trying to fight the pandemic on a war footing.

CONTENTION OF THE PARTIES

Mr. Shiv Bhatt, the experienced counsel, contended that the pandemic issue was wreaking havoc on the entire State as a result of the State Government’s lack of preparedness. There were still a huge number of samples to be evaluated (almost 29,000), and the results must be declared. The delay in announcing the test results was wreaking havoc on people’s lives. As a result, there is an immediate need to increase the number of clinics/laboratories capable of performing the tests. Private hospitals, according to the experienced counsel, should be enlisted to do the testing.

Second, despite the fact that the Pradhan Mantri Jan Arogya Yojana/Ayushman Bharat Yojana enables patients to get E-cards that can be used to seek treatment at private hospitals, the State Government has not distributed a sufficient quantity of such E-cards. Similarly, the Deen Dayal Antyodya Upchaar Yojana allows for the distribution of E-cards to those who are below the poverty line in order to seek care at private institutions. However, a huge percentage of persons living in poverty do not have access to such E-cards. As a result, the Director General of Health should be directed to issue the aforementioned E-cards in large quantities for the event.

Shiv Bhatt further submits that there are long queues at the cremation grounds, and the crematoriums are devoid of sufficient quantity of wood. According to the media reports, the dead-bodies of those, who have died due to COVID-19, are being received without body pack kits. Therefore, the State Government needs to ensure that dead bodies, being released from the hospitals, follow the SOPs for the release of such dead bodies. The dead bodies should be sent to the crematoriums in accordance with the SOPs issued by the ICMR, and by the Central Government.

As a result of the paucity of drugs and antiviral injections, black-market activity among pharmacists has skyrocketed. As a result, the State Government should be directed to take action against such black-market operators. Finally, he claims that, though those seeking vaccination must register online, connectivity is a major difficulty in the state’s hilly regions. As a result, people should be given an alternative method of registering for the immunization.

Mr. Dushyant Mainali, learned counsel for the petitioner in Writ Petition (PIL) No. 50 of 2020, submits that a large number of contractual workers are working at the Sushila Tiwari Government Hospital at Haldwani. They are working with COVID-19 positive cases. However, there is lack of accommodation for them within the hospital campus. There are three different types of COVID-19 facilities earmarked for different patients. People have to run from pillar to post in order to get their family members admitted. A procedure should be evolved by the State Government to ensure that persons with their respective symptoms are, indeed, admitted in the respective Care Centres/ health centres/Hospitals. In every district there should be a Nodal Officer, who can act as a bridge between the people and the Care Centre/Health Centres.

The learned counsel suggests that the State Government should be directed to immediately establish Dedicated Covid Health Centres, or Dedicated Covid Care Centres in Ramnagar so that the local population can be taken care of in Ramnagar itself, due to the unavailability of dedicated covid care centres.

Lastly, Mr. Dushyant Mainali, the learned counsel, submits that there is a shortage of home collection of samples especially from the elderly population, who live in our towns and cities. Therefore, the home collection from such vulnerable section of the population should be increased so that proper medical cures can be applied for saving the lives of the senior citizens.

Mr. D.K. Joshi, the petitioner, party-in-person, in Writ Petition (PIL) No. 67 of 2020, submits that during the full curfew imposed by the Government, while most of the shops are closed, for reasons best known to the Government, the Government is not closing the liquor shops. According to him even these liquor shops should be closed.

JUDGMENT OF THE COURT AND OBSERVATION

Without a doubt, the state is engaged in a huge battle against the pandemic. Despite the significant initiatives made by the State Government, as described by Mr. Amit Negi, the learned Secretary, Medical Health and Family Welfare, the State Government must still take specific tangible efforts to protect the people from the pandemic’s onslaught. As a result, this Court gives the State Government the following instructions:

The State Government must plan and strategize as to how to tackle the emergence of the third wave. As soon as the recommendations of the High Powered Committee, consisting of the leading Pediatricians, and the recommendations of the another Committee, constituted under the Director General, Medical, Health and Family Welfare, are made available to the State Government, the Government must implement the said recommendations on war footing both in letter and spirit.

(ii) In order to deal with the menace of Black Fungus, the Government must come up with concrete plans. Since the Government claims that it has ample infrastructure both in terms of medical infrastructure and in human resources, since it claims that Black Fungus can be treated in different hospitals throughout the State, the necessary information with regard to the existence of such facilities should be disseminated to the 21 public at large through electronic and print media.

(iii) The State Government, in collaboration with the Central Government, must ensure that the lifesaving drugs such as “Liposomal Amphotericin B” are steadily and continuously supplied to the State in order to ensure its free availability.

(iv) The infrastructure required for treating Black Fungus should be strengthened by the State Government in the different hospitals, which are functioning throughout the State. 

(v) The Department of Medical Health and Family Welfare is also directed to issue a circular, both for the benefit of the public at large and for the private hospitals, clearly prescribing the upper cap applicable to the fees being charged by the private hospitals. The said circular should make it amply clear that the fee structure being prescribed is the maximum that a private hospital can charge from a patient. In case the private hospitals are found to be charging more than the prescribed fees, the State should take strict action against the erring hospitals in accordance with law.

(vii) The Health Department should carry out an audit with regard to the 23 functioning of the ventilators, and with regard to the functioning of the other lifesaving equipments, which are already in stock in the District Hospitals.

(ix) The State Government is directed to implement the SOP dated 06.05.2021, issued by the Central Government, with regard to vaccination of persons who do not possess the prescribed identity cards. The State Government should specifically endeavour to inoculate the Tribal population, the elderly population, the physically challenged persons, and the eligible homeless people.

 (x) The State should also consider the feasibility of creating Isolation Centers at the Panchayat Level so as to ensure that the villagers can safely be quarantined in the said Isolation Centers.

(xi) Since large percentage of the population is a non-covid affected population, 24 since large number of people continues to suffer from different medical ailments, since such persons are not being treated properly by the Designated Covid Hospitals, the State Government should also consider designating Non-Covid Hospitals so that the large population may be referred to such Non-Covid Hospitals for the treatment of their medical ailments.

(xii) The State Government should also consider the feasibility of soliciting the help from the Civil Society by creating a portal where volunteers can give their data, and can volunteer their services for resolving the problems created by the COVID-19 pandemic. This may become necessary in case the third wave of COVID-19 strikes the State.

(xiii) Considering the fact that the population is unevenly distributed, considering the fact that in the mountainous areas of the State, the population is highly dispersed, the State Government should consider the possibility of creating a system which would permit the nurses, accompanied with an Asha Worker and a Home Guard, who can go door to door and inoculate the eligible persons in each village. For, until and unless inoculation is carried out on war footing, it will be extremely difficult to prevent the onslaught of the third wave.

(xiv) It is the duty of the State to ensure surveillance, screening, isolation and referral of the cases from the villages, since it is the duty of the State Government to provide home isolation kits, and to provide oximeters and thermometers at the village level.

(xv) The State Government is directed to examine the complaint that Asha workers and Aaganbadi workers, who are dealing with COVID-19 pandemic, are not being provided with the necessary PPE kits and other protective gears. In case such an allegation is found to be true, the State Government is directed to immediately ensure that PPE kits and other protective gears are, indeed, provided to the Asha workers and Aaganbadi workers.

(xvi) Mr. Amit Negi is directed to file sufficient cogent and convincing evidence to establish that death audit is being carried out. The said death audit report should also be accompanied with the corresponding death certificate of the patient.

(xix) Mr. Amit Negi is directed to submit a detailed report with regard to the directions issued by this Court in the present order on or before 21.06.2021.

(xx) Due to the paucity of time, this Court has not been able to interact with Mr. Dilip Jawalkar, the learned Secretary, Tourism. However, as this Court is concerned with the possibility of the opening of the Char Dham, as is being contemplated by the State Government, this Court directs  Mr. Dilip Jawalkar, the learned Secretary, Tourism to be present before this Court on 16.06.2021.

This article has been written by Uthra Varadharajan.

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