Whip-lashing at the State Government for its “total inaction in procuring State quota of Remdesivir allotted by Centre and not distributing it further to districts,” Nagpur bench of Bombay High Court on Tuesday gave a earful to State and its authorities for sorry state of affair. A division bench consisting of Justice Sunil Shukre and Justice Avinash Gharote while hearing a suo-motu public interest litigation on Covid-19 mismanagement, lambasted the State and questioned lack of any concerted efforts to secure the life saving drug from the Manufacturer as directed by Centre in its allotment letter. The High Court has now sought complete procurement plan from State and its authorities for procurement of Remdesivir upto May 31 by Friday along with formula to distribute it fairly among districts.

 

The High Court also asked the Drug Controller of India to place on record steps taken by it to facilitate Remdesivir procurement, directions issued to manufacturers to jack up production and provide it to all states including Maharashtra to tackle the second wave of pandemic. The Centre on April 21 had allotted 2.69 lakh Remdesivir vials to Maharashtra and on April 24 the number was enhanced to 4.35 lakh for a period from April 21-30. The High Court repeatedly asked details about quantity received so far even as per old order, how it was distributed district-wise and plans to procure remaining quantity from the drug manufacturers, only to get ambiguous answers. The State claimed that it was getting less supply from the manufacturer and had floated the global tender for procurement of 10 lakh vials and tried to pass on the blame on centre. State is playing a hapless victim card, your FDA must ascertain total vials supplied to state and provide succour to thousands of patients, the High Court stated while virtually rejecting this attempt to pass the buck. Mincing no words in deploring this approach the High Court slammed the Government and observed, “State is playing with the lives of people and it seems state is not interested in helping citizens.”

 

When Amicus Curiae Shreerang Bhandarkar pointed out that the Centre’s allotment letter clearly made the state responsible to place orders with drug manufacturers, appoint a nodal officer and form a group with central authorities. The Centre has made your task easy but State is not forthcoming in procurement and distribution, the High Court lamented while blaming the Government for wasting everybody’s time due to inaction and disappointing thousands of patients expecting speedy procurement and fair and equitable distribution of Remdesivir vials. The High Court once again sought to know the district-wise allotment from April 21 to ascertain whether the districts like Nagpur with heavy load of active patients got its due or not, but got no concrete reply from FDA authorities. Should we ask patients to hold breath till State finalises the quota, a visibly disturbed High Court asked State authorities. Perhaps, you want patients to die, the High Court bitterly remarked while reminding the State that it has to play the role of parens patriae (Parent of citizens).

 

Making it amply clear that it was not interested in micro-management of the pandemic management, the High Court also warned the authorities it would not be a mute spectator and would not allow the situation to deteriorate further due to inaction of authorities. The High Court also took a dig at all big leaders who take credit for the enhanced quota of Remdesivir and wondered whether despite their tall claims the State received the Remdesivir vials as per revised or even old allotment order. They got due publicity, but very little changed on the ground, observed a dismayed High Court while sparing nobody. Adv Shreerang Bhandarkar (Amicus Curiae), Adv Sudhir Puranik (NMC), ASGI Ulhas Aurangabadkar (Union), In-charge GP Ketaki Joshi and Addl GP Deepak Thakre (State), Adv Bhanudas Kulkarni (IMA), Adv Nitin Lambat (Railways), Adv Sushma Jha (Union), Adv Tushar Mandlekar and Rohan Malviya, Dr Pradeep Arora, Adv Ram Heda, Adv M Anil Kumar, Adv Aditya Goyal and Adv Vaibhav Bhure (Intervenors) appeared in the matter.

 

Produce procurement details The HC has directed Nodal Officer for Remdesivir procurement Ganesh Rokde, Joint Commissioner of FDA to place on record orders placed to procure Remdesivir as per old and new allotment order by Thursday afternoon. The HC also sought plans to get Tocilizumab from FDA authorities along with the revised district-wise allocation order issued by the State Government to districts to ascertain whether Remdesivir vials are supplied as per quota allocated to that district. The State claimed that it received 1,30,638 Remdesivir vials in last six days. What are you doing to get remaining vials ? Are you so helpless, asked HC while seeking details of orders placed with each company and future plan to procure allotted quantity while warning not to play victim card. Centre has done its job, allotted vials, laid down a road map but no steps have been taken by the State, the HC noted. Throughout the hearing the State cut a a sorry figure as it was unable to respond and place on record necessary documents to satisfy court query. The HC also sought to know the practice of allowing private pharmacies in some districts to directly procure Remdesivir and whether it is consistent with guidelines issued by Centre in its revised allotment letter dated April 24.

 

The HC also asked the Centre to clarify whether it had granted permission to Maharashtra Government to import 10 lakh Remdesivir vials through a global tender. The State Chief Secretary had sought permission while a letter dated April 22. HC asks WCL, MOIL to help in setting up Oxygen plants Amidst reports about increased oxygen supply, the GMC has decided to reduce 20 percent of its oxygenated beds and keep them for contingency due to erratic oxygen supply. This effectively reduced the bed availability from 600 to 480 beds. GMC Dean Dr.Sudhir Gupta informed the HC that the consultancy firm had advised the hospital to earmark 20 per cent of it’s oxygenated beds as contingency beds due to sudden increase in demand of oxygen corresponding with erratic supply. A situation may arise that on a given day there is insufficient storage of oxygen, which may lead to collapse of the entire distribution system leading to endangering the lives of all patients, Dr Gupta stated. Apprehension so expressed is reasonable, the HC noted while accepting reduction of oxygen beds by 20 per cent as advised by the Consultant.

 

The HC directed District Collector to accelerate the process of augmenting oxygen supply capacity in Nagpur district and take immediate steps for setting up individual oxygen generation plants at GMC, IGGMC and also AIIMS. If any permissions in this regard are required, same shall be granted by all the concerned Authorities within 48 hours, the HC directed. About the pending decision of Western Coalfields Limited in setting up oxygen generating plants at GMC, IGGMC and AIIMS from its CSR funds, the HC directed WCL CMD to take a decision within a day looking at the emergency situation. HC also accepted suggestion of Amicus Curiae to take help of another PSU the Manganese Ore India Ltd. and directed the MOIL Chairman and Managing Director to utilise it’s “Corporate Social Responsibility Fund” for setting up oxygen generation, storage and distribution plants at the hospitals indicated to him by the District Collector, Nagpur in consultation with Commissioner, NMC. Set up Centralised system to prevent pilferage The High Court on Tuesday expressed concern over misuse of Remdesivir quota by certain hospitals and indulging in some unethical practices leading to black marketing or pilferage. Normally six vials are required for a patient and hospitals or staff often deny it to some patient or provides less quantity to patient and sell remaining vials in black market, the HC noted while directing District Collector and Municipal Commissioner to check whether any pilferage or tampering of vials is taking place from private hospitals.

 

The HC also suggested to have a centralized distribution system in place to streamline distribution of Remdesivir to check the black marketing at source and also set-up a 24x7 control room to supervise distribution of life saving drugs, hospital beds and oxygen. IMA members requested to volunteer Nagpur bench of Bombay High Court on Tuesday gave a clarion call to members of Indian Medical Association (IMA), Nagpur to volunteer and help public healthcare institutions like AIIMS facing acute shortage of trained medical manpower. Amicus Curiae pointed out that IMA has 3300 members and many of them can render services during this pandemic and in addition to these experts other young doctors and even Ayush doctors can be deployed.

 

Agreeing to this suggestion, the HC asked the IMA, Nagpur to request all it’s members for volunteering their services as specialists to AIIMS, Nagpur. A list of doctors must be placed on record on or before the next date of hearing, the HC directed. About shortage faced by AIIMS, the HC noted that if the DMER of Maharashtra considers allocating bond services of 25 to 40 MBBS graduates in pursuance of its notice dated April 16 to AIIMS. The HC also asked the District Collector to ensure improved oxygen supply to AIIMS and also depute Ayush, BHMS doctors or even depute some doctors from GMC or fresh MBBS graduates to allow AIIMS to start from ICU beds. The HC also asked authorities to explore the possibility of using the command hospital of Indian Air Force for covid patients.

 

Oxygen supply normalised Pursuant to HC order about retaining state share of Oxygen from Bhilai plant, the authorities informed the High Court that the State and region is getting adequate Oxygen supply from Bhilai which is only 120 kms away and turnaround time of tankers is only one day. Collector Nagpur informed that Nagpur will get close to 110 metric tonne and 20 metric tonne extra supply for the region. Amravati Divisional Commissioner also informed about the comfortable position in the division except Akola where a shortfall of 10MT was recorded. But from the enhanced quota, this shortfall can be tackled.