SC Asks Government to Prepare in Advance for Third Wave, PM Reviewed Situation

Manas Dasgupta

NEW DELHI, May 6: Jolted by the unpreparedness of the administration to meet the exigencies caused by the second wave of Coronavirus in the country, the Supreme Court on Thursday asked the Centre to start preparing for the possible third wave by creating a buffer stock of medical oxygen and other health infrastructure.

Highlighting the need for the Union government to start preparations for oxygen allocation to the States, its supply and distribution ahead of a third wave, the court drew the attention of the government to reports that children may be affected in the next wave.

“We may enter stage three and if we prepare today, we may be able to handle it. Whatever stocks procured needs to be sent to the hospitals. It’s not about allocating it to the state but also the logistics to see that it is distributed to hospitals,” Justice DY  Chandrachud said during the hearing of Centre’s response to non-compliance of its direction to supply 700 MT of oxygen to Delhi.

Continuing the surge, India on Thursday reported 4,12,262 new cases and 3,980 deaths in the last 24 hours, both the highest in a day so far. India had become the first country in the world to register over 4 lakh infections in a single day on April 30, when it reported 4.08 lakh infections. The new infections have pushed India’s caseload to over 2.06 crore while active cases stand at 35.66 lakh.

As the situation continued to remain grim, the prime minister Narendra Modi undertook a comprehensive review of the Covid-19 situation in India. “He was given a detailed picture on the Covid outbreak in various states and districts. He was informed about the 12 states which have more than 1 lakh active cases. PM was also apprised about the districts with high disease burden,” an official statement said.

The statement also said, “PM was briefed about the ramping up of healthcare infrastructure by the states. PM directed that states should be given help & guidance about leading indicators to ramp up healthcare infrastructure. The need to ensure quick and holistic containment measures were also discussed. PM noted that an advisory was sent to the states to identify districts of concern where case positivity is 10% or more & bed occupancy is more than 60% on either oxygen supported or ICU beds. PM also reviewed the availability of medicines. He was briefed about the rapid augmenting of production of medicines including Remdesivir.”

PM reviewed the progress on vaccination and the roadmap for scaling up production on vaccines in the next few months. He was informed that around 17.7 crore vaccines have been supplied to the states. PM also reviewed the state wise trends on vaccine wastage. PM was briefed that around 31% of eligible population over the age of 45 has been given at least one dose. PM spoke about the need to sensitise states that the speed of vaccination doesn’t come down,” it said.

The SC Bench also comprising Justice MR Shah said the government needed to finalise a formula for allocation, supply and distribution of oxygen in a “scientific manner” ahead of the coming wave. It said the “rough-and-ready” formula devised presently on the “oxygen-for-bed” arrangement would hardly work. The current formula of allocating oxygen to Delhi, for example, on the basis of the number of ICU/non-ICU beds grossly underestimated need for oxygen in the National Capital.

“What is the problem in enhancing the supply (of oxygen)? If it’s not required then it can be stored. But then it can be said that there is no need for oxygen panic. This will be a buffer for Delhi,” the bench said.

The remarks came a day after Dr K V Vijay Raghavan, the Principal Scientific Advisor to the Prime Minister, cautioned the country on Wednesday that the “third wave was inevitable” given the high levels of the circulating virus and that they couldn’t predict a time frame for it.

“We need to reassess the basis for oxygen allocation. We are in stage two of the pandemic. Stage three might have very different parameters… But, if we prepare today, we will be able to handle stage three. It is about proper allocation of oxygen and working out the modalities, including proper distribution. A buffer stock has also to be created,” Justice Chandrachud pointed out.

The court underlined the importance of vaccination. “Children are going to be affected. They will be taken into hospitals. They will be accompanied by parents. Vaccination needs to be done,” it stated.

“Also, not everyone who went to a hospital required an oxygen bed and not everyone required ICU or ventilator. There are many who have been asked to stay at home and quarantine,” Justice Chandrachud picked the loopholes in the formula.

The court said the formula for allocation and distribution of oxygen among the States should be based, among other things, on an “oxygen audit”, that is, to determine the actual need of oxygen in a State.

Solicitor General Tushar Mehta, while informing the court that 730.7 MT (metric tonnes) of oxygen was received in Delhi on Wednesday as directed by the Bench, agreed that a “minimum fault prone formula” for oxygen supply, allocation and distribution was the need of the hour. The government agreed to revisit the formula.

At one point, the court suggested incentivising young doctors who have completed their courses and young trained nurses to augment the fatigued healthcare professionals who are at the end of their tether. It said that offering them a few 1,000 rupees for their services would not incentivise them to pitch in. The Bench suggested giving them grace marks as a reward for their services in combating the pandemic.

“Today, you have 1.5 lakh doctors who are waiting for NEET and have completed their courses. If you give them ₹5000, nobody will come serve… Likewise, 2.5 lakh nurses are trained and sitting at home,” the Bench noted.

During the hearing, Justice Shah asked about the care given in rural areas of the nation.

“At the moment we are only looking at Delhi. But what about the rural areas where most of the people are suffering? We have to consider a pan-India situation as well as the future situations,” Justice Shah asked the government.

Justice Chandrachud said there was a rudimentary health infrastructure in rural areas. However, in Maharashtra, a task force of a dozen doctors was formed to communicate and advise hospitals on pandemic care in rural areas.

Senior advocate Rahul Mehra, for the Delhi government, questioned the Centre’s apprehension that giving 700 MT oxygen to Delhi may short-change the supply to other States. He said the Centre had said there was no dearth of oxygen supply in Delhi and there was a reserve of 160000 MT. There was an 113% increase in Delhi’s demand for oxygen from 490 MT to 700 MT on April 28. The Centre was again making an attempt to reduce Delhi’s supply to less than 560 MT.

As Tushar Mehta countered claiming of an equitable distribution  of resources, amicus curiae and senior advocate Jaideep Gupta persisted on the same line of argument, saying if 700 MT requirement of oxygen for Delhi was incorrect and the National Capital could make do with 490 MT, why was there a shortage at all.

The submissions were referring to Mr. Mehta’s initial statements in the hearing that significant stocks of oxygen were available in Delhi hospitals and continued supply of oxygen to Delhi in excess would affect other States.

The SG argued that if the Centre supplies 700 MT of oxygen to Delhi then they will have to take it from some other state’s share. “If there is an adverse consequence then we can’t be held responsible because of someone else’s incompetence,” he said.

To this, Justice Chandrachud said the Centre’s formula for allocation of oxygen to states needs a relook while calling for an “oxygen audit” across the country.

On Wednesday, the top court had stayed a contempt notice against the Centre issued by the Delhi High Court over the non-compliance of its direction to supply 700 MT of oxygen to Delhi. However, the court had made clear that it was not stopping the high court from monitoring Covid-19 management related issues.

Delhi High Court on Thursday suggested the Delhi government to rope in LPG cylinder distributers for distribution of oxygen cylinders. Delhi government told the court that they are working on the website for online booking for refilling of oxygen cylinders

Centre also moved the SC against the Karnataka High Court order asking it to increase daily liquid medical oxygen allocation for state to 1200 MT instead of 965 MT. The central government sought stay of Karnataka HC order asking it the state’s supply . “Will have to look at paper book before issuing any order,” says SC on Centre’s plea for stay of Karnataka HC order on supply of LMO.