Release 10,000 vials of Remdesivir to Nagpur COVID-19 hospitals by 8 pm, Bombay HC tells Maharashtra govt

The Nagpur bench of the Bombay High Court on Monday directed the Maharashtra government to immediately release around 10,000 vials of the drug Remdesivir to hospitals in Nagpur, reported Bar&Bench.

The court also directed that permission to be granted to all private hospitals interested to set up their own oxygen generation units and ordered that home delivery of food by restaurants should be permitted beyond the curfew limit of 8 pm.

Home delivery of food by restaurants which is restricted beyond 8 pm because of the #Curfew be permitted till the hour of the night permissible under shops and establishments act considering it is #essentialservices

— Bar & Bench (@barandbench) April 19, 2021

The court issued fresh directions while continuing its hearing on its suo moto PIL regarding the non-availability of the anti-viral drugs Tocilizumab and Remdesivir, lack of oxygen supply, and hospital beds in Nagpur.

Remdesivir is listed for use in serious patients. In view of a sudden spike in demand for the drug due to the surge in cases, the Centre last week banned its export till the situation improves.

A division bench of justices SB Shukre and SM Modak, in its order, observed that the situation has become the worst ever.

"The spike in cases being witnessed by Nagpur is of the steepest kind, not seen even during first phase of the pandemic last year," LiveLaw quoted the court as saying.

The court further observed that life-saving drugs are not available in sufficient quantity, the supply of medical oxygen is also insufficient and there is also a dearth of medical and paramedical staff.

Nagpur on Sunday reported a record 85 deaths, while the day also saw 7,107 cases being added to the district's tally.  The caseload rose to 3,23,106, including 6,273 deaths.

Remdesivir

According to LiveLaw, during the hearing advocate Tushar Mandlekar highlighted the disparity in the distribution of Remdesivir, pointing out that the collector of Thane has allocated 5328 vials for 2664 patients, while in Nagpur there were 3,326 vials for 8,215 patients earlier.

"There is a discriminatory practice by the state government, only half is being provided in Nagpur," he alleged and also claimed that there is no scarcity of Remdesivir in the country.

Amicus curiae SP Bhandarkar alleged that the state government is not making payments to the companies providing the anti-viral drug due to the lack of funds. Senior advocate MG Bhangde appearing for the state, denied the allegations and said that everything is being controlled by the Centre.

As per LiveLaw, the court observed that as Maharashtra is contributing 40 percent of patients, it is reasonable to expect that 40 percent of remdesivir vials produced should be allocated to the state. "The allocation has to be need-based and not on any other factors that are not relevant," PTI quotes Justice Shukre as saying.

Bhandarkar argued that only government hospitals are making payments to suppliers through the government and the Central agency is deciding the allocation to states.

Amicus-It is wrong to say that payments are being made. Dedicated covid centres are making payment to the supplier. Only gov hosp. make payment through gov to the supplier. The procedure adopted is that central agency decides quantity to states.#COVID19India #Nagpur #Remdesivir

— Live Law (@LiveLawIndia) April 19, 2021

According to PTI,  the bench noted that on 13 April and 18 April, not a single vial of Remdesivir was allotted to Nagpur and on 17 April only 500 vials were allotted.

"This has severely affected the administration of health care to patients in Nagpur. The possibility of mortality because of lack of Remdesivir cannot be ruled out," it said.

"We must point out that it is the solemn duty of the State to save and preserve precious lives under Article 21 of the Constitution of India....Every doctor at a government hospital is duty-bound to extend medical assistance. There must be no delay in discharging medical assistance to those in need," LiveLaw quoted the court said.

The court observed that there is a shortage of the drug as there has been a "not so rational distribution " of Remdesivir by the state committee and directed that 10,000 vials of the anti-viral drug be released for the hospitals in Nagpur latest by 8 pm on Monday.

The collector should ensure the equitable distribution across 19 hospitals, it said.

Court - We also had a meeting with the functionaries managing situation in Nagpur. We do not understand the logic behind the release of 5328 Remdesivir vials against 2448 beds in Thane district
and just 3326 Remdesivir vials against 8250 beds in Nagpur#COVID19India

— Live Law (@LiveLawIndia) April 19, 2021

It ordered that the daily requirement of Remdesivir told to the Centre by the Maharashtra government be place on record latest by Tuesday and directed it to place on record the regulation of production and distribution of the drug by the central agency to the state.

Oxygen supply

According to LiveLaw, the court observed that the shortage of oxygen appears to be due to production capacity being unable to meet the demand and said the long-term solution lies in ramping up the production.

The court directed that permission to be granted to all private hospitals interested in setting up their own oxygen generation units without delay. It also said that hospitals be given permission to import oxygen generation units based on Air Separation Technology without delay. It also directed the state to set up oxygen generation plants.

During the hearing,  when the court was considering directions to be issued till the setting up of a proposed oxygen plant, advocate Anil Kumar appearing for an intervenor, suggested that concentrators can be procured from China. A suggestion was also made that oxygen tankers should be procured.

Court - Lloyd steel will create a dome-like facility at Wardha with the pipeline for O2.

Intervenor -If hospitals are in a position to procure a machine in bulk that provides O2 with immediate payment, state govt should give clearance for that

— Live Law (@LiveLawIndia) April 19, 2021

The court also issued directions regarding setting up of temporary centres for patients and facilities for those waiting outside hospitals and instructed medical and paramedical personnel to comply with orders requisitioning their services.

According to Bar&Bench, the court also directed the district collector to ensure that medical facility buildings which not being utilised even despite being ready for giving healthcare facilities to patients, are verified and given requisite permissions to function by this evening.

The matter was adjourned till 21 April.

Last Monday, the court had asked the Maharashtra government to consider setting up a unit or plant for production of oxygen at Nagpur for patients.

According to reports Union minister Nitin Gadkari also pitched in the efforts to overcome oxygen shortage and a 16-tonne oxygen tanker reached Nagpur on its first trip from the Bhilai Steel Plant on Monday. The second tanker carrying 36-tonne of  oxygen will reach Nagpur at midnight.

To overcome shortage of oxygen supply, first trip of 16-tonne oxygen tanker reached Nagpur on Monday from Bhilai Steel Plant.

The second tanker consisting of 36-tonne of extra oxygen will reach Nagpur from Bhilai at midnight tonight.@nitin_gadkari pic.twitter.com/KQZUWSoCTE

— Prasar Bharati News Services पी.बी.एन.एस. (@PBNS_India) April 19, 2021

Amid spiralling cases in the country, the demand for medical oxygen in the country has gone through the roof.

According to the All India Industrial Gases Manufacturers’ Association, Maharashtra, Gujarat and Madhya Pradesh are facing a major shortage of oxygen and Delhi will soon join the list of cases continue to rise, said a report by MoneyControl.

On Sunday, Maharashtra health minister Rajesh Tope had "false" the media reports that the shortage of medical oxygen resulted in the death of patients in some parts of the state.

"I have received reports from (government) hospitals in the state. No patient died due to the shortage of oxygen in these hospitals," he told reporters.

Also on Sunday, Railways said it will run 'Oxygen Express' trains over the next few days to transport liquid medical oxygen and oxygen cylinders across the country.

With inputs from PTI