'Minuscule' bleeding, clotting events post COVID-19 vaccination, says Centre; AP, Manipur, Chandigarh extend curfew

India has reported 26 potential cases of bleeding and clotting after administration of the Covishield vaccine, which is "minuscule" and "in line with the expected number of diagnoses", a government panel investigating adverse events following COVID-19 immunisation found on Monday.

The National Adverse Event Following Immunisation committee (AEFI) has completed an in-depth case review of 498 serious and severe events, of which 26 cases have been reported to be potential thromboembolic (formation of a clot in a blood vessel that might also break loose and carried by the bloodstream to plug another vessel) events - following administration of Covishield vaccine - "with a reporting rate of 0.61 cases/ million doses".

This, as the government on Monday revising the clinical guidance for COVID-19 treatment, dropped the off-label use of convalescent plasma as it was found not beneficial in reducing the progression to severe disease or death. The development came following a meeting of the ICMR-National Task Force for COVID-19 last week wherein all members were in favour of removing the use of convalescent plasma from the guidelines citing its ineffectiveness and inappropriate use in several cases.

An Indian Council of Medical Research (ICMR) official said the task force "revised" the Clinical Guidance for Management of Adult COVID-19 Patients and "dropped convalescent plasma (off label)". The previous guidelines recommended off-label use of plasma therapy at the stage of early moderate disease, that is, within seven days of the onset of symptoms and if there is availability of a high titre donor plasma.

The decision to remove it from the guidelines comes in the backdrop of some clinicians and scientists writing to Principal Scientific Advisor K VijayRaghavan cautioning against the "irrational and non-scientific use" of convalescent plasma for COVID-19 in the country. In the letter, which was also marked to ICMR chief Balram Bhargava and AIIMS Director Randeep Guleria, public health professionals alleged that the current guidelines on plasma therapy are not based on existing evidence and pointed out some very early evidence that indicates a possible association between emergence of variants with lower susceptibility to neutralising antibodies in immunosuppressed" people given plasma therapy.

Also on Monday, the Union health ministry in a statement said that over 23,000 adverse events have been reported since the vaccination drive involving Covishield and Covaxin vaccines started in the country and of these, 700 cases were reported to be serious.

This, on the same day that the first batch of anti-COVID oral drug 2-DG, developed by the DRDO, was released by defence minister Rajnath Singh and health minister Harsh Vardhan. The Drugs Controller General of India (DGCI) approved the 2-deoxy-D-glucose (2-DG) drug for emergency use as an adjunct therapy in moderate to severe coronavirus patients earlier this month.

The medicine will play a crucial role in winning the fight against COVID-19 . The development and production of the drug is a shining example of public-private sector partnership to help the nation in these challenging times.

— Rajnath Singh (@rajnathsingh) May 17, 2021

In his brief remarks, Singh said the drug has brought a new ray of hope for the treatment of COVID-19 patients. "This is a great example of the scientific prowess of our country," he said. At the same time, the defence minister warned that it is not the time to relax and get tired as there is nothing definitive about the course of the pandemic.

Meanwhile, India's COVID-19 tally mounted to 2,49,65,463 with 2,81,386 fresh cases, the lowest in 27 days, while the toll climbed to 2,74,390 as 4,106 more people succumbed to the disease, according to Union health ministry data. However, 2,11,74,076 patients have recuperated from the disease, while the case fatality rate stands at 1.10 percent, it stated.

The number of active cases stands at 35,16,997, accounting for 14.09 percent of the total infections. The national recovery rate has improved to 84.81 percent, the data updated at 8 am showed.

Also on Monday, noted virologist Shahid Jameel quit as the head of INSACOG, a Central Government panel that conducts genome sequencing of coronavirus. This just days after Jameel claimed that scientists are facing "stubborn resistance to evidence-based policy making".

Jameel announced his plan to step down in a meeting of INSACOG held on Friday, said two officials who were part of it. Calls and messages to Jameel went unanswered. An official said the virologist did not give any reason for why he was quitting.

AP, Manipur, Chandigarh extend COVID-19 curfew

Meanwhile, authorities in Andhra Pradesh, Manipur, and Chandigarh extended COVID-19 lockdowns in order to combat the second wave of the coronavirus .

In Andhra Pradesh, the government decided to extend the curfew till 31 May as the coronavirus graph continued to be on a steep upward spiral.

The COVID-19 curfew, daily from noon to 6 am, that came into force on 5 May was supposed to end on Tuesday but, at a high-level review meeting on the pandemic, Chief Minister YS Jagan Mohan Reddy decided to extend it till the month-end. The state added 1,43,684 cases in the first week of May and the number shot up to 1,90,117 between 8 to 16 May. The state reported over 20,000 cases per day, with a record 24,171 on 16 May, in the last six days, clearly indicating that the curfew had had no impact.

"The curfew should be in force at least for four weeks to achieve the desired results (breaking the coronavirus chain). So continue it," the chief minister directed the authorities. A release from the Chief Minister's Office said Jagan Mohan Reddy asked the health officials to take steps to bring down the COVID-19 cases, particularly in rural areas.

The chief minister also asked the officials to take care of children who lose their parents to COVID-19 . "Prepare an action plan on extending required financial assistance to such children. Deposit a fixed amount in their name so that they can utilise the interest for their regular needs," Jagan said.

The Manipur government also extended the curfew imposed in seven districts of the state till 28 May to check the spread of the virus. The state government had clamped 24-hour curfew in the seven districts of Imphal West, Imphal East, Bishnupur, Thoubal, Kakching, Churachandpur, and Ukhrul from 8 to May 17 to combat the surge in COVID-19 cases.

An order issued by the state Home Department said, "the virulence of COVID-19 virus continues unabated and the need for stringent measures to check physical contact among people still exists."  However, the government has allowed additional relaxations including permitting local vegetable vendors from 7 am to 10 am on 20, 23, and 26 May with strict observation of SOPs, though vehicular movements during the period will be strictly prohibited, the order said.

Banking and postal services will be allowed to function on Mondays, Wednesdays, and Fridays from 10 am to 2.30 pm for urgent transactions. Healthcare, essential services, and Imphal Airport will continue to operate, the order said. For the rest of the nine districts, residents have been asked not to travel to the seven districts where curfew has been imposed.

Villages and localities with no COVID-19 cases have been encouraged to display the sign - "My village is corona free"- at the entrance of the localities. The respective deputy commissioners of the nine districts have been directed to monitor the spread of the infection in the districts. The state on Monday reported 330 new cases pushing the COVID-19 tally to 40, 059, and 14 fatalities to take the death toll to 592. So far, 33,129 patients have recuperated from the infection and at present, the number of active coronavirus in Manipur is 6,338.

Similarly, the Chandigarh administration also decided to extend weekend curfew restrictions by one more week till 25 May. The Union Territory administration said it was extending the weekend curfew so that gains made by the plateauing number of cases due to the lockdown are not lost.

“Following extensive discussions in various forums and with medical experts, it was decided that the restrictions already imposed under corona curfew should remain in force for another week, that is up to 5 am on 25 May, so that gains of plateauing of caseload due to lockdown is not lost,” an official said according to the decision taken in a COVID-19 review meeting.

Last week the Chandigarh administration had decided to extend night and weekend curfew restrictions by one more week beginning 11 May in the wake of rising COVID-19 cases in the city. However, the cases have been coming down in the city during the past few days.

The night curfew in the city is in place from 6 pm till 5 am on weekdays. The weekend curfew starts at 5 am on Saturday and continues till 5 am on Monday. To check the spread of COVID-19 infection, the UT administration had first imposed a night curfew. Later, weekend curfew/lockdown was also imposed, which was then extended by a week-long curfew that has now again been extended.

Plea in SC to quash Delhi Police FIRs

A plea has been filed in the Supreme Court seeking quashing of FIRs registered by Delhi police for allegedly pasting posters critical of Prime Minister Narendra Modi in connection with the vaccination drive against COVID-19 .   The plea filed by advocate Pradeep Kumar Yadav also sought direction from Delhi Police Commissioner to not register any further cases/FIRs with regard to COVID-19 posters /advertisement/ brochures which have surfaced in context to the ongoing vaccination drive.

Yadav said that he is seeking the indulgence of this court to intervene with the “illegal arrest of innocent general public” for their speech and expression by way of pamphlets affixed on the wall, which is now viral on social media. He said that this court had in its catena of cases held that freedom of speech and expression with regard to the public cause is a fundamental right of every citizen guaranteed under the Constitution of India.

The advocate referred to the top court's 2015 verdict in the Shreya Singhal case in which section 66A of the IT Act was quashed and the recent order in suo motu case on COVID management, in which state authorities were directed not to register any criminal case against the public seeking medical help in the social media.

“In contrast to decisions of this court the authorities are registering FIR against the innocent persons over their hate speech against the Prime Minister with regard to his official functions during the second wave of COVID-19 crisis and Government vaccine policies,” the plea said.

'Remdesivir coordination lacking between Centre, state'

The Gujarat High Court on Monday said there appears to be a "lack of coordination" between the Centre and the state government in the allocation of the required amount of Remdesivir injections. The court noted that the Union government continued to supply vials to the state in the range of 16,000 per day for the last one month while the demand was around 25,000 vials per day.

A division bench of justices Bela Trivedi and Justice Bhargav D Trivediasked Assistant Solicitor General Devang Vyas, representing the Centre, why Gujarat's demand was not being met. "What will happen to the patients who require this (injection)? Should the government allow the patients to die for want of Remdesivir?" the court asked.

The court further directed the Centre to put on record the policy in place for the allocation of Remdesivir, an injection used to treat critical COVID-19 patients, to the states. It observed that, despite an increase in production to 1 crore vials per month from 30,00,000 earlier, the Centre's allocation to Gujarat had remained at around 16,000 per day since 21 April.

The HC is hearing a suo motu PIL on issues concerning the COVID-19 pandemic.

Representing the state government, Advocate General Kamal Trivedi told the court that between 21 April and 16 May, Gujarat received 4,19,000 vials of Remdesivir, at the rate of 16,115 vials per day, despite the state making demand for more than 25,000 vials "during the course of a video conference". He later clarified that the state was conveying the demand of 25,000 vials "on the higher side".

"As of now, your (state's) GMSCL (Gujarat Medical Services Corporation Limited) is distributing it (to the hospitals) in Gujarat, as per the requirements. Then, in those circumstances, demand comes from the hospitals to the GMSCL, and you (government) send it to the Centre. Now, there is a total lack of coordination, it appears, between the Centre and the state for the procurement of the balance amount of about 10,000 Remdesivir vials for the last one month," the court observed. The court said the Centre must give enough quota from Monday itself.

Vyas told the court Remdesivir was being allocated as per demand from 36 states and Union Territories and availability of vials, and it was not that the Centre had an unlimited supply and was withholding the same from the states and UTs. Vyas said, between 21 April and 23 May, the supply to Gujarat had increased to 5,10,000 vials, making it the second-highest among 36 states and UTs in the country.

The bench then asked the Centre to justify the mismatch between demand and allocation, and also put on record the policy being adopted for allocation.

The matter will next come up for hearing on 26 May.

'PIL disguise to stop project'

The Centre on Monday opposed in the Delhi High Court a PIL to halt the construction of the Central Vista project in view of the pandemic and alleged that the plea was a "facade" to stall the work. The petitioners on the other hand contended they were only interested in the safety of the workers at the site and the citizens' lives and compared the project to "Auschwitz", a German concentration camp during World War II.

Hard-hitting arguments against the maintainability of the plea and the continuation of the project were made during the over three-hour-long hearing before a bench of Chief Justice DN Patel and Justice Jyoti Singh which reserved its judgement in the matter. Shapoorji Pallonji and Company Pvt Ltd, which has been awarded the tender for the project, also opposed the PIL, saying it lacks bonafide and the company was taking care of its workforce.

Opposing the claims of the petitioners, Solicitor General Tushar Mehta said that the plea was a "facade", a "disguise" in the form of a PIL to stall the project which they always wanted to stop. Senior advocate Sidharth Luthra, appearing for the petitioners, told the court that his clients were only delivering a message of health and safety for the people of Delhi and if the government cannot see it, then it was a "sorry reflection" of their concerns for the lives of the citizens.

Delhi HC seeks govt stand on facility for public prosecutors

The Delhi High Court on Monday sought the stand of the Delhi government on a plea seeking setting up of dedicated 100-bed COVID facility for catering to public prosecutors, their staff, and family members in the National Capital. A bench of Chief Justice DN Patel and Justice Jyoti Singh issued notice to the Delhi government and sought its response to the plea by an Assistant Public Prosecutor (APP).

Dishank Dhawan, the APP, has contended that he had sent a representation to the Delhi government for a dedicated health facility for prosecutors, staff of the prosecution department, and their respective family members. However, he received no reply to the same, and therefore, he moved the instant plea in the high court.

"That as part of their duty, the public prosecutors and other staff of the prosecution department of the Delhi government faced extreme exposure and worked selflessly and had to interact with public, police, and other court staff constantly even during the nationwide lockdown. The petitioner and various other public prosecutors and other staff of the prosecution department were exposed to high risk due to public dealing, and have tested positive. The petitioner himself has tested positive for COVID-19 on 9 April," the petition has said.

It has sought that the prosecutors be also identified as "front line workers" and that they and their families be provided vaccination in the dedicated facility.

'More than 2 crore vaccine doses available'

Also on Monday, the health ministry said more than two crore COVID-19 vaccine doses are still available with the states and Union territories, while nearly three lakh doses are in the pipeline and will be received by them within the next three days. The Centre has so far provided over 20 crore (20,76,10,230) vaccine doses to the states and Union territories for free. Of this, the total consumption, calculated on the basis of average figures, up to May 16, including wastage, is 18,71,13,705 doses (according to data available at 8 am on Monday), it added.

"More than two crore COVID-19 vaccine doses (2,04,96,525) are still available with the states and UTs to be administered," the ministry said. Furthermore, 2,94,660 vaccine doses are in the pipeline and will be received by the states within the next three days, it said.

This comes on the same day that AAP MLA Atishi said on Monday that Delhi has less than a day's stock of Covaxin left for the 45 plus age group and they will have to temporarily shut down centres administering it. The centres administering Covaxin to the 18-44 age group have been closed.

While issuing the vaccination bulletin, Atishi said that Delhi also started walk-in vaccinations for 45-plus, healthcare workers and frontline workers from Monday.  There are many people who don't have smartphones and can't register online, she said, adding that there were 97 schools where such centres have been opened.  "We will have five days stock of Covishield, but less than a day's stock of Covaxin for 45 plus age group after today's vaccination," she said.

Atishi said they have only four days of Covishield left for the 18-44 age group. "We urge the Centre to supply us vaccines for the 18-44 age group since the new strain of coronavirus is affecting the young people," she said.

With inputs from PTI