Accurate Numbers Of Covid Cases Needed To Ensure Supplies Of Oxygen, Drugs, Vaccines Are Based On True Figures: Madras High Court

During its suo motu proceedings instituted to take stock of Covid management in the State, the Madras High Court directed the State to ensure underreporting of Covid cases did not occur.

Chief Justice Sanjib Banerjee and Justice Senthil Ramamoorthy underscored the necessity of "ensuring that accurate numbers are indicated so that adequate supplies of O2, drugs, vaccines can be based on true figures..."

In any case, recording of true numbers is necessary to maintain true and accurate records for a study for the future, Chief Justice Sanjib Banerjee records in the order, pointing  out that the Prime Minister had also advised against underreporting.

Other directions

Distribution of drugs

The Bench, after referring to the Centre and State Government's documents, expressed that there appeared to be certain anomalies in distribution of essential drugs particularly on basis of positive cases. With this observation, the Court directed the Advocate-General to look into basis of allocating drugs. In its Order, the Court referred to the papers presented on behalf of the Centre which made a reference to additional drugs which are necessary to deal with virus. As far as Tocilizumab is concerned, it is indicated that country is dependent on imports and there is limited supply, it was recorded.

The Drugs Controller General indicates there are domestically produced drugs equal to or better than Tocilizumab (Itilizumab, Dexamethasone and Methyl prednisolone), the Court recorded in the order.

On need to check prices of drugs dispensed by private healthcare institutions

While drug is directly reached to private hospitals, there must be check on prices charged since one of the difficulties faced by ordinary citizens is the massive bills generated by private healthcare institutions, the Court stated.

On ensuring oxygen to persons not affected by Covid

Needs and concerns of others must be kept in mind and addressed, patients other than those affected by covid must receive oxygen in the usual course. Local authorities should ensure continuous supply for such purpose, the court instructed.

Supplies of Remdesivir

Adverting to overcrowding at a Remdesivir distribution center in Nehru Stadium, the Court was informed that the state has stopped the distribution of Remdesivir from the Nehru stadium, apprising the Court that the drug would be directly distributed to hospital upon background check and patients necessity.

"While the drug is directly reached to private hospitals there must be a check on price charged by private hospitals since one of the difficulties faced by ordinary citizens is the massive bills generated by private institutions affording healthcare facilities..", the Court mandated.

Facilities in Puducherry

During the hearing, intervenors brought to the Court's attention that there may not have adequate beds in Puducherry proper. 

The Court pointed out that figures furnished by the Union Territory indicate adequate supply of Oxygen, remdesivir, and beds at Kayathar, Mahe, Yanam. However, there appears to be a dearth of beds, ventilator and oxgyen beds...with even the website showing the same, the Court recorded in its order.

"It is submitted on behalf of the Union Territory that patients form bordering districts in TN have taken admission at the Pudicherry hospitals which may have resulted in the shortage...Be that as it may, the endeavour to augment no of beds should continue as number of cases on daily basis is quite heavy though rate of increase has shown a dip", Court recorded.

Disposal of dead bodies

It was also submitted that the manner in which dead bodies were kept in the hospital wards several hours after the death of the patient and the manner in which some deaths are not attributed to Covid.

It was also stated that dead bodies in wards demoralise other patients, surely authorities need to remove the dead bodies as soon as possible.

The Court appreciated the possibility of number of deaths being higher than mortuary facilities at hospital, but emphasized that the aspect of the case being a Covid death had to be considered. "If there has been a covid death, even if overwhelming factor was the co-morbidities, body has to be disposed based on COVID protocol so that the body does not become a source of infection", tChief Justice Sanjib Banerjee emphasized in his order.

"All should endeavour to accord a level of dignity to the departed, at least for a final time," the Court additionally said.

Conversion of ESI hospitals to COVID hospitals

The Centre's statement revealed that the Centre had two ESI hospitals in Tamil Nadu, while the rest were under the control of the State.

In its order, the Court opined that ESI hospitals could have wards dedicated for Covid treatment but could not be converted completely into Covid hospitals. "Should be kept in mind that ESI hospitals for those who contribute, though covid wards can be created," the bench specified

Drawing from suggestions made during the hearing, the Court opined that ESI dispensaries may be used as vaccine centers as and when vaccine drives are set into motion in the state and Pudicherry.

Need for more stringent conditions of lockdown

The Court left it to the government and local bodies to decide on the need to heighten the stringency of the lockdown

"If you go to areas where fishermen stay, slums... 10 people cramped together in 1 house, can you expect them to stay inside all day? All don't have lawns and bungalows within walls of homes..", Chief Justice Sanjib Banerjee remarked during the hearing today.

On vulnerability of children to infection

On this count, the Bench highlighted the need to set plans in place by the State and Union Territory to tackle the issue.

"Children are more difficult to control even if admitted to hospitals and beds are available. Children need additional care and may not respond to unknown persons in absence of parents and known relatives...This area needs to be addressed, should the pandemic divert its attention to children in the near future", the Bench stated in its Order.

Overcrowding in prisons 

After this aspect was raised by one of the Counsel, the Court directed that undertrials be released on lines of Supreme Court's order so as to ensure there is no overcrowding in correctional homes.

On workmen

In a related matter taken up prior to the suo motu case, the High Court expresses a hope that industries exempted from lockdown maintained COVID19 protocol strictly in the interest of workmen. State should take immediate steps, in larger interest, if any of the industries were found as not following protocol, the Court said.

Click here to download the Order