Gujarat Govt Figures On COVID19 Not Matching With Actual Positive Cases : Gujarat High Court

The Gujarat High Court on Thursday observed that had the Gujarat Government taken pre-emptive steps earlier, the present grim situation of COVID-19 pandemic could have been avoided.

"If the state had taken steps, not that the State was sleeping, but if there was a push, if all of this had been done earlier, before the PIL was registered, situation would have been better", Chief Justice Vikram Nath told Advocate General Kamal Trivedi.

While the AG maintained that the State was adequately prepared, CJ said "no, you have the complete machinery &resources to see if things are controlled. But this is not being done".

The CJ said that last year the Court had passed a slew of directions in a suo moto PIL giving suggestions for increased testing, arranging for more hospital beds, maintaining social distancing and wearing of masks, etc.

"Our suggestions have not been implemented seriously. People are taking it too lightly", the Chief Justice said.

On Thursday, a Bench of Chief Justice Vikram Nath and Justice Bhargav Karia of the Gujarat High Court was continuing the Court's suo motu proceedings taking stock of the surge in COVID-19 cases in the State.

At the hearing today, Chief Justice Nath pointed out that there seemed to be a divergence between the numbers of those tested, as provided by the state, and the actual numbers of those infected.

"Figures given by State are not matching with the actual number of positive cases", CJ said.

The Chief Justice also declared that the High Court's academy and auditorium halls can be used to house lawyers and Court staff who were COVID-19 positive and did not have the space to isolate in their homes.

Asking the President of the Bar Association to make arrangements with the Registry the Court orally said "The State has to make arrangements for food".

The previous hearing had seen Advocate General Kamal Trivedi being called upon to submit to Court details of steps the State was proposing to take to cope with the rise in COVID-19 cases in the state.

A major chunk of the day's hearing was devoted to the availability of Remdesivir, the availability of testing and hospital beds across the State and other facilities such as CT-Scans.

On Remdesivir

At the outset, the Court asked the Advocate General to clarify the use and application of drug Remdesivir.

Commenting that people were not sure of its use and that as a result of the demand, it was being hoarded and being sold at nearly four times its price, the Court remarked,

"WHO has different concept, ICMR has another, state has different concept, people don't know (its use)… Unnecessarily Remdesivir has been made amrut!".

The Advocate General underscored that the Remdesivir injection is not a recognised drug under the Drug Control Act and the drug was presently confined for use in emergencies.

"There is a lot of misinformation, it is being used indiscriminately because people recommend…", he said.

To this, Chief Justice Nath responded, people are not recommending, doctors are!

Pointing the Court to the recommendations of an expert Committee of Doctors, the Advocate General said that the Committee has said that injection should be administered when a person has fever for 4-5 days, and oxygen levels below 90. The injection has side effects.

"According to doctors, this injection has to be given under medical supervision. As per Central Government, should be given by hospitals. Wrappers of 7 manufacturers say that injection can be given only in hospital. Not for home use", the Advocate General added

He went on to say,

"This is freely available on retail, but not over the counter, cannot be given like paracetamol..Needs medical prescription…Now, Central Government is faced with situation of demand…Drug cannot be brought under the Drug Control Act, price cannot be controlled because does not come under Act… From day one, people have been purchasing for home care."

Adding that Remdesivir has been over-prescribed, he also emphasized that the injection was to be made available to hospitalised patients and hospitals.

When the Court suggested that the expert committee make public how the drug was to be used, Advocate General Trivedi stated that the Committee's experts were using social media to speak about drug

The Chief Justice then queried on whether the State had sufficient injections to match demand.

At a later point in the proceedings, the Advocate General submitted that 1 lakh vials of Remdesivir were being manufactured for the whole country. He added that the heightened use of the drug along with the slowed manufacture was shooting up demand.

"Why don't you do it on oath, that the injection is available everywhere, whenever required, on medical prescription and that anyone whether in hospital or otherwise will get?", the CJ asked.

The Advocate General responded stating he had reservations on use of term 'sufficient' stock

He then said that doctors cannot prescribe indiscriminately, and that there was no sufficient stock to meet demand in such a case.

Where are statistics to show that Doctors are prescribing Remdesivir like paracetamol whenever person is testing positive for COVID?, the Court asked

"Whenever there is a medical superintendent's prescription that person is running fever and has low oxygen level, we will part with medicine", he stated.

Senior Advocate Percy Kavina stated that there was a tendency to hoard the medicine.

The Court then asked why anyone would anyone hoard if they have confidence of availability.

Senior Advocate Kavina additionally said, "the role of Government in a crisis is confidence building..If Govt's words were more credible, it would be better…We should admit that goof ups were made by everyone.."

He also stated, "Quackery methods should be condemned for what they are. Government should say that neem, Ayurveda don't help

On Testing

The Advocate General submitted that there were RT-PCR Testing Facilities in every district, except for the district of Dang.

"1 crore tests have been conducted (RTPCR and Antigen) 3L+ tested positive. All districts have RTPCR facility", he said.

To Justice Karia's question on whether Anand had testing facilities, the Advocate General submitted that there was one RT-PCR testing facility and another Tru Nat testing centre.

"Why doesn't anyone know about TruNat", Justice Karia asked.

The Advocate General told the Court he would get further information on the test, but that it was on par with the RT-PCR and that the ICMR had approved of it.

Apart from this, drive-through Rapid Antigen test drives were being organised, he informed.

He additionally told the Court that steps were being taken to encourage labs to improve their testing capabilities to collect samples from people's homes. Earlier, it used to take 3-4 days. Today they are testing 8,000-12,000 samples per day, he said.

However, Advocates Amit Panchal and Anand Yagnik averred that certain districts did not have facilities. They said there should be transparency on RTPCR tests, beds. Advocate Yagnik added that many Municipalities did not have testing facilities even if Districts did, he says. He also asserted that the facility needed to be made available in the 13 tribal districts should be covered

The Counsel enjoined the Court to shift the focus on rural areas, as opposed to the urbanised parts of the State.

Advocate Yagnik informed the Court that there were no labs to run RTPCR Tests in Ahmedabad either. "I have been trying to call a lab for RTPCR test in the two hours of hearing, all are engaged", he said.

On Beds and CT Scans

While the Advocate General averred that persons were being suitably accommodated in health centres and being shifted to higher facilities if there situation worsened, Senior Advocate Percy Kavina appearing for the Gujarat High Court Advocates Association averred from anecdotal experience that there were ambulances with patients lined up outside of hospitals.

Advocate Chetan Pandya raised concerns about how the dashboard of live cases and beds available in the State was not updated real time.

The Court directed the State to ensure this was being done.

On CT Scans the Advocate General stated that the new variant is peculiar and that when RTPCR tests negative, even with symptoms, doctors had to send for CT Scan to confirm.

The Chief Justice then narrated,

A friend of mine in Allahabad tested negative twice. After CT Scan found COVID-19, RTPCR also turned positive...

The Court directed the State to get CT Scan facilities as soon as possible.

With a direction to the State to get more information on testing, bed availability etc.

The Chief Justice stated that the matter would be taken up again, but did not indicate a date.