Concerned By "Sky-rocketing" COVID Cases, Telangana HC Directs State To Increase Daily Samples, Test Direct, High-Risk Contacts [Read Order]

Naming it "a cause of concern", the Telangana High Court on Thursday observed that "immediately the spread of the Coronavirus should be controlled by the Government".

"Before the Government can plan the strategy for controlling the Coronavirus, the first step that needs to be taken is to increase the number of samples per day", said the Chief Justice-led bench.

The Court noted that undoubtedly, in its initial endeavour to control the spread of Covid-l9, the Government had succeeded to a certain extent. Initially, while the media reports claimed that covid-l9 had spread its tentacles to twenty-three districts, subsequent media reports claimed that the number of districts suffering from covid-I9 cases had decreased. Considering the positive turn of events, the Government, in its wisdom, had decided to roll-back the lockdown which had been imposed on the State since March, 24. However, unfortunately, with the rolling back of the lockdown, in a controlled and calibrated manner, the number of Covid-l9 positive cases have skyrocketed in the last three weeks. According to the Media Bulletin, dated 17.06.2020, 269 cases have been discovered in a single day, with more districts beginning to show increase in number of Covid-I9 cases.

Accordingly, the Court on Wednesday directed the government to increase the number of samples being tested on a daily basis. "The Government should also consider the use of Rapid Antigen Detection Test as recommended by the ICMR. In compliance of the ICMR guidelines those who have been closely in contact with a Covid-19 patient should be tested once between day 5 and day l0 of coming into contact with such patient, For, it seems that despite the guidelines issued by the ICMR the said guideline is not being implemented by the State", ordered the Court.

Besides, taking note of the claim of the state's Health Department in its report dated June 17 that it is difficult to carry out the RT-PCR test, a test which has been successfully carried out in the State of Kerala, the Court called upon the Director to explain the difficulties being faced by the State in using the said tests.

It was urged before the Court that in the report submitted by the Health Department on Wednesday, the State has declared that it will carry out 50,000 Covid-I9 tests just in ten days across the area of Greater Hyderabad Municipal Corporation and the surrounding districts. Thus, if 50.000 samples were to be taken just in ten days, it would require that at least 5,000 tests need to be carried out on a daily basis. However, the Media Bulletin dated 16,06,2020 clearly states that only 1251 samples were tested, and the Media Bulletin dated 17.06.2020 reveals that only 1096 samples were tested, Thus, in two days only 2,347 samples were taken, whereas 10,000 samples should have been taken in two days. Hence, according to the documents submitted by the State, the testing is hopelessly low from the target set by the State itself.

Secondly, it was pointed out that according to the National Data available, as on 16.06.2020, the State of Maharashtra has tested 5496 persons per million; Gujarat has tested 2448 persons per million; even the neighbouring State of Andhra Pradesh has tested 10,865 persons per million. Yet, the Telangana State has tested merely 761 persons per million. Thus, the testing being carried out in the State is too little.

"Although in the Report dated 17.06.2020, the Government claims that it will be carrying out 50,000/- tests in the coming ten days, but according to the Media Bulletin issued on 16.06,2020 and 17.06.2020, the number of samples being tested is roughly 1500 cases. As pointed out (...), in order to achieve the target of 50,000 tests within ten days, the sampling has to be minimum of 5000 cases per day. Therefore, obviously, the samples being taken by the Government are far below the target established by the Government itself", reflected the bench. The Court proceeded to remark that "Even if the target of completing 50,000 samples within ten days is claimed to be a reasonable one by the State, even then, as pointed out above, the sampling is too low to be able to achieve the target within the short period of ten days".

Furthermore, it was argued that according to the recent most guidelines issued by Indian Council of Medical Research (ICMR) dated 18.05.2020, "all symptomatic (ILI symptoms) health care workers/frontline workers involved in containment and mitigation of Covid-l9" and "asymptomatic direct and high-risk contacts of A confirmed case to be tested once between day 5 and day 10 of coming into contacl".However, there is no evidence that has been produced by the State to show that these two guidelines, especially the second guideline dealing with the "asymptomatic direct and high-risk contacts of a confirmed case" is, indeed, being carried out by the State. The bench required the Department to inform this Court whether this particular guideline issued by the ICMR is, indeed, being followed or not.

The attention of the bench was drawn to a report published by the "Express News Service", dated 08.06.2020, according to which the cases of Covid-l9 inTelangana are likely to peak in July, 2020. But due to the low testing of the population, the extent and the spread and the rapid growth of Covid-l9 would not be known to the Health Department.

It was further contended that on 14,06.2020, the ICMR had issued an Advisory on use of Rapid Antigen Detection Test for Covid-I9. According to the Advisory, the said test was, indeed, a test "with good sensitivity and specificity for early detection of lhe disease". Moreover, according to the Advisory, the said test was now readily available in India. Therefore, the Advisory had clearly recommended that the said test be used in the containment zones/hot spots and in the Healthcare settings. But, despite the fact that the said Advisory has been issued, so far, there is no indication that it has been adopted by the Health Department of the State.

"By order dated, 26.05.2020 in W.P. (PIL) Nos. 59 of 2020 and Batch, this Court had issued the following direction, among others, to the State, which rcads thus:-

Secondly, the Government is directed to carry out "random testing" and "community testing" in the districts declared as 'Red Zone', 'Orange Zone' and 'containment area'. Having carried out such tests, the Government is directed to inform this Court about the number and the place where such tests were carried out. However, the aforementioned directions are yet to be complied with by the State", commented the division bench.

On June 8, the Court had directed the State to, not only publish vital statistics on COVID on the Internet, but most importantly to have it published on the front pages of all the Newspapers in the Print Media.

Noting that the direction is not being complied with, the bench on Wednesday reiterated that the critical information should be published on a daily basis not only in the Media Bulletin, but also in the regional newspapers. "Secondly, the information available within the GHMC area, should be published ward-wise, and the said information should immediately be communicated to the Colony Associations. For, the wider the information is spread, the more the people will become aware of the danger being posed by Covid-I9. And hopefully, people will continue to observe the safety measures prescribed by the Government/ICMR", the Court required.

The Government is further directed to publicise the names of the fifty-four Government Hospitals, which have been designated for treatment of Covid-l9. "For, the impression exists not only in the minds of the people at large, but even in the minds of the Doctors working at Gandhi Hospital that Gandhi Hospital in Hyderabad is the only designated hospital for treatment of Covid-19. Since the Government claims that Government Hospitals have been designated in the districts itself, the said information needs to be given as wide a publicity as possible, so as to reduce the rush of patients to the Gandhi Hospital", said the bench.

Besides, the bench was of the view that since about 274 police personnel are said to be deployed at the Gandhi Hospital, these police personnel are to be given sufficient PPEs so as not to adversely affect their lives while discharging their duties. "Moreover, since there seems to be sufficient stock of PPEs, the Superintendent of Gandhi Hospital is further directed to ensure that the PPEs/Protective gears are made readily available not only to the Senior Doctors, or Doctors working in the ICU, not only to the Medical Staff working in the ICU, but even to the Junior Doctors, Resident Doctors and the Nurses, male and female. After all, it is imperative that the frontline warriors, the Medical Staff from the senior most Doctors to the Ward-Boy, are totally protected from the Covid-l9 infection", the bench said.

Further, since the Gandhi Hospital has already decided to deploy nearly 50% of its staff, the Government is directed to consider the possibility of issuing the necessary instructions even to the private hospitals, which have been permitted to treat the Covid-l9 patients, to reduce the staff and to employ them, in shifts, on weekly basis.

The bench was alive to the fact that though fifty-four hospitals have been designated as centres for treatment of Covid-l9, patients tend to go to other hospitals as well. Due to the congregation of patients in other hospitals, the possibility does exist that many of these patients may be the carriers of Coronavirus. Therefore, the Government is directed to consider the possibility of issuing instructions and at least providing thermal screening to all the hospitals so that any patient or his relative, who may accompany such a patient is thermally screened at the entrance of the hospitals. In case, any patient or the accompanying member is found to indicate any covid-l9 symptoms, the patient or the relative should immediately be quarantined, and the information should immediately be shared by the concerned hospital with the State Health Department. "Such a procedure would not only protect the other patients, who are reporting to the hospitals, but would also protect the Medical staff of the concerned hospital", the bench expressed.

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