New Delhi: The Delhi High Court on Wednesday (April 28) expressed its unhappiness with the Centre over the non-supply of the full oxygen quota allocated to the national capital. It also objected to a "change" in COVID treatment protocol on Remdesivir use, saying "it appears you want people to die".


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"This is wrong. This is a complete non-application of mind. Now people who do not have oxygen will not get Remdesivir either," Justice Prathiba M Singh said, adding "It appears you want people to die." 
 
The court made this observation when the central government submitted that under the COVID treatment protocol being followed now only patients on oxygen support were being given Remdesivir. The court also appealed to citizens and suppliers not to hoard oxygen cylinders and medicines to avoid creating an artificial shortage.


"People will keep dying and you will keep sitting," a bench of justices Vipin Sanghi and Rekha Palli said, questioning the Centre's order which allots oxygen to the national capital from three far off plants in West Bengal and Odisha that consumes a lot of time in transportation.


"The allocation made by the Centre to Delhi is 490 Metric Tonnes per day. Not for a single day, Delhi has been able to get the complete quantity," it said adding that this is primarily because three of the plants are situated in West Bengal and Odisha which are at a distance of 1300-1500 km from here.


The bench, which heard the matter for four hours, asked senior advocate Raj Shekhar Rao, who was appointed amicus curiae, to study the national allocation order and give suggestions on optimal usage of tankers and minimisation of turn-around time.


It said Rao may communicate the suggestions to Solicitor General Tushar Mehta, who had initially opposed the idea of amicus looking into the national allocation plan.


During the hearing, senior advocate Rahul Mehra, representing the Delhi government, said the issue was raised at the central war room. When the central government officer concerned denied it, Mehra said they would again do it and this time the communication would be in writing.


"People will keep dying and you will keep sitting. So many lives we are losing because of your inaction. What about the promise of 480-490 Metric Tonnes of oxygen per day. How many states are facing the kind of shortage Delhi is facing," the bench said to the central government officer.


The bench said now the Delhi government has even arranged the tankers and what was the point of allocating a certain quantity of oxygen to Delhi when it was not being supplied. "It actually pains my heart. I don't know what to say now. At least take empty tankers back by air," Justice Palli said.


The bench further said, "You have to do it on an SOS basis. You can't say one round of oxygen for Delhi will take 5 days. You can airlift empty tankers. If your turnaround time is five days, we must say your allocation is bad." To this, Additional Solicitor General Chetan Sharma said whatever is humanly possible is being done and there is a complete coordinated effort in this regard.


The bench said the amicus will come up with suggestions and the Centre shall look into the logistic problems relating to transporting oxygen from the faraway plants to Delhi. The court asked the Centre to file its response in this regard by April 30.


Justice Singh also said the court will consider later whether a medical committee should review if the protocols or guidelines for administering Remdesivir need any modification. "Don't change the protocol only to reduce the shortage. That is wrong. As a result, doctors are not able to prescribe Remdesivir," the court said and added, "This is complete mismanagement."


The high court is handling multiple petitions relating to the pandemic with various benches conducting marathon hearings. The bench headed by Justice Sanghi appointed senior advocate Raj Shekhar Rao as amicus curiae to assist the court in dealing with the medical oxygen crisis and other issues related to the COVID-19 pandemic.


It also asked the Delhi government to place a report on the number of RT-PCR tests conducted in the last seven days and the reasons for the reduction in the tests. 


The bench also asked the Delhi government to examine the suggestion by senior advocate Krishnan Venugopal for taking services of armed forces in this situation as they can set up field hospitals which will help a large number of COVID-19 patients in the national capital, and take appropriate steps.


Another issue was raised that a large number of ambulances are carrying bodies of COVID-19 patients to crematoriums and due to the long queue, it takes time to complete the journey and the vehicles can't used for ferrying patients to hospitals.


The court asked the Delhi government to consider the suggestion that old DTC buses be used to carry bodies to crematoriums and file its reply in two days. It also asked the government to consider the suggestion of senior advocate G Tushar Rao that mohalla clinics be used for providing immediate consultation and treatment to COVID-19 patients and also for the collection of test samples.


The court was also informed that in pursuance of its Tuesday's direction, the Delhi government has issued orders relating to the allocation of medical oxygen to hospitals taking into account the requirement for ICU beds and other oxygen beds.


It noted that the government's order mentions the names of oxygen refiller units that would supply the gas cylinders to the hospitals here and directed the state to implement it forthwith.


Following a court's order, some of the refillers were present in the hearing and assured the bench that they will comply with the government's order in letter and spirit and also made some suggestions to streamline the supplies to hospitals and individuals.


The court appealed to citizens not to hoard oxygen cylinders and medicines required for COVID-19 patients to avoid creating artificial scarcity and make them available to people in need.


'Consider amending corona app to show which beds have oxygen support'


The Delhi High Court also issued a number of directions on categorisation of beds in the Delhi corona mobile app, setting up of helpline numbers, delay in testing and shortage of RTPCR test kits.


Justice Prathiba M Singh, while hearing several pleas with regard to non-availability of beds and shortage?of Remdesivir which is used in treatment of COVID-19, asked the Delhi government to consider amending its mobile app to display which beds have oxygen support and which do not.


The court questioned the need for providing non-oxygen support beds, saying that patients suffering from COVID-19 would normally isolate themselves at home and would seek hospitalisation primarily when oxygen support was required.


The court also asked the Delhi government and the hospitals to consider indicating on the corona mobile app the waiting list for beds in each hospital and also the medical institutions where the beds would be instantly available.


On the grievance of some petitioners that telephones of hospitals are always busy, the court asked the Delhi government whether a helpline can be set up in each hospital "which will ring on rotational basis and can be manned, even remotely, by the nodal officers allocated to a bunch of hospitals".


The court said it was told that delay in testing was occurring due to shortage of testing kits. It asked the Delhi government to interact with the labs to find out why the delays were occurring and whether there was any shortage of testing kits and also what remedial measures can be taken.


Insurance firms asked to clear bills quickly to prevent delay in patient discharge


The Delhi High Court on Wednesday said insurance companies cannot take 6-7 hours for approving bills of COVID-19 patients as it delays their discharge from hospitals and those in need for beds have to wait longer.


Justice Prathiba M Singh said if the court comes to know of an insurance company or a third-party administrator (TPA) processing insurance claims taking 6-7 hours for clearing bills, contempt action would be taken against them.


A few minutes after her order, a similar direction was passed by a bench of Justices Vipin Sanghi and Rekha Palli which directed insurance companies and TPAs to ensure that time taken to grant approvals to bills was reduced to a reasonable amount as there were long queues of people outside hospitals waiting for beds during the massive surge in COVID-19 infections. 


Justice Singh said in her order that insurance companies or TPAs should not take more than 30-60 minutes to grant approval to the bills on receiving the request from hospitals and directed insurance regulator IRDAI to issue instructions in this regard.


The division bench, in its order, said delay in discharging patients was leading to delay in admitting needy patients and was causing more suffering to them.


The direction by the division bench came after it was informed by some hospitals and lawyers that delay in approvals by insurance companies and TPAs was resulting in delay in discharging patients and admitting new ones.


(With PTI Inputs)