Guidelines for optimum usage of oxygen to be presented to all hospitals across Karnataka: Karnataka High Court

 1 CJ & AKJ: Through Video Conferencing) and connected matters Firstly we deal with the issue of allocation distribution of oxygen in various districts and taluks of the State. A draft of the guidelines has been placed on record by the learned Additional Advocate General. He categorically states that as of today there is no exhaustive written protocol or guidelines for the benefit of the hospitals in the districts and taluks about securing the supply of oxygen. He states that the State Government will immediately issue exhaustive guidelines for the benefit of all the hospitals across the State whether Government or private dealing with all the aspects of the supply and utilization of oxygen. The written submissions filed today show that helplines have been created attached to Oxygen Control Room. The telephone numbers of the helplines have been mentioned in paragraph 6 of the written submissions filed today which are referred in the letter dated 5th May 2021 addressed by the State Nodal Officer Oxygen Distribution to the Chief Commissioner of 2 Bruhat Bengaluru Mahanagar Palike and all the Deputy Commissioners of the districts. We direct the State Government to ensure that the information about the helplines is made available to each and every hospital in the State which is admitting COVID 19 patients. The Deputy Commissioners and Assistant Commissioners shall be issued immediate directions to communicate the availability of helplines to all the COVID hospitals within their respective jurisdictions. We direct that this exercise shall be completed immediately as the State can always send the necessary details by e mail and by the use of social media. Even the guidelines framed for the optimum use of oxygen which are produced along with the written submissions of 4th May 2021 shall be made available across the State to all the hospitals. It appears that a centralized database of the locations of manufacturing plants of oxygen and bottling plants of oxygen in the State the capacity of such manufacturing bottling plants and the availability of the quantity of oxygen in those plants has not been created. Even the centralized data of the requirement of oxygen of various districts and taluks is not available. The War 3 Room created by the State Government for dealing with the requirements of oxygen can work efficiently provided centralized data as aforesaid is made available and real time updation thereof is made. The State Government shall take immediate steps in this behalf. As regards additional quota of 100 MT of oxygen per day made available to the State from 1st May 2021 the learned Advocate General stated that 60 MT per day is allowed to be lifted from the units at Ballari and 40 MT per day is required to be from Kalinga Odisha. He states five empty containers tankers having a capacity of 74 MT each have been sent to Odisha by air. He states that the filled tankers containers will be back in the State approximately within 48 hours. He states that the Government of India has allotted to the State a quota of 20 MT of oxygen which has been received from Beharain and 20 MT from Saudi Arabia. As regards Pressure Swing Absorption PSA) units the learned Advocate General stated that the Government of India has permitted the State Government to set up 28 such units attached to various hospitals which will manufacture 500 litres of oxygen per minute. Each unit will take 4 care of the need of about 15 20 patients. He states that the State Government is procuring another 40 PSA units. He stated that by 15th May 2021 6 10 PSA units in the State will become functional and by the end of May the remaining units will become The learned Advocate General further stated that as per the order passed by this Court yesterday the Hon ble Minister of the Department of Industries of the State Government has already made a request to the Government of India to allow utilization of the entire production of oxygen within the State itself. Now we come to the important issue of vaccination. In the written submissions filed today by the State Government it is stated that through the Central Government and through its own resources the State Government has till 5th May 2021 procured 1 08 49 470 doses of vaccine which consists of doses of COVISHIELD and COVAXIN. Paragraph 14 of the written submissions of the State Government records that out of the total of 1 08 49 470 doses 1 00 72 795 doses have been already administered. Thus what remains as of today which is available in the State is a quantity of only 7 76 675 doses. We must note 5 here that 1 00 72 795 doses cover all the categories including the category of the age group of 18 44 years. The figures given in paragraph 14 indicate that as on 5th May 2021 83 28 241 beneficiaries were vaccinated for the first dose and about 17 44 554 beneficiaries were vaccinated for the second dose. Thus 65 83 687 beneficiaries need the second dose. The learned counsel representing the Central Government Shri Shivakumar stated that the second dose has to be administered within the time span prescribed which is recorded in the FAQs Frequently Asked Questions) posted by the Health Ministry of the Government of India on its website. Thus the scenario which emerges as of today is that out of 65 83 687 beneficiaries who have taken the first dose only 7 76 675 persons can be provided with the second dose. Shri Shivakumar states that as far as the categories of Healthcare Workers Frontline Workers and citizens who are aged 45 years and above are concerned free vaccine is made available by the Central Government the State Governments which can be administered through the public hospitals. He states that as regards vaccination to the age group 6 of 18 44 years the State Government can directly place orders with the manufacturers of the vaccine. At this stage the learned Amicus Curiae Shri Vikram Huilgol states that from 1st May 2021 50% of the vaccines are required to be procured by the State Government the Central Government and remaining 50% directly from the manufacturer. Thus the present position regarding availability of vaccines in the State to say the least is shocking. The available 7 76 675 doses will have to be given firstly to those beneficiaries who have taken the first dose and in whose cases the requisite period for taking the second dose as per the mandate of the Central Government is likely to expire. The second category which deserves priority is Healthcare Workers and Frontline Workers. In short as the situation prevails today it is virtually impossible for the citizens to get the first dose of vaccine unless they fall in the category of Healthcare Workers and Frontline Workers. The learned Additional Advocate General states that an indent has been submitted by the State Government to the manufacturer for procuring the supply of vaccines. 7 9. We direct the State Government to immediately submit an indent requisition to the concerned authority of the Central Government for supply of the required quantity of free doses of vaccines. All the details shall be provided by the State Government in the requisition. The State Government will also specify the number of beneficiaries who are likely to be deprived of the advantage of the first dose if the second dose is not We direct the State Government to submit the indent requisition with all particulars to the concerned authority of the Central Government during the course of the day. The concerned authority of the Central Government shall take an appropriate decision immediately and in any event within three days from the date of receipt of the requisition. We may note here that considering the figures which are set out in the written submissions filed today by the State Government there is hardly any stock of vaccine available in the State for administering the first dose as well as the second dose. We hope and trust that this critical situation will be considered by the Central Government while dealing with the requisition made 8 by the State Government. The learned Additional Advocate General states that a requisition has been submitted to a manufacturer on 3rd May 2021 for vaccines to the age group of 18 44 years. But so far the doses of vaccine have not been received by the State Government. It is necessary for the Central Government to take up the issue with the manufacturer of the vaccine so that the State Government can immediately procure the quota of vaccines for the age group of 18 44 years. In W.P. No.8651 of 2020 though the petition is filed by one of the Trusts along with certain individuals prima facie it appears that it is for espousing the cause of private COVID Vaccination Centres. The challenge is essentially to clauseof the order dated 21st April 2021. Prima facie at this stage we find nothing wrong with clauseof the said order. However as we are dealing with the issue of vaccination we keep the petition pending. It will be heard along with the main petition. In W.P.No.8773 2021 the first substantive prayer is for directing the State Government to pay ex gratia of compensation to the victims of the incident at Chamarajanagar District. This 9 prayer will have to be kept pending till the preliminary report of inquiry either by the officer appointed by the State Government or by the Committee appointed by the Legal Services Authority is placed on record. The second prayer seeks conduct of the autopsy on the bodies of the persons who have died due to COVID 19. We do not think that at this stage we can issue a direction to the State Government to undertake the autopsy of each and every person who has allegedly died due to infection of COVID 19. The third prayer is for holding an enquiry into the incident that occurred at Kalaburagi District. At this stage we need not consider this prayer. However as the prayer of compensation is made the petition shall be kept pending and it shall be heard along with other petitions. I.A.No.4 of 2021 has been filed in W.P.No.8619 of 2020. We direct the respondents to respond to the interlocutory application either by filing a statement of objections or by filing written submissions before the next date. I.A.No.3 of 2021 has been filed in WP No.6435 of 2020. This interlocutory application raises an important issue regarding 10 those who are residing in slums in the city of Bengaluru. The learned counsel appearing for the applicant states that there are about 1 000 slums in the city of Bengaluru and a large population in the city is occupying the slums. We direct the State Government to file written submissions statement of objections dealing with this application and come out with a scheme for ensuring that COVID 19 does not spread in the slums in the city. The written submissions statement of objections shall be filed on or before next date. As regards vaccination our attention is invited to certain observations made by the Apex Court in its order dated 30th April 2021 wherein the Apex Court has noted certain issues in paragraph 37. No citizen is entitled to vaccination unless he complies with the mandatory requirement of registration. The State Government will have to evolve a scheme for assisting the citizens for getting themselves registered. Assistance will have to be rendered to the citizens belonging to the vulnerable sections of the society to get themselves registered. Unless people belonging to the vulnerable sections get registered and get vaccinated the very purpose of vaccination will be frustrated. 11 The second issue which the State Government will have to be respond on the next date is regarding undertaking targeted vaccination drives of frontline workers such as crematorium workers Healthcare Workers etc. The State Government s response is necessary on this issue on the next date. 16. At this stage the learned counsel appearing for BBMP states that as of now only 38 HDU beds 20 ICU beds and 9 ICU with Ventilator beds are vacant in the city of Bengaluru. About 1 933 general beds are available. The situation about the availability of beds in the city continues to be very critical. However the learned counsel Shri.V.Sreenidhi states that several efforts are being made to provide additional beds. He states the Chief Commissioner of BBMP is also doing the exercise of ascertaining Ward wise availability of oxygen. He states that all these initiatives will be placed on record on the next date. Compliances made not only with this order but the earlier orders will have to be reported by all the parties by 10th May 2021. We also direct the State Government to place on record the decision taken on the issue of food security by 10th May 2021. We have already clarified in the earlier order that after 12 identification of the vulnerable sections of society by the State Government the benefits which are ordered to be provided under the orders of the Court passed in these petitions shall be immediately made available to the vulnerable sections. The order passed on the last date refers to specific orders passed by this Court dealing with the issue of food security. 18. Further hearing of this group of matters will be on 11th May 2021 at 11.00 a.m. Sd CHIEF JUSTICE Sd vgh DR 

Summary: Information about helplines connected to Oxygen Control Room must be made available to each and every hospital in the State that is admitting Covid-19 patients. The bench of Chief Justice Abhay Oka and Justice Aravind Kumar in Re Karnataka High Court case [W.P.No.6435/2020] dealt with guidelines framed for optimum use of oxygen and the requirement of distribution of centralized data across various districts, taluks and cities in Karnataka. The learned Advocate general representing the State expressed that the Central Government has allotted 20MT of oxygen to the State, to be received from Bahrain and Saudi Arabia individually. Further, he stated that the Central Government had permitted the State Government to attach 28 centres that will manufacture 500 litres of oxygen per minute which are linked to various hospitals. The second issue that was dealt with by the Advocate General was the subject of vaccination. He stated that the State had procured around one crore doses of vaccine out of which around 7 lakh doses of vaccine are remaining. The learned counsel representing Central Government, stated that the second dose has to be administered within the prescribed period. According to today’s scenario, out of the 65 lakh beneficiaries who have taken the first dose, only 7 lakh of them can be provided with the second dose. With regards to the facts stated above, pertaining to the first issue, the Court held that; a centralised database of the locations of oxygen manufacturing plants must be made known to all those hospitals that admit covid-19 patients, including those hospitals in districts and taluks. Apart from providing details on where these oxygen centres are located, effective guidelines on the optimum usage of oxygen must also be circulated to these hospitals. With regards to the second issue regarding vaccine availability, the court held that priority of administering vaccine must be given to those beneficiaries who have taken the first dose and are due for the second dose. The Court directed the State Government to request Central Government for the required quantity of free doses. Since the situation is critical, the Court hopes the Central Government will consider the request made by the State Government and take actions in furtherance of the same. The Bench hence sounded the judgment that; “Unless people belonging to the vulnerable sections get registered and get vaccinated, the very purpose of vaccination will be frustrated.  The second issue which the State Government will have to be respond to on the next date is regarding undertaking targeted vaccination drives of frontline workers such as crematorium workers, Healthcare Workers, etc.” Click here to read judgement