Lok Sabha Question No. 3012 (UNSTARRED), answered on 2021-08-06
Subject: Primary Transmission Route of Coronavirus
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Margani Bharat

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH RESEARCH

## LOK SABHA UNSTARRED QUESTION NO.3012

TO BE ANSWERED ON 06 th  August, 2021

## PRIMARY TRANSMISSION ROUTE OF CORONAVIRUS

## 3012   SHRI MARGANI BHARAT:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government has taken cognizance of the recent publication in 'The Lancet' which  indicates  that  there  is  a  strong  evidence  that  the  primary  transmission  route  of Coronavirus is airborne, if so, the details thereof;
- (b) whether the second wave in the country was caused due to airborne transmission of the COVID-19 virus, if  so,  the  details  of  public  health  measures  taken  in  this  regard  by  the Government in coordination with States/UTs;
- (c) whether  the  Government  is  aware  that  six  experts  from  US,  UK  and  Canada  identified some evidence which supports spread  of Coronavirus through air;
- (d) if so,  details of such evidence and the manner in which the Government proposes to plan ahead; and
- (e) the assessment of the Government about the third wave?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a)  to  (e)  Government  of  India  has  provided  the  required  technical  support  and  has  also supported the states through logistic and financial support to further strengthen the existing health infrastructure to tackle COVID-19 pandemic. Some of the ongoing initiatives to further strengthen healthcare infrastructure are as follows :
-  With  the  intent  to  reduce  the  risk  of  cross  infection  to  non-COVID  patients  a  well  as  to maintain continuity of non-COVID  essential  health services in the country, a three-tier arrangement  of  dedicated  COVID-19  health  facilities  [(i)  COVID  Care  Center  (CCC);  (ii) Dedicated COVID Health Centre (DCHC) and (iii) Dedicated COVID Hospital (DCH)] has been implemented in the country.
-  Government  of  India  ,  to  supplement  the  hospital  facilities  has  roped  in  tertiary  care hospitals under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. Further, many large temporary treatment facilities were established by DRDO to manage surge in COVID-19 cases in the country.

 The isolation bed capacity and ICU bed capacity which was only 10,180 and 2,168 before the first  lockdown (as on 23 rd March 2020) is being enhanced continuously and is currently at 18,03,266 isolation beds and 1,24,598 ICU beds (as on 3 rd August,2021).

 There are 2808 labs reporting to ICMR for COVID-19 testing and they have tested 46.96 crore  samples.  1373  diagnostic  kits  have  been  evaluated  out  of  which  673  have  been recommended. Also, the testing kits and equipment have been made available on Government e-Marketplace (GeM) for procurement by States.

 The  daily  liquid  medical  oxygen  (LMO)  supply,  which  was  about  1292  MTs  per  day  in February 2021 increased to 8593 MTs in April 2021. On 28 th May 2021, a total of 10,250 MTs of LMO was allocated to the states. This was done by enhancement of LMO production in steel plants as well as in other LMO plants. Restrictions were imposed on industrial use of oxygen.

 A dynamic and transparent framework for allocation of medical oxygen in consultation with States/UTs and all the stakeholders such as relevant Ministries, manufacturers/suppliers of liquid oxygen etc. was prepared.

 Online  digital  solutions  viz.  Oxygen  Demand  Aggregation  system  (ODAS)  and  Oxygen Digital  Tracking  System  (ODTS)  have  been  developed  to  ascertain  the  demand  for  medical oxygen from all medical facilities and to track their transportation.

 To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued on 25 th September 2020, and further revised and disseminated to States on 25 th April 2021.

 1,02,400  oxygen  cylinders  were  procured  in  April  and  May  of  2020  and  distributed  to States. Further orders for additional 1,27,000 cylinders have been placed on 21.04.2021 (54,000 jumbo  cylinders  (D  type)  and  73,000  regular  cylinders  (B  type).  Deliveries  of  the  same  have started and 73,352  cylinders have been delivered as on 3 rd August 2021.

 To generate oxygen at the health facility level, PSA plants are being established in each district hospitals, especially in far flung areas enabling the hospitals to become self-sufficient in generation  of  oxygen  for  their  needs  and  thereby,  reduce  the  burden  on  the  medical  oxygen supply grid across the country.

 Further, to fast-track the availability of Medical Oxygen in rural and peri-urban areas, more than 39,000 oxygen concentrators have been allocated to various States.

 A  COVID  Drugs  Management  Cell  (CDMC)  has  been  set  up  in  the  Department  of Pharmaceuticals (DoP) to oversee the management of smooth supply of drugs used in COVID19 management.

 A Drugs Coordination Committee  (DCC)  has  been  constituted as an institutional mechanism under Department of Pharmaceuticals for efficient decision making on all the issues with respect to COVID-19  related  drugs  including availability through inter-departmental consultations.

 Remdesivir is a patented drug, manufactured in India under voluntary licenses granted by Gilead Life Sciences USA  (the patent holder) to 7 Indian pharmaceutical companies. Manufacturing capacity was augmented from 38 lakh vials per month in March 2021 to nearly 122  lakh  vials  per  month  in  June  2021.  In  addition,  40  additional  manufacturing  sites  were approved by the CDSCO, thus increasing the manufacturing sites from 22 (in March 2021) to 62 (June 2021).

 All States /UT and State Drugs Controllers have been requested to verify stock of drugs and check other malpractices and take effective steps to curb hoarding and black marketing of some drugs like Remdesivir.

 Department  of  Pharmaceuticals  and  the  Drug  Controller  General  of  India  (DCGI)  have actively  coordinated  with  the  industry  to  enhance  availability  of  Amphotericin  B  through identification of manufacturers, alternate drugs and expeditious approvals of new manufacturing facilities.

 Besides, the existing five manufacturers, DCGI had issued permissions to manufacturing /marketing of Amphotericin B Liposomal Injection to six additional firms.

 The guiding principle to avert/ minimize the risk of future resurgence of COVID - 19 cases in  the  country  remains  the  five  fold  strategy  of  test  -  track  -  treat  -  vaccinate  and  COVID appropriate behaviour.

 Ministry  of  Health  and  Family  Welfare  continues  to  provide  technical  guidance  for managing  various  aspects  of  COVID-19.  So  far  more  than  150  guidelines  /  advisories  / SoPs/plans have been provided to States/UTs. Taking note of ingress of COVID-19 pandemic in peri-urban and rural areas, Ministry of Health & Family Welfare on 16 May, 2021 issued a SOP on COVID-19 Containment & Management in Peri- urban , Rural & Tribal areas.

 Further COVID-19 treatment protocols and advisories both for adults as well as paediatric age groups were issued and widely disseminated to promote rational use of drugs and oxygen.

 During the F.Y. 2019 -20, funds to the tune of Rs 1113.21 crore was released to the States /UTs under NHM towards management and containment of COVID-19 pandemic.

 In September 2020, the Union Government further allowed use of SDRF by the States for oxygen  generation  and  storage  plants  in  hospitals  ;  strengthening  ambulance  services  for transport of patients ; and setting up containment zones , COVID-19 care centres. States were allowed to spend maximum 35% of annual allocation of funds under SDRF for the financial year 2019-20. The ceiling was further enhanced to 50% during the financial years 2020-21 and 202122 for containment measures of COVID-19.

 During the FY 2020-21, funds to the tune of Rs 8257.88 crore has been released to the States/UTs towards the India COVID-19 Emergency Response and Health System Preparedness Package.

 In  addition,  'India  COVID-19  Emergency  Response  and  Health  System  Preparedness Package;  Phase-II'  has  also  been  approved  by  the  Cabinet  with  Rs  23,123  crores  (with  Rs 15,000 Cr as Central Component & Rs 8,123 Cr as State component) and is to be implemented from 1 st July 2021 to 31 st March 2022. So far Rs 1827.78 crore has been released to States /UTs in  2021.  So  far  Rs  1827.78  crore  has  been  released  to  States/UTs  in  2021-22  under  ECRP Phase-II in FY 2021-22.

 It includes support to State/UT level for ramping up Health Infrastructure including those in rural , tribal and peri-urban areas closer to the community, providing support for procurement of drugs  and  diagnostics  to  enhance  service  delivery  at district and  sub  district level for management  of  a  buffer  of  drugs  ,  support  for  IT  Interventions  such  as  implementation  of Hospital  Management  Information  System  and  expanding  access  to  tele-consultations  in  all districts, and support  for capacity building and training for all aspects of management of COVID19.

-  Further, under the National COVID Vaccination Program, Government of India is procuring vaccines and providing them free of cost to States and UTs. As on 3 rd August 2021, a total of about 50.21 crore doses have been supplied to States/UTs from all sources i.e. Government of India's  Covid  vaccine  supply  free  of  cost  to  all  States/UTs.  States/UTs  and  Private  Hospitals procured Covid vaccine.

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