Lok Sabha Question No. 745 (UNSTARRED), answered on 2021-07-23
Subject: Shortage of Multiple Medical Equipments
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DNV Senthilkumar. S., Harsimrat Kaur Badal, Deepak Baij, Satyadev Pachauri, Subhash Ramrao Bhamre, Kuldeep Rai Sharma, Manickam Tagore B, Sunil Dattatray Tatkare, Amol Ramsing Kolhe, Supriya Sadanand Sule

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

LOK  SABHA UNSTARRED QUESTION NO. 745 TO BE ANSWERED ON 23 RD JULY, 2021

## SHORTAGE OF MULTIPLE MEDICAL EQUIPMENTS

## 745. DR. DNV SENTHILKUMAR. S.:

SHRIMATI HARSIMRAT KAUR BADAL:

SHRI DEEPAK BAIJ:

SHRI SATYADEV PACHAURI:

DR. SUBHASH RAMRAO BHAMRE:

SHRI KULDEEP RAI SHARMA:

SHRI MANICKAM TAGORE B.:

SHRI SUNIL DATTATRAY TATKARE:

DR. AMOL RAMSING KOLHE:

SHRIMATI SUPRIYA SULE:

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

- (a) whether the country faced acute shortage of oxygen, ventilators and critical care medicines duringrecent search in COVID - 19 cases in the country and if so, the details thereof;
- (b) the number of deaths reported due to shortage of these items and corrective measures taken by the Government in this regard, State/UT - wise;
- (c) the details of proposals accepted and financial grants released by the Government for setting up ofoxygen plants during the last two years, State/UT - wise including Maharashtra and Tamil Nadu;
- (d) the quantum of funds realeased and utilised on the purchase of multiple medical equipments including ventilators and critical care medicines since January 2020 and also the number of these provided to hospitals, State/UT - wise;
- (e)  the  other  steps  taken  by  the  Government  to improve  oxygen  production  and  set  up  more oxygen bedand ventilators to fight the coming waves of Covid - 19;and
- (f) whether the Government has affixed any responsibility on sudden non - provisioning of oxygen by the authorities that resulted into death of lakhs of people and if so, the details thereof and steps taken to curb reoccurence of such disasters in future?

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

- (a) to (f) : Ministry  of  Health  &  Family  Welfare  monitors  cases  of  COVID - 19  and  its management as per the details provided by the States. A surge in cases which w as noted during May  2021,  and  a  peak  of  more  than  4  lakh  cases  per  day  was  observed  during  the  per straining the available health infrastructure at the state level.

Health  is  a  state  subject.  MoHFW has  conveyed  to  States/UTs,  WHO  and  ICMR guidelines  on  correct  recording  of  COVID - 19  related  deaths  in  accordance  with  globally accepted ICD - 10 classification. In addition, the issue of correct and timely reporting o has also been stressed to all States/UTs through video conferences and formal communication. Accordingly, the details are obtained from states/UTs.

It has been noted that some of states based on reconciliation of mortality data ha revised the reported COVID - 19 deaths. All stat es have also been advised that while reconciling the data, the details of deaths shall be indicated date wise & district wise to get corre the pandemic. States have also been regularly advised to undertake death audit to ascer cause of deaths and undertake measures for improving quality of healthcare services.

Union Government has provided the required technical support and has also support the  states  through  logistic  and  financial  support  to  further  strengthen  the  existi in frastructure.

Some of the ongoing initiatives include:

- Government of India, to supplement the hospital facilities has roped in tertiary care under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. Further, many temporary  t reatment  facilities  were  established  by  DRDO  to  manage  surge  in  COVID - 19 cases in the country.
- Due to concerted actions of Central and State Governments, the isolation bed capacit ICU bed capacity which was only 10,180 and 2,168 before the first lockd own (as on 23 rd March 2020) in being enhanced continuously and is currently at 18,21,845 isolation bed 1,22,035 ICU beds (as on 20 th July 2021).
- The daily liquid medical oxygen (LMO) production, which was about 5700 MTs per day in August  2020increased  to  a  high  of  9690  MTs  as  on  13 th May  2021.  This  was  done  by enhancement of LMO production in steel plants as well as in other LMO plants.
- A system for real - time monitoring of oxygen production in steel plants and distribution oxygen to States /UTs was also put in place.
- Restrictions were imposed on industrial use of oxygen.
- A dynamic and transparent framework for allocation of medical oxygen in consultation States/UTs and all the stakeholders such as relevant Ministries, manufacturers/s uppliers of liquid oxygen etc. has been prepared.
- Online  digital  solutions  viz.  Oxygen  Demand  Aggregation  system  (ODAS)  and  Oxygen Digital Tracking System (ODTS) have been developed to ascertain the demand for medica oxygen from all medical facilities an d to track their transportation.
- To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued 25 th September 2020, and further revised and disseminated to States on 25 th April 2021.
- 1,02,400 oxygen cylinders were procured in Apr il and May of 2020 and distributed to States. Further orders for additional 1,27,000 cylinders have been placed on 21 st April 2021, (54,000 jumbo cylinders (D type) and 73,000 regular cylinders (B type). Deliveries of the same started and 24,207 (24,5 11 B- type and 8,893 D - type) cylinders have been delivered as on 7 th July 2021. In addition, around 4962 B - type and 1895 D - type cylinders are in - tra sit.
- To generate oxygen at the health facility level, PSA plants are being established in h especia lly 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 across the country.
- Further, to fast - track the availability of Medical Oxygen i n rural and peri - u ban areas, more than 18,000 Oxygen Concentrators have been allocated to various States.
- Remdesivir is a patented drug, manufactured in India under voluntary licenses grant Gilead  Life  Sciences  USA  (the  patent  holder)  to  7  Indian  ph armaceutical  companies. Manufacturing capacity was augmented from 38 lakh vials per month to nearly 122 lakh vi per month. In addition, 40 additional manufacturing sites were approved by the CDSCO, t increasing the manufacturing sites from 22 to 62.
- All States/UT and State Drugs Controllers have been requested to verify stock of the and check other malpractices and take effective steps to curb hoarding and black mark of Remdesivir.
- Ministry  of  Health  &  Family  Welfare  also  continues  to  prov ide  technical  guidance  for managing various aspects of COVID - 19. So far more than 150 guidelines/advisories/SoPs/plans have been provided to States/UTs.
- During  the  F.Y.  2019 -20  funds  to  the  tune  of  Rs.1113.21  crore  was  released  to  the States/UTs  under  NHMtowards  management  and  containment  of  COVID - 19  pandemic. Details are given at Annexure I .
- During  the  FY  2020 - 21,  funds  to  the  tune  of  Rs.8257.88  crore  has  been  released  to  t States/UTs towards the India COVID - 19 Emergency Response and  Health System Prep aredness Package, through Agency -National Health Mission (NHM). Details are given at Annexure II . The funds are released as total grants and not distributed item wise.
- In addition, 'India COVID - 19 Emergency Response & 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 as State component) and is to be implemented from 1s July 2021 to 31" March 2022. It includes su pport 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 delive district and sub district levels for management of COVID - 19 cases (including pediatric care) and for maintaining a buffer of drugs, support for IT Interventions such as implementa Hospital Management Information System and expanding access to tele -consultations in all distri cts,  and  support  for  capacity  building  and  training  for  all  aspects  of  managem COVID - 19.

## Central Release of Grants in aid for management and containment COVID-19

| S. No.   | Name of the State /UTs            | Central Releases (2019-20) In Rs. Crore   |
|----------|-----------------------------------|-------------------------------------------|
| 1        | Andaman & Nicobar Islands         | 0.74                                      |
| 2        | Andhra Pradesh                    | 37.11                                     |
| 3        | Arunachal Pradesh                 | 8.91                                      |
| 4        | Assam                             | 72.73                                     |
| 5        | Bihar                             | 66.79                                     |
| 6        | Chandigarh                        | 1.04                                      |
| 7        | Chhattisgarh                      | 25.97                                     |
| 8        | Dadra & Nagar Haveli              | 0.52                                      |
| 9        | Daman & Diu                       | 0.45                                      |
| 10       | Delhi                             | 22.26                                     |
| 11       | Goa                               | 1.48                                      |
| 12       | Gujarat                           | 29.69                                     |
| 13       | Haryana                           | 37.11                                     |
| 14       | Himachal Pradesh                  | 18.55                                     |
| 15       | Jammu &Kashmir (including Ladakh) | 29.69                                     |
| 16       | Jharkhand                         | 25.97                                     |
| 17       | Karnataka                         | 59.37                                     |
| 18       | Kerala                            | 74.21                                     |
| 19       | Lakshadweep                       | 0.22                                      |
| 20       | Ladakh                            | -                                         |
| 21       | Madhya Pradesh                    | 55.66                                     |
| 22       | Maharashtra                       | 74.21                                     |
| 23       | Manipur                           | 5.94                                      |
| 24       | Meghalaya                         | 5.94                                      |
| 25       | Mizoram                           | 3.71                                      |
| 26       | Nagaland                          | 3.71                                      |
| 27       | Orissa                            | 37.11                                     |
| 28       | Puducherry                        | 0.74                                      |
| 29       | Punjab                            | 40.82                                     |
| 30       | Rajasthan                         | 85.35                                     |
| 31       | Sikkim                            | 2.98                                      |
| 32       | Tamil Nadu                        | 48.24                                     |
| 33       | Telangana                         | 33.40                                     |
| 34       | Tripura                           | 7.42                                      |
| 35       | Uttar Pradesh                     | 132.09                                    |
| 36       | Uttarakhand                       | 18.55                                     |
| 37       | West Bengal                       | 44.53                                     |
|          | Grand Total                       | 1,113.21                                  |

## Note:

1. For the FY 2020-21, the UT of Dadra & Nagar Haveli and Daman & Diu have been combined.

## Central Release of Grants in aid under the India COVID-19 Emergency Response and Health System Preparedness Package during the FY 2020-21

| S. No.   | Name of the State /UTs           | Central Releases In Rs. Crore   |
|----------|----------------------------------|---------------------------------|
| 1        | Andaman &Nicobar Islands         | 14.80                           |
| 2        | Andhra Pradesh                   | 422.67                          |
| 3        | Arunachal Pradesh                | 21.96                           |
| 4        | Assam                            | 216.69                          |
| 5        | Bihar                            | 193.94                          |
| 6        | Chandigarh                       | 35.92                           |
| 7        | Chhattisgarh                     | 109.21                          |
| 8        | Dadra& Nagar Haveli &Daman & Diu | 4.67                            |
| 9        | Delhi                            | 787.91                          |
| 10       | Goa                              | 17.65                           |
| 11       | Gujarat                          | 304.16                          |
| 12       | Haryana                          | 187.71                          |
| 13       | Himachal Pradesh                 | 54.48                           |
| 14       | Jammu & Kashmir                  | 194.58                          |
| 15       | Jharkhand                        | 70.84                           |
| 16       | Karnataka                        | 409.63                          |
| 17       | Kerala                           | 573.96                          |
| 18       | Ladakh                           | 44.77                           |
| 19       | Lakshadweep                      | 0.79                            |
| 20       | Madhya Pradesh                   | 286.57                          |
| 21       | Maharashtra                      | 1,185.12                        |
| 22       | Manipur                          | 19.92                           |
| 23       | Meghalaya                        | 14.82                           |
| 24       | Mizoram                          | 8.86                            |
| 25       | Nagaland                         | 10.27                           |
| 26       | Orissa                           | 146.44                          |
| 27       | Puducherry                       | 23.35                           |
| 28       | Punjab                           | 165.28                          |
| 29       | Rajasthan                        | 426.39                          |
| 30       | Sikkim                           | 7.16                            |
| 31       | Tamil Nadu                       | 868.09                          |
| 32       | Telangana                        | 386.37                          |
| 33       | Tripura                          | 23.21                           |
| 34       | Uttar Pradesh                    | 541.56                          |
| 35       | Uttarakhand                      | 72.25                           |
| 36       | West Bengal                      | 295.28                          |
|          | Total                            | 8,147.28                        |
|          | Health Insurance Grand Total     | 110.6 8,257.88                  |