Lok Sabha Question No. 267 (STARRED), answered on 2021-08-06
Subject: SARS-CoV-2
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Gaurav Gogoi, Kani K. Navas

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

## LOK SABHA STARRED QUESTION NO. 267 TO BE ANSWERED ON 06 th  AUGUST, 2021

SARS-COV-2

## 267 SHRI GAURAV GOGOI ; SHRI K. NAVASKANI

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

- (a)   the  precise  date  in  March,  2021  when  scientists  of  the  Indian  SARS-CoV-2 Genomics Consortium (INSACOG) had warned the Government about a new and more contagious variant of the virus;
- (b)   the  date  on  which  the  Government  took  cognizance  of  the  aforementioned warnings and made them public;
- (c)   whether phrases like 'high concern' were removed from the draft prepared by the INSACOG in the statement shared with the public; and
- (d)   if so, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI MANSUKH MANDAVIYA)

(a) to (d) A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 267* FOR 6 TH  AUGUST, 2021.

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(a) to (d): Health though is a state subject, but 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 include:

-  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  to reduce the risk of cross infection to non-COVID patients as well as to maintain continuity of non-COVID essential health services in the country.
-  Government of India has roped in tertiary care hospitals under other ministries to  supplement the hospital facilities. 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 was also enhanced continuously.
-  The daily liquid medical oxygen (LMO) supply was increased by enhancement of  LMO  production  in  steel  plants  as  well  as  in  other  LMO  plants.  Further, restrictions were also imposed on industrial use of oxygen.
-  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.
-  To generate oxygen at the health facility level, PSA plants are being established in  each  district  hospitals  to  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 COVID-19 management.
-  Action is initiated at the National level to augment production of critical drugs including import besides support in terms of equitable distribution of the critical supplies.
-  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.
-  All States/UTs  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.
-  Ministry of Health & 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.
-  Ministry of Health & Family Welfare on 16 th April 2021 issued a detailed SOP on  COVID-19  Containment  &  Management  in  Peri-urban,  Rural  &  Tribal areas. The SOP provides for strengthening primary level healthcare infrastructure at all levels to intensify COVID-19 response in peri-urban, rural &  tribal  areas,  while  continuing  to  provide  other  essential  health  services through  inter-sectoral  approach  by  involving  community-based  organizations, Village Health Sanitation and Nutrition Committees (VHSNCs), Pachayati Raj institutions, Urban Local bodies, etc.
-  Further COVID-19 treatment protocols and advisories both for adults as well as pediatric age groups were issued and widely disseminated.
-  Under  the  National  COVID  Vaccination  Program,  Government  of  India  is procuring vaccines and providing them free of cost to States and UTs.  As on 31 st July  2021,  a  total  of  about  48.40  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, State/UTs and Private Hospitals procured Covid vaccine.

Union Government has provided financial support to States/UTs for ramping up Health Infrastructure and support all aspects of management of COVID-19.

-  During the F.Y. 2019-20. funds to the tune of Rs.1113.21 crore was released to the States/UTs under NHM.
-  In  September  2020,  the  Union  Government  allowed  the  states  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 2021-22 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 & 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  2021-22 under ECRP Phase-II in FY 2021-22.

This 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  levels  for  management  of  COVID-19  cases (including pediatric care)  and for  maintaining  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 COVID-19.

From  the  beginning  of  the  Pandemic  genomic  sequencing  was  conducted through National Institute of Virology, Pune, IGIB CSIR, NIBMG under DST and NCDC to monitor the variants of SARS-CoV-2 virus.

Subsequently, Government of India established Indian SARS-CoV-2 Genomic  Consortium  (INSACOG)  in  December,  2020,  as  a  consortium  of  10 laboratories  of  Ministry  of  Health  &  Family  Welfare,  Dept.  of  Biotechnology, Indian  Council  of  Medical  Research  (ICMR)  and  Council  of  Scientific  and Industrial  Research  (CSIR).    The  network  of  INSACOG  laboratories  has  since been increased to 28.  NCDC is the nodal agency of INSACOG for communication with states regarding the public health response.

Analysis of the genomic data is a continuous and ongoing process. Periodic updates are shared with experts and states and are also regularly made available in the public domain through the media bulletin of INSACOG. Periodic releases on outcomes from INSACOG analysis have been made on Press Information Bureau. A central team led by Director NCDC was deputed to Maharashtra from 4 th -  8 th February,  2021.    The  recommendations  of  the  team  were  communicated  to  the State Government by the team itself and subsequently followed up by an advisory from Union Health Secretary.    On 24 th March, a specific advisory was sent to all states on the importance of genome sequencing and sharing data with NCDC. On 24 th March  2021,  the  release  had  highlighted  that  analysis  of  samples  from Maharashtra  has  revealed  that  compared  to  December  2020,  there  has  been  an increase in the fraction of samples with mutations that confer increased infectivity.

Besides,  the  National  Center  for  Disease  Control  has  communicated  State specific results formally to the concerned States also from time to time. MOHFW has  also  shared  the  same  with  states  though  VC  and  reviews  as  well  as  written communication from time to time as the situation aroused.

States  are  regularly  advised  to  send  samples  for  genome  sequencing  and provide clinical data of positive persons to enable greater epidemiological insights to identify link between surge in cases at various places to the variants.

While monitoring the prevalence of variants through the network of labs, as per advice from experts,   it is noted that the public health measures to manage the Pandemic,  particularly  the  new  variants,  in  the  field  and  the  treatment  protocol remain the same and the five-fold strategy of test-track-treat-vaccinate and COVID appropriate behavior is to be followed at the field level.

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