Lok Sabha Question No. 1893 (UNSTARRED), answered on 2021-07-30
Subject: COVID Preparedness
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Mahesh Sahoo

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED Q. No 1893 TO BE ANSWERED ON 30 th JULY, 2021

## COVID PREPAREDNESS

## 1893:SHRI MAHESH SAHOO

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

- ( a) whether Government has made arrangements for deploying adequate personnel in wake of a next COVID - 19 wave;
- ( b) if so, the details thereof, State/UT - wiseparticularly in Odisha;
- ( c) the details of initiatives taken in the far - flung rur l areas to counter COVID - 19; and
- ( d) other steps taken after the second wave by the Government to negate such a situati future?

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

(a) to (d) :Health is a state subject. To augment health care personnel including their ca building, Union Health Ministry has taken a number of steps to support states/UTs.

- To build the capacit ies  of  human  resources  including  the  medical  personnel,  non - medical personnel  and  front - line  workers  for  COVID -19  management  an  'Advisory  for  Human Resource Management of COVID 19' was issued to provide guidance to States/UTs on the human resources mobiliz ation, their role assignment and training requirements for COVID -19 management.
- The training resources for medical and non - medical personnel on infection prevention and control, clinical management including ventilation, logistics etc. is being updated ularly and is available on the website of Ministry of Health & Family Welfare.

healthcare

- Online training and webinars for physicians and nursing personnel have been conducted AIIMS  on  management  of  patients  with  COVID - 19,  septic  shock,  ventilation  strategy, mana gement  of  aerosol  generating  medical  procedures,  infection  and  prevention  cont practices, psychological care of patients etc.
- In addition, training modules have also been made available on iGOT online platform DOPT ( https://igot.gov.in/igot ). These include:
- o Basics of COVID - 19
- o Quarantine and isolation
- o Infection prevention through PPE
- o Psychological care of patients with COVID - 19
- o Infection prevention and control
- o Laboratory sample collection and testing
- o Clinical management of COVID- 19
- o Management of COVID -19
- o ICU Care and Ventilation Management
- Capacity building initiatives to conduct large scale containment operations for acti search  and  tracking  has  been  carried  out  through  training  of  State  Surveillance  Of ficers, Rapid Response Teams and grass root level workers/volunteers identified for surveil activities,  ASHAs,  Anganwadi  Workers,  Auxiliary  Nurse  Midwives,  National  Service Scheme,  Indian  Red  Cross  Society  volunteers,  Nehru  Yuvak  Kendra  Volunteers,  Ay ush Students and National Cadet Corps.
- A Clinical Center of Excellence (CoE) initiative has also been launched by Union Minist Health with AIIMS, Delhi as apex nodal institution and State level CoEs to provide gui on clinical management protocols . AIIMS, Delhi is conducting regular webinars on clinical management  and  related  aspects  and  the  State  CoEs  are  further  disseminating  it  to medical colleges, district and sub - district hospitals.
- In  order  to  increase  the  availability  of  trained  human resources  to  tackle  the  Covid - 19 pandemic  situation,  the  States  have  been  advised  to  explore  avenues  for  utilizat services of Medical Interns, Final Year MBBS students, Final Year PG Students (broad well as super - specialties)  as  residents,  B.Sc./G NM Qualified Nurses, Final Year GNM or B.Sc. (Nursing) students under appropriate guidance and for utilization of services o Health Care professionals based on their training and certification.
- Further,  Government  of  India's  flagship  telemedicine  p latform  'eSanjeevani'  provides  for doctor - to - doctor  consultations  where  in  all  Health  and  Wellness  Centres  under  Ayushman Bharat Scheme of Government of India are covered.

Government of India has also provided the required technical support and has support ed t e states through logistic and financial support  to  further strengthen  the  existing infrastructure to tackle COVID - 19 pandemic.

Taking note of ingress of COVID - 19 pandemic in peri - urban and rural areas, Ministry of Health & Family Welfare on 16 th May 2021 issued an SOP on COVID - 19 Containment & Management in Peri - urban, Rural & Tribal areas.

Some of the ongoing initiatives to further strengthen healthcare infrastructure include:

- With the intent 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,  a  three - tier arrangement of dedicated COVID - 19  health  facilities [(i) COVID Care Center (CC C); (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 under ESIC, Defence, Railways, par amilitary forces, Steel Ministry etc. Further, many larg 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 f irst lockdown (as on 23rd March 2020) in being enhanced continuously and is currentl 18,02,949 isolation beds and 1,24,514 ICU beds (as on 28 th July 2021).
- 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 States/UTs and all the stakeholders such as relevant Ministries, manufacturers/suppl 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 medica oxygen from all medical facilities and to track their transportation.
- To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued o 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 St Further  orders  for  additional  1,27,000  cylinders  have  been  placed  on  21.04.2021  (54 jumbo cylinders (D type) and 73,000 regular cylinders (B type). Deliveries of the same started and 53,056 (40,729 B - type and 12,327 D - type) cylinders have been del ivered as on 26th July 2021.
- To  generate  oxygen  at  the  health  facility  level,  PSA  plants  are  being  established district hospitals, especially in far flung areas enabling the hospitals to become sel - sufficient in generation of oxygen for their need s 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  i COVID - 19 management.
- Action is initiated at the National level to augment production of critical drug s including import besides support in terms of equitable distribution of the critical supplies.
- A Drugs Coordination Committee (DCC) has been constituted as an institutional mechanis under Department of Pharmaceuticals for efficient decision making on al l 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 grant 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 manufacturin were approved by the CDSCO, thus increasing the manufacturing sites from 22 (in March 2021) to 62 (in June 2021).
- 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.
- Department  of  Pharmaceuticals  and  the  Drug  Controller  General  of  India  (DCGI)  hav actively  coordinated  with  the  industry  to  enhance  availability  of  Amphotericin  B  th identification of manufacturers, alternate drugs and expeditious approvals o f new manufacturing facilities.
- Besides, the existing five manufacturers, DCGI had issued permissions to manufacturi marketing of Amphotericin B Liposomal Injection to six additional firms.
- Ministry of Health & Family Welfare continues to provide tech nical guidance for managing various aspects of COVID - 19. So far more than 150 guidelines/advisories/SoPs/plans have been provided to States/UTs.
- Under the National COVID Vaccination Program, Government of India is procuring vaccines and providing them free of cost to States and UTs. As on 25th July 2021, a total of abo 44.91  crore  doses  have  been  supplied  to  States/UTs  from  all  sources  i.e  Government India's Covid vaccine supply free of cost to all States/UTs, State/UTs and Private Hospitals procured C ovid vaccine.
- Ministry of Health & Family Welfare continues to provide technical guidance for manag 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  t he  tune  of  Rs.1113.21  crore  was  released  to  the States/UTs under NHM towards management and containment of COVID -19 pandemic.

- Earlier in September 2020, the Union Government further allowed use of SDRF by the Sta 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 financi year 2019 - 20. The ceilin g was further enhanced to 50% during the financial years 2020 - 21 and 2021 - 22 for containment measures of COVID - 19.
- Further, during the F.Y. 2020 - 21, funds to the tune of Rs.8257.88 crore has been released t the  States/UTs  towards  the  India  COVID - 19  Emergency  Response  and  Health  System Preparedness Package.
- 'India COVID - 19 Emergency Response & Health System Preparedness Package: Phase -II' has  been  approved  by  the  Cabinet  with  Rs  23,123  crores  (with  Rs.  15,000  Cr  as  Cent Component & Rs 8,123 as State comp onent) and is to be implemented from 1st July 2021 to 31 st March 2022.

This includes support to State/UT level for ramping up Health Infrastructure including 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 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 H ospital Management Information System and expanding access to tele - c nsultations in all districts, and support for capacity building and training for all aspects of management of COVID - 19.