[COVID-19 in Gujarat] Night curfews, Remdesivir shortage and more: State files reply in Gujarat High Court, GHCAA seeks to intervene

The Gujarat government is committed to its fight against the COVID-19 pandemic and is putting in all efforts to ensure a coordinated and systematic response, the Gujarat High Court has been told via a reply filed in the suo motu case being heard by the Court. .The Bench of Chief Justice Vikram Nath and Justice Bhargav D Karia has been hearing the suo motu case since April 12..After the matter was taken up by the High Court, a core committee meeting was held on the same day, following which various immediate measures were implemented by a notification, the State adds..Gujarat High Court hears suo motu case on COVID-19 situation [LIVE UPDATES].The reply filed through Dr Janayanti Ravi, Principal Secretary, Department of Health and Family Welfare, points to the following immediate measures:.On and from April 14, no more than 50 persons can assemble at wedding functions. Time duration is restricted to curfew timings. No more than 50 persons are permitted for funerals and like events either. Religious celebrations and festivities are prohibited for the months of April and May. Public gatherings, processions, social events, for any reason, are strictly prohibited. Strength of employees coming in to work reduced to 50% and on alternate days. This is not applicable to essential services. Religious places to be closed. Entry to worshipers and pilgrims to be stalled till April 30. Negative RT-PCR report mandatory for all passengers coming into Gujarat from April 1, 2021. 22 Senior IAS officers assigned special duty of monitoring of corporations and districts where number of cases are increasing. 8 senior IAS officers have been given special responsibility of monitoring COVId-19 care centres in corporations. Vaccination available to all above 45 years. Night curfew imposed in 20 cities along with 4 metro cities from 8 pm till 6 am till April 30. Education institutes in the State closed till April 30. Public transport closed in Surat and Ahmedabad Corporation. Intern doctors and students of final year of nursing and MBBS dental, physiotherapy are involved in containment activities of COVID-19.Strict implementation of social distancing and mask-wearing measures. Over Rs 1.2 crore being collected as fines for breaching the rules. Mass gatherings, social and political or other activities prohibited. Festivities restricted to symbolic offerings. Chaitri Navratri, Gui Padavo, Ram Navami, Ramzan eid celebrations restricted. Suggestions received from the GHCAA for physical infrastructure, availability of medication, availability of oxygen, norms of physical movement, restrictions on assembly for social or religious event were considered duly..On prevailing COVID-19 situation and available infrastructure.The State has informed that as of April 11, there are 30,680 active COVID-19 cases. Till April 12, 1,50,52,985 tests were conducted of which 3,53,516 persons tested positive. Of these, 4,855 persons died. The State has adopted a strategy of Test-Trace-Treatment to tackle the pandemic. The measures implemented to this end include, drive-through testing, contact tracing, Dhanvantri Raths (medical care including treatment for common ailments, screening of elderly patients for hypertension and diabetes, rapid antigen testing etc. at the doorstep of the patients), House to house surveillance, COVID helpline, IT-enabled Hotspot Analysis System etc. There are 97 COVID-19 testing labs of which 43 are government hospitals and 54 are private labs. 70 RT-PCR machines are available in government labs and 40 are being purchased to enhance testing capacity. Rapid Antigen Testing (RAT) has even started in all Primary Health Centres, Community Health Centres, Health and Wellness Centres, Urban Health Centres and Outdoor walk in facility kiosks. 2177.7 tests per day per million are being conducted by the State as against 66 tests per day per million on June 15, 2020. WHO norms for testing are 140 tests per million per day, it is noted. To strengthen the health system, a total of 71,021 beds are available for COVID patients in around 1,224 dedicated COVID facilities. Almost 15,000 beds were added in the first week of April. Further 10,000 beds to be added in the third week of April. As on April 12, 2021, 53% beds are occupied in the State. State has decided to start a fully-equipped 900-bed dedicated COVID-19 care hospital within 2 weeks on a war footing in association with the Defence Research and Development Organisation (DRDO) of the Government of India’s Home Department at the University Convention Centre, GMDC, Ahmedabad. A decision has been taken to start COVID Care centres with the help of the local community in Morbi with a total of 55 beds with full facilities within a “very short time.” Surat Municipal Corporation has persuaded the local communities to join the fight through the creation of Community COVID-19 Isolation Centres (CCIC) by converting marriage halls and other such halls. So far, 15 CCICs are operational with 1,400-bed capacity of which 232 beds are with O2 facilities. 599 doctors, 679 staff nurses, 299 lab technicians, 238 ward boys, 92 ayes, 3,600 multipurpose health workers have been recruited on contractual basis. In Ahmedabad, 142 private hospitals are designated as dedicated COVID-19 hospitals with a total of 6,283 beds and the 900 beds would be added in a few days. There are already 1,271 beds in various COVID-19 care centres..Reason for the short supply of Remdesivir injections.In response to the Court expressing concern over the same, the State has also made submissions on the availability of Remdesivir injections as part of COVID-19 treatment. .The State has clarified, at the outset, that the drug is not viewed as direct treatment for COVID-19. The reply affidavit recounts that the drug was originally developed to treat Hepatitis C and Ebola. It is currently being used as an antiviral drug to fight Coronavirus. It is recommended to be given on an emergency basis and under supervision to patients complaining of continuous, high-grade fever and showing a lack of oxygen saturation. It is reported to reduce the hospitalisation period. However, even according to the World Health Organisation (WHO), there is no evidence that Remdesivir improves survival in corona patients, the reply states. .The reason for Remdesivir shortage in Gujarat, on the other hand, is being attributed to the low number of suppliers coupled with a dip in production in the recent months. "Unless and until there is sufficient availability of the sad Remdesivir injections in the market, it is very difficult for the State to procure a sizeable stock," the reply states. .There are only 7 manufactures in the country engaged in the manufacture of Remdesivir, it is pointed out. The State further submits that in the previous few months, with a drop in COVID-19 cases and consequential reduction in demand of the said injection from December 2020 to February 2021, the manufacturers were reported to have scaled down their production of the product very significantly by about 5-10%, which affected the supply chain. The total production was hardly to the tune of 1 lakh vials of 100 ml per day, it is added. .A concern is also raised that since the price of Remdesivir is presently being fixed by the manufacturers, it has led to huge price variations, over charging, hoarding, black marketing and short supply. On April 14, a communication flagging these issues was addressed to the Chairman of the National Pharmaceutical Pricing Authority, New Delhi, the State says. .The State adds that the Centre has stopped the export of Remdesivir since April 2021 and that manufacturers were asked to scale up production by both the Centre and the State governments. .The police has also been cracking down on hoarders and black marketeers when it comes to Remdesivir. 6 cases were registered over illegal sale or Remdesivir, the reply states further. .The State has put up a herculean effort to procure the stock of Remdesivir injection from all sources and succeeded in obtaining about 4 lakh number of 100 ml vials between April 1-12, 2021, the Court has been told. It is further submitted that the State government has placed order for 3 lakh more vials. .GHCAA seeks to intervene.In the meanwhile, the Gujarat High Court Advocates' Association (GHCAA) has also moved a plea to intervene and assist the Court in the matter..“It is now beyond pale of doubt that existing resources and infrastructure available both publicly and privately are unable to cope with the spread of COVID-19 and it is necessary proper guidelines are framed", the plea reads. .The GHCAA adds that the guidelines issued by the Court ought not to be knee-jerk reactions and alludes to remedial measures to counter media misinformation, to rope in celebrities and MLAs to create awareness, to build State credibility, to develop a portal for disseminating accurate information on a real-time basis, for the use of video call facilities by hospitals, for regulating charges for COVID-19 treatment etc.