Gujarat High Court
Maitree Kanan Muzumdar vs State Of Gujarat Notice To Be Served ... on 23 July, 2021
Author: Bela M. Trivedi
Bench: Bela M. Trivedi, Bhargav D. Karia
C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021
IN THE HIGH COURT OF GUJARAT AT AHMEDABAD
R/WRIT PETITION (PIL) NO. 42 of 2020
With
R/WRIT PETITION (PIL) NO. 53 of 2021
With
R/WRIT PETITION (PIL) NO. 67 of 2021
FOR APPROVAL AND SIGNATURE:
HONOURABLE MS. JUSTICE BELA M. TRIVEDI Sd/-
and
HONOURABLE MR. JUSTICE BHARGAV D. KARIA Sd/-
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1 Whether Reporters of Local Papers may be allowed
to see the judgment ? YES
2 To be referred to the Reporter or not ?
YES
3 Whether their Lordships wish to see the fair copy
of the judgment ? NO
4 Whether this case involves a substantial question
of law as to the interpretation of the Constitution NO
of India or any order made thereunder ?
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SUO MOTU
Versus
STATE OF GUJARAT & 2 other(s)
Appearance:
SUO MOTU(25) for the Applicant(s) No. 1
In WP(PIL) No.42 of 2020
MR KAMAL TRIVEDI, LD. ADVOCATE GENERAL WITH MS MANISHA
LAVKUMAR SHAH, LD. GOVERNMENT PLEADER(1) for the Opponent(s)
Page 1 of 28
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C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021
No. 1,2,3
MR NM KAPADIA(394), ADVOCATE for the Opponent(s) No. 4
MR SATYAM Y CHHAYA(3242), ADVOCATE for the Opponent(s) No. 5
ROHAN A SHAH(7497),ADVOCATE WITH MR RUSHABH H SHAH(7594),
ADVOCATE for the Opponent(s) No. 6
NOTICE SERVED(4) for the Opponent(s) No. 10
In WP(PIL) No.53 of 2021
MR KAMAL TRIVEDI, LD. ADVOCATE GENERAL WITH MS MANISHA
LAVKUMAR SHAH, LD. GOVERNMENT PLEADER(1) for the Opponent(s)
No. 1
MR DEVANG VYAS, LD. ASG for the Opponent(s) No.2-4
MR MIHIR JOSHI, LD. SR. ADVOCATE WITH MR SATYAM Y
CHHAYA(3242), ADVOCATE for the Opponent(s) No. 5
MR PRECY KAVINA, LD. SR. ADVOCATE WITH MR.R. PARIKH,
ADVOCATE - AS INTERVENER
In WP(PIL) No.67 of 2021
MR AMIT PANCHAL, LD. ADVOCATE for the Petitioner No.1-2
MR KAMAL TRIVEDI, LD. ADVOCATE GENERAL WITH MS MANISHA
LAVKUMAR SHAH, LD. GOVERNMENT PLEADER(1) for the Opponent(s)
No. 1-2
MR DEVANG VYAS, LD. ASG for the Opponent(s) No.3
NOTICE UNSERVED - Opponent No.4
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CORAM:HONOURABLE MS. JUSTICE BELA M. TRIVEDI
and
HONOURABLE MR. JUSTICE BHARGAV D. KARIA
Date : 23/07/2021
CAV JUDGMENT
(PER : HONOURABLE MS. JUSTICE BELA M. TRIVEDI) (I) WP (PIL) NO.42 OF 2020
1. In the wake of Pandemic of Corona Virus (Covid-
19), the Bench headed by the Hon'ble the Chief Justice had directed the Registry to register a suo motu Public Interest Litigation (PIL), Page 2 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 giving title "Precautionary Measures in the Wake of the Pandemic of Corona Virus (Covid-19)". The same was registered as WP(PIL) No.42/2020. The Bench gave various directions to the State of Gujarat, the Members of Bar Association, the Registry of the High Court, to all Subordinate Courts, and to all other stake-holders for taking all necessary precautions. The said order was followed by an array of orders on 20.3.2020, 27.3.2020, 1.4.2020, 3.4.2020, 17.4.2020, 1.5.2020, 11.5.2020, 14.5.2020, 22.5.2020, 29.5.2020, 19.6.2020, 24.7.2020, 17.8.2020, 4.9.2020, 9.10.2020, 27.11.2020, 8.1.2021, 22.1.2021, 26.2.2021, etc. The orders were passed and the directions were issued considering the affidavits/replies/ reports filed on behalf of the State of Gujarat as also considering the exigencies warranting the judicial review of the functioning of the various departments, more particularly the Health and Welfare Department of the State Government to curb and control the upsurge of Covid-19.
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2. However, on 11.4.2021, taking suo motu notice of the articles published in the daily newspapers regarding unimaginable difficulties and unmanageable conditions of the infrastructure and the shortfall and the deficit of testing, availability of beds, ICU, supply of oxygen, etc., the Division Bench headed by the Hon'ble the Chief Justice, directed the Registry to register a fresh suo motu Public Interest Litigation titled as "In Re: Uncontrolled Upsurge and Serious Management Issues in Covid Control", impleading the State of Gujarat and others as the parties. The same was registered as WP(PIL) No.53/2021. On 15.4.2021, considering the affidavit-in-reply filed by the Principal Secretary, Department of Health and Family Welfare in response to the suggestions made by the Court on 12.4.2021, the Division Bench flagged various issues pertaining to RT- PCR Testing, availability of Remdesivir injection, display of details about the availability of vacant beds and occupied beds on Page 4 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 the portal of the State Government, procuring sufficient quantity of oxygen vis-a-vis demand, availability and modalities of required amenities, medication and related infrastructure for the treatment of Covid patients, strict implementation of the standard protocol of wearing masks, keeping social distance, sanitization, etc.
3. Again on 20.4.2021, considering the affidavit- in-reply filed on behalf of the State, and submissions made by the Law Officers on behalf of the State, and the inputs given by the learned Senior Advocates, on the issues flagged by the Court earlier, the Court emphasized the need of proper coordination amongst the officers of the State Government, Corporations and the District Collectors in the matter of providing Remdesivir injections, for providing assistance of Ambulance 108, and for educating people for breaking the chain, with a view to see that situation of Covid cases is stabilized and the curve is flattened. In the meantime, various Civil Applications also came to be filed in the Page 5 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 WP(PIL) No.53/2021, by various public spirited persons/advocates appearing party-in-person, offering their suggestions and seeking various directions in respect of the issues already flagged by the Court. The Court, considering the same, reiterated its concern and directed the respondent State authorities to make available necessary medications, injections, infrastructure, etc., to the Covid patients and to file report as regards the status of every district in the State. The Court also directed the ASG appearing for Central Government to file a status report on the various issues as discussed in the order, more particularly considering the fact that the supply of oxygen was being controlled/allocated by the Central Government.
4. On 4.5.2021, the Court after hearing the learned Advocates for the parties, directed the State Government to provide the details as mentioned in paragraph 17 thereof. The same reads as under:-
"17. Having heard the learned counsels for the Page 6 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 respective parties and having gone through the materials on record, the response of the State is lacking in various points and directions given in the earlier order dated 27th April, 2021 and therefore, it is expected from the State to provide following details in the next affidavit:
(a) With regard to the testing, the State is required to place on record the details of functioning of the RTPCR machines in the various laboratories and the data of increase of RTPCR facility in each of the District placed together with the steps taken for starting testing facilities at remaining 21 Universities referred to in the affidavit to whom request has been made to use the laboratories for RTPCR testing.
(b) State is also expected to provide clear and transparent data with regard to the availability of RTPCR test, as well as, facility at the district level as submitted by Shri Percy Kavina, learned Senior Advocate referring to the inputs received by him from various districts.
(c) We reiterate that the State should also disclose the true and correct data through public media with regard to the testing facility available in each of the town and primary health center so as to enable the public at large to avail the facility of RTPCR test at the earliest.
(d) Let details be provided with regard to the distribution of Remdesivir injections received from Central Government to various Districts, as against the demand received from each of the district/hospitals for the last 15 days and the basis of such distribution to justify the prorata allocation as highlighted in the affidavit.
(e) In the next affidavit, State should also provide details and data with regard to the distribution of supply of oxygen and further details as to augment the supply of oxygen from other alternative sources with data and also to give date wise demand and supply of oxygen for the past two weeks, as well as the future projected demand and the measures for meeting out such demand in the next two weeks.Page 7 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021
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(f) With regard to the grievances raised by the various counsels for lack of medical and housekeeping facilities at Dhanvantri Hospital at GMDC, the details be made available for steps taken for redressal of the complaints made during the course of the hearing.
(g) The State should also come out with data and details with regard to the plan of making the 900 beds Dhanvantri hospital operational.
(h) The State should place on record
the details with regard to the details
of upload real time updation of the
availability of the beds in each hospital of the State for Covid 19 patients on the web portal and the efforts made for the same by the State to co- ordinate between all the hospitals of the State for the same.
(i) During the course of hearing, various counsels submitted that in the hospital and more particularly in the Dhanvantari Hospital the washrooms are not kept clean and the patients are suffering because of such unhygienic conditions prevailing in the hospitals. State is therefore directed to place on record the steps taken to resolve such basic issues of cleaning washrooms in the hospitals in the State.
(j) During the course of hearing on 27th April,2021, two issues were highlighted by the Court viz. (i) extension of time for registration of death by the Registrar of Birth and Death and (ii) second issue with regard to the flashing the mobile numbers of Higher officials of Ahmedabad Municipal Corporation by a news channel instigating the public at large to contact such Higher Officials in case of need of bed or other facility."
5. Thereafter, the Special Bench having been constituted by the Hon'ble the Chief Justice, the matters were placed before this Bench. This Bench on 17.5.2021, taking a serious note of the new challenge being faced by the State with Page 8 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 regard to the rapid increase in the cases of flesh eating Black Fungal infection called "Mucormycosis" and the shortage of the injections and medicines for the treatment of the said disease, called upon the State Government to provide the details as contained in paragraph 19 of the said order. The same reads as under:-
"19. In the aforestated premises, we call upon the State Government to provide the details of the following on oath, on the next date of hearing:
(a) How far the Primary Health Centers (PHCs) and the Community Health Centers (CHCs) which constitute the backbone of the State's rural health infrastructure are equipped with the facilities to treat the COVID-19 patients?
(b) What is the mechanism for providing the RT-PCR test kits, necessary medicines, 'Remdesivir' Injection, Oxygen supply, etc., to such PHCs and CHCs and other healthcare centers in the Districts and the Talukas?
(c) Whether the Doctors and trained nursing staff are available to carry out the RT-PCR tests, administer the 'Remdesivir' injections and the oxygen etc.? If the answer is in negative, what is the course of action planned in that regard?
(d) How many dedicated COVID hospitals, dedicated COVID Health Centers and COVID Care Centers have been set up at the District and Taluka level? The details of each District and Taluka be specifically provided.
(e) How many persons have been fully vaccinated and how many have been partially vaccinated in each of the categories i.e. above 60 years, between 45-60 years and between 18-44 years? What is the estimated requirement of the vaccines for vaccinating all categories of people fully and what is the road-map for achieving the said estimate?
(f) Whether any special provision has been made Page 9 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 for vaccinating the inmates of and the staff members working at the special homes like old age homes, mental/lunatic asylums, Nari Samrakshan Gruh, juvenile homes, remand homes, correction homes, orphanages, etc.?
(g) What is the preparedness of the Government in the Health Department to combat the Mucormycosis disease?
(h) The policy, if any, framed with regard to the procurement and the distribution of the injections and the medicines used for the treatment of the Mucormycosis patients in the private hospitals?"
6. In response to the said order dated 17.5.2021, the Principal Secretary of the Department of Health and Family Welfare filed an affidavit and the Union of India also filed a response. The Court, after considering the submissions of the concerned Law Officers of the State, the ASG and the other Senior Advocates, took a note that there was considerable decline in the number of Covid-19 cases all over the State. However, considering the possibility of the third wave of the Pandemic Covid-19, the Court directed the State Government to take all necessary actions with regard to the improvement of the health infrastructure, more particularly in the rural areas, as also for creating an awareness amongst the public at large of the disease mucormycosis, as also for making the policy of distribution of Page 10 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 Liposomal Amphotericin B injection more transparent, specific and effective. The Court passed the following order on 26.5.2021 :
"6. Having regard to the submissions made by the learned Advocates for the parties and to the affidavits placed on record on behalf of the State Government from time to time, the Court is of the opinion that the broad issues pertaining to the management of Covid-19 pandemic as highlighted by the interveners have been positively responded by the State Government and all possible efforts have been made to alleviate the concern of the Court as reflected in earlier orders. It is reported that there is a considerable decline in the number of Covid-19 cases all over the State. Therefore, there is a glimmer of hope seen that the situation has improved, however, it is too early to say anything on the trend of Covid-19 waives. Considering the magnitude of the cases of Covid-19 and its fall out, the Court is of the opinion that the State should not remain complacent and should continue its endeavour to do its best to fight with the third-waive as apprehended by the medical experts.
7. It cannot be gainsaid that there is a need to strengthen the Health infrastructure in rural areas by not only making the sub-centres, primary health centres and community centres well equipped with the machines but by providing enough manpower by appointing doctors and nursing staff on permanent basis.
8. The State Government in its affidavit has elaborately stated about the types of Mucormycosis disease and the steps being taken by the State for combating the said disease. Since the death rate is going high in the said disease, in the opinion of the Court, in order to allay the panic created in the minds of people, as a part of awareness programme, it would be more beneficial and in the interest of public at large to release the official video and to widely publish the literature about the said disease, which is now declared as a notifiable disease under the Epidemic Disease Act 1897.
9. At this juncture, it is also germane to note that the policy dated 19.5.2021 placed on record at Annexure-R-/10 formulated by the State for the distribution of Liposomal Amphotericin B does not seem to be very clear or specific. The Court is of the Page 11 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 opinion that in order to systematize the distribution and to establish efficient and time-bound system of distribution of Liposomal Amphotericin B injections to the needy, as there is a shortage of the said injections in the State, the policy must notify the authority/expert body constituted in each district, as also the procedure to be followed by the hospitals i.e. Government/Corporation/ Private hospitals for the procurement of the said Liposomal Amphotericin B injections. The allocation made to the said hospitals and the usage of the said injections made by the hospitals also should be displayed on the website of the Health department. The concerned hospitals also should be made responsible to submit the reports regarding the usage of the said injections.
10. In view of the above, it is expected that the State Government shall take all necessary actions immediately with regard to the improvement of the Health infrastructure in the rural areas as also for creating awareness amongst public at large of the Mucormycosis disease and for making the policy of distribution of Liposomal Amphotericin B injections more transparent, specific and effective."
7. The crux of the affidavits filed on behalf of the respondent State in response to the orders passed on 17.5.2021 and 26.5.2021 was that the medical needs in the rural areas are served by Three-tier system comprising of Sub-Centres, Primary Health Centres and Community Health Centres. As on 31.3.2021, there were 9163 Sub- centres, 1477 Primary Health Centres, and 345 Community Health Centres in the State of Gujarat. The Sub-centre is the most peripheral and the contact-point between the Primary Health Care Centre and the Community Health Care Centre. The Primary Health Centre is the first Page 12 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 contact point between the village community and the medical officers. The Community Health Centre is manned by 3 Medical Specialists i.e. Surgeon, Gynecologist, and Pediatrician supported by 21 medical, para-medical and other staff. It has been stated that the Sub-centres, Primary Health Centres and Community Health Centres have played a vital role in Covid Testing as RT-PCR Centres have been established in the said Centres, however, the supply of medicines, Remdesivir injections and the oxygen for providing treatment to the Covid-19 patients do not take place in the Primary Health Centre or Community Health Centre, and that the same would take place in the dedicated Hospitals and dedicated Covid Health Care Centres as stated in the affidavit. As regards the availability of doctors and trained nursing staff to carry out RT-PCR Tests, administer Remdesivir injections and the Oxygen, it has been stated that there are adequate doctors and trained nursing staff available at the Government dedicated hospitals to serve the Covid-19 patients. As per the said affidavit as on 21.5.2021, there were 54 Page 13 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 Government dedicated Covid Hospitals having 8229 beds, 706 private dedicated Covid Hospitals having 20927 beds, 193 Government dedicated Government Health Centres having 6203 beds, 184 private dedicated Government Health Centres having 5073 beds, 256 Covid Care Centres having 11728 beds and 98 private Covid Care Centres, having 4041 beds. Thus, in aggregate there were 56201 beds in the rural area of the State consisting of 5353 ICU beds out of which 2026 beds with ventilators and 3327 without ventilators, 22677 Oxygen beds and 28171 isolation beds without Oxygen. The State has also stated the details about the status of vaccination drive as on 20.5.2021 and also about the directions given by the State Government for giving priority for vaccination to the persons/staff members working at the Special Homes. The State Government has also placed on record the details of the preparedness of the Government to combat the Mucormycosis disease and also about the policy for the distribution of injection Liposomal Amphotericin B. The State Government has also stated about the steps taken Page 14 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 by it to increase the awareness amongst the people about Mucormycosis, and to increase the manpower in the health care institutions.
(III) WP (PIL) No.67 of 2021:
8. In the meantime, another PIL being WP(PIL) No.67 of 2021 came to be filed through the learned Advocate Mr.Amit Panchal with regard to the surge in Mucormycosis cases in the State of Gujarat, making various suggestions for effectively controlling and dealing with the Mucormycosis disease and seeking directions to call for compliance/status report with regard to the surge in Mucormycosis disease in the State. The State Government filed an affidavit-in-reply with regard to the relevant aspects of the disease Mucormycosis over and above the affidavits filed by it in WP(PIL) No.53 of 2021. (IV) Third Wave Preparedness Plan:
9. The Court on 15.6.2021 recording the submissions of the learned Advocate General Mr.Kamal Trivedi as also the other Senior Advocates, expected Page 15 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 that the State Government shall take all necessary actions with regard to the improvement of health infrastructure considering the likelihood of third wave of pandemic and directed to place on record the action plan if any, prepared in that regard.
10. In response to the said order passed by the Court, an affidavit has been filed on behalf of the State Government placing on record the "Third Wave Preparedness Plan for Covid-19" as a Guidelines Note for the Districts and the Municipal Corporations. As stated therein, the preparedness plan focuses on the planning and development of an integrated response plan on the basis of ten pillars of planning i.e. Governance, Human Resources Management and Capacity Building, Covid Appropriate Behaviour and Social Measures, Community Engagement, Containing Transmission, Vaccination, Infrastructure Preparedness and Expansion of Logistics and Supply Chain Management and Clinical Care. The State Government has also appointed 20 IAS Officers from various Page 16 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 departments as Nodal Officers for Covid Management. The State level tasks force has been created for looking after various aspects such as hospital infrastructure, oxygen supply and PSAs, procurement of medicines and other essential supplies, procurement of 108 Ambulance, Dhanvantari and Sanjeevani Rath, human resources and training, vaccination, tele- medicine, genome sequencing, etc., vide the order dated 16.6.2021. The State Government has also placed on record its planning for improvement in health infrastructure, which includes increase in the number of Covid Hospitals, including private hospitals from 1800 to 2400, oxygen beds from 61000 to 110000, ICU beds from 15000 to 30000 and Ventilators from 7000 to 15000. As regards paediatric care, it has been stated that there shall be increase in the number of paediatric beds from 2000 to 4000 and also increase in the paediatric ventilators in Government Hospitals. The affidavit also states about the planning for increasing the production of oxygen for meeting the future medical requirement of Covid patients, by Page 17 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 increasing the number of PSA Plants in the State from 24 to 400. The increase in the number of Dhanvantari Raths from 1500 to 3000 and Sanjeevani Raths from 1400 to 3000 has also been planned. As regards Human resources management, it has been stated that it has been planned to create district level task-forces, patient flow algorithm, deployment and rotation of HR including recruitment of residents and nursing staff and pooling of HR from various institutes and cadres. There is also a planning to improve surveillance and testing for Covid cases by increasing total number of units, total number of field teams and total number of house-to- house testing teams, as also to increase the number of RT-PCR laboratories, RT-PCR machines.
11. As regards the vaccination drive, it has been stated that considering the revised guidelines of National Covid Vaccination Programme declared by the Government of India, which have come into effect from 21.6.2021, the vaccination would be available free of cost to all persons above the age of 18 years at the Page 18 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 Government Covid Centres. As per the revised guidelines, 75% of the vaccine stock will be supplied to the State Government and 25% will be kept reserved for private hospitals and industrial units for the purchase of vaccines directly from the manufacturers. The State Government has set the target for vaccination coverage to the extent of 80% and for 18 plus population by the end of September 2021 for the first dose. The affidavit states in details about the implementation of the vaccination programme administered in the various districts. It also states about the vaccination programme for the underprivileged section of the society like vaccination in homes for disabled persons, vaccination in children's homes, in Old Age Homes, in Homes for Beggars, in Women Protection Homes, in Working Women's Hostel, in Swadhar Homes, in Preventive and Rescue Centres, and vaccination in Sakhi-One Stop Centres. According to the State Government, it is taking all necessary steps to meet with the new challenges and threats posed by Covid-19 and is making all efforts to prepare itself to combat Page 19 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 the Third Wave of Pandemic in case it is witnessed.
(V) Conclusions:-
12. From the afore-stated narration of the proceedings, the picture that emerges is that the first waive of Covid-19 Pandemic, which surfaced in March 2020 had shown a little downward trend at the end of 2020, however, due to complacency in such dropping of cases, the State Authorities and the public lowered their guards, which gave rise to the second wave. As the whole nation witnessed, the second wave spread like a wild fire and damaged the very fabric of the nation to a great extent. Thousands of people in the State lost their lives and hundreds are still suffering due to its after-effect and the complications of mucormycosis. The second wave has entailed a very dismal, depressing and gloomy state of affairs in the entire nation. The loss of lives in such a huge number has left permanent deep scars on the psyche of people.
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13. Now, the ordeal and melancholy of the second wave appears to have receded. The short term measures taken by the Central and the State Authorities coupled with the vaccination programme have definitely flattened the curve of Covid-19. The decline in the number of Covid cases and in the death rate has inspired a hope that the Covid seems to have run its course in the State. We all need to gradually limp back to our normal routine. The lessons learnt hard way from the second wave will have to be put in practice at the individual level and at the State level to combat the third wave, in case it is witnessed. The State has also placed on record a comprehensive "Third Wave Preparedness Plan for Covid-19", covering almost all areas for strengthening/improving the health infrastructure in the State.
14. It may be noted that the present suo motu proceedings were initiated by the Court considering the unprecedented and extraordinary circumstances created by the Covid-19 Pandemic, which required extraordinary measures to be Page 21 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 taken by the State authorities. The valuable suggestions made by the Advocates, the Senior Advocates, and the public spirited persons, and the cordial and collaborative approach of the Central and the State authorities, in the compliance of the directions issued by the Court from time to time, have brought a very positive results, and to an extent, have brought constructive reforms in the Health related services of the State. The State has also prepared the comprehensive "Third wave preparedness plan for Covid-19." Such being a policy matter, it would fall within the exclusive domain of the Executives, and the Court would be very loath in interfering with the same.
15. Having said that, it must be appreciated that the Covid crisis has revealed number of hidden opportunities to grow us individually and collectively. Compelling the State and its citizenry to travel on various untraded paths, has opened new vistas and avenues for strengthening and developing ourselves as a Page 22 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 responsible Nation. Much has been done by the State authorities, but much needs to be done. We, having gathered some thoughts and ideas from the material on record and from the submissions made by the learned Advocates for the parties, propose to make following recommendations/ suggestions for the consideration of the respondent State Authorities, while disposing of these proceedings:-
i. The apprehension and unpredictability of the new variant and of developing new symptoms still baffle the medical experts and the scientists. In order to avoid any kind of catastrophe, the laxity on the part of the public in observing the Covid protocols and Convid-appropriate behaviour - like wearing masks, maintaining social distancing, sanitization etc., must be strictly dealt with by the State Authorities.
ii. The State authorities must maintain extreme vigilance over the multiple markers indicating surge in cases and emerging variants in order to avert the worst impact of the possible Page 23 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 third wave.
iii. The State must engage itself in continuous awareness programmes keeping the public appraised and well informed about the symptoms, treatment and after-effects of the Covid-19 and its new variants, as also about the contact details of all the Government/Semi-Government/Private Hospitals. iv. Apart from the time-tested strategies of testing, tracking and treating the patients, the State must make all the Government/Semi Government/Private hospitals designated as the Covid hospitals, Covid Care Centres etc., responsible and accountable for displaying and reporting the real time data with regard to the availability of beds, and of the medicines and the injections, required to treat the Covid or its variants as the case may be, on their Web portals.
v. To avoid the possible surge in the cases, which may occur on account of the unknown variant, it is imperative for the State Page 24 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 authorities to strive hard to procure sufficient stock of the vaccines and to boost the vaccination coverage.
vi. The State must provide special door-to-door services for the vaccination of the underprivileged, disabled and aged persons of the society.
vii. Apropos the apprehension that the third wave may affect the children the most, the paediatric care must be pursued vigorously by establishing efficient health infrastructure for the children.
viii. The vaccination drive must also be accelerated for the children below 18 years. ix. The vaccination hesitation in the rural areas must be tackled by organizing awareness camps and undertaking the confidence-building exercise in the rural areas.
x. The PSA Oxygen plants must be commissioned at all levels at the earliest, considering the past experience.
Page 25 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 xi. The doctors, nursing staff and other staff members working in the Government/Semi- Government hospitals have borne the brunt during the first and second wave of Covid-19 Pandemic due to the shortage/vacancies in the Government/Semi-Government hospitals. It is expected that for filling up the vacancies, the process of recruitment of the medical professionals/staff members on permanent basis shall be initiated and completed by the concerned State Authorities at the earliest. xii. A time bound and effective programme must be chalked out to strengthen the SCs, PHCs, and CHCs which constitute the backbone of the rural health infrastructure.
xiii. By augmenting the Information, Technology and Communication Services, linked with social media services, the State must explore to bring major constructive reforms in the Medical services, which may not only be competent and cost effective but also transparent.
Page 26 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 xiv. The State also must address a very vital issue on the reforms of Medical education so as to make it multi-disciplinary and socially responsive model, imparting education on the essential principles of Epidemiology, as also imparting training for the requisite technical and social skills for the Tele-medicine Consultancy, which has emerged as an important method of consultancy during the restricted mobility period of Covid-19.
16. With these few recommendations/suggestions, we intend to put an end to these long drawn proceedings, with the hope that we start living in the movement of the Present. Shri J. Krishnamurti, one of the greatest philosophers of all time, has noted in his "Commentaries on Living - Series 1 Chapter 82.84 'Suffering' (Page: 197)" that -
"Can life ever be what it has been?
Can the joy of yesterday ever be repeated today? The desire for repetition arises only when there is no joy today; when today is empty, we look to the past or to the future. The desire for repetition is desire for Page 27 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021 C/WPPIL/42/2020 CAV JUDGMENT DATED: 23/07/2021 continuity, and in continuity there is never the new. There is happiness, not in the past or in the future, but only in the movement of the Present"
17. All the three petitions stand disposed of.
Sd/-
(BELA M. TRIVEDI, J) Sd/-
(BHARGAV D. KARIA, J) V.V.P. PODUVAL Page 28 of 28 Downloaded on : Sun Sep 05 23:31:18 IST 2021