Writ Petition on COVID-19 situation in Karnataka

BEFORE THE HON’BLE KARNATAKA HIGH COURT AT BENGALURU
Writ Petition No. 6435 of 2020 (PIL) and Connected Petitions

Between:

Mohammed Arif Jameel & Anr.                         … Petitioners

And:

Union of India & Ors.                                       … Respondents

INDEX

 

Sl. No.	Contents	Pg. Nos.
1	Memo filed by AICCTU
2	Annexure – A: Screenshots of MirrorTV’s tweet displaying video of covid patients lying on the pavement outside hospital in Bidar
3	Annexure – B: News report regarding acute shortage of ICU beds in Kasturba Hospital in Manipal, Udupi district.
4	Annexure – C: Print-out of the Covid-19 Hospital Bed Status of the BBMP, as on 20.04.2021.
5	Annexure – D: News reports on the shortage of beds in hospitals
6	Annexure – E: News reports on oxygen shortage in hospitals
7	Annexure – F: Newsreports on shortage of drugs
8	Annexure – G: Newsreport about Hon’ble Revenue Minister, Government of Karnataka communication to district administrations to identify government land to perform the cremation of COVID-19 victims.
9	Annexure – H: News report on the huge space constrain faced by the Christian community in their burial grounds.
10	Annexure – J: News report on the severe problems faced by crematoriums in Bengaluru city
11	Annexure – K: Report of the State’s Technical Advisory Committee dated 30.11.2020
12	Annexure – L: News report in regard to the State’s Technical Advisory Committee dated 30.11.2020

 

 

Place: Bengaluru

Date:

Advocate for the Applicant

 

BEFORE THE HON’BLE KARNATAKA HIGH COURT AT BENGALURU

Writ Petition No. 6435 of 2020 (PIL) and Connected Petitions

Between:

Mohammed Arif Jameel & Anr.                               … Petitioners

And:

Union of India & Ors.                                              … Respondents

Memo of Submissions

The Advocate for the Applicant Union – AICCTU wishes to draw this Hon’ble Court’s attention to certain crucial matters that has a bearing on the right to life of the people in the State of Karnataka:

1. A summary of the details of the surging Covid cases in Karnataka culled out from the “Media Bulletin” issued daily by the Department of Health and Family Welfare, Government of Karnataka (available at https://covid19.karnataka.gov.in/govt_bulletin/en) is summarised below:

 

	Covid Cases			Deaths
	New cases	Total active cases	New cases in Bengaluru Urban	Covid deaths (Bangalore Urban)	Total deaths	Admitted in ICU (among total active cases)	Daily tests
21.04.2021	23558	176188	13640	116 (70)	13762	904	152281
20.04.2021	21794	159158	13782	149 (92)	13646	751	147488
19.04.2021	15785	142084	9618	146 (97)	13497	721	123212
18.04.2021	19067	133543	12793	81 (60)	13351	620	145645
17.04.2021	17489	119160	11404	80 (43)	13270	589	143308
16.04.2021	14859	107315	9917	78 (57)	13190	577	133737
15.04.2021	14738	96561	10497	66 (30)	13112	555	129400
14.04.2021	11265	85480	8155	38 (23)	13046	506	113242
13.04.2021	8778	78617	5500	67 (55)	13008	474	121899
12.04.2021	9579	75985	6387	52 (40)	12941	470	116165
11.04.2021	10250	69225	7584	40 (27)	12889	440	132706
10.04.2021	6955	61653	4384	36 (19)	12849	405	98790
09.04.2021	7955	58084	5576	46 (29)	12813	378	135163
08.04.2021	6570	53395	4422	36 (22)	12767	357	108757
07.04.2021	6976	49254	4991	35 (25)	12731	353	125390
06.04.2021	6150	45107	4266	39 (26)	12696	351	102021
05.04.2021	5279	42483	3728	32 (18)	12657	345	97829
04.04.2021	4553	39092	2787	15 (8)	12625	331	119881
03.04.2021	4373	36614	3002	19 (6)	12610	327	123830
02.04.2021	4991	34219	3509	6 (5)	12591	269	118933
01.04.2021	4234	30865	2906	18 (11)	12585	265	115732
31.03.2021	4225	28248	2928	26 (18)	12567	266	108568
30.03.2021	2975	25541	1984	21 (11)	12541	240	106917
29.03.2021	2792	23849	1742	16 (9)	12520	227	87197
28.03.2021	3082	23037	2004	12 (7)	12504	204	106328
27.03.2021	2886	21252	1820	8 (2)	12492	196	107416
26.03.2021	2566	19553	1490	13 (3)	12484	174	112271
25.03.2021	2523	18207	1623	10 (6)	12471	150	108396
24.03.2021	2298	16886	1398	12 (7)	12461	143	108013
23.03.2021	2010	15595	1280	5 (3)	12449	136	98733
22.03.2021	1445	14267	886	10 (4)	12444	136	78178
21.03.2021	1715	13493	1039	2 (1)	12434	137	101840
20.03.2021	1798	12828	1186	7 (5)	12432	134	94043
19.03.2021	1587	12067	1037	10 (6)	12425	131	91884
18.03.2021	1488	11359	925	8 (7)	12415	131	93370
17.03.2021	1275	10220	786	4 (3)	12407	134	86648
16.03.2021	1135	9428	710	6 (3)	12403	129	68469
15.03.2021	932	8860	550	7 (5)	12397	125	62358
14.03.2021	934	8364	628	3 (3)	12390	125	73108
13.03.2021	921	8042	630	1 (0)	12387	123	72650
12.03.2021	833	8114	526	5 (2)	12386	125	73632
11.03.2021	783	7831	492	2 (2)	12381	110	73101
10.03.2021	760	7456	488	6 (5)	12379	115	70133
09.03.2021	590	7033	363	6 (4)	12373	115	66426
08.03.2021	436	6815	287	5 (4)	12367	116	56445
07.03.2021	622	6862	389	3 (3)	12362	115	75960
06.03.2021	580	6594	367	5 (3)	12359	109	82229
05.03.2021	677	6374	444	4 (2)	12354	112	78807
04.03.2021	571	6128	385	4 (2)	12350	115	78618
03.03.2021	528	6057	311	3 (2)	12346	116	68339
02.03.2021	437	5945	282	7 (4)	12343	116	64247
01.03.2021	349	5824	210	5 (4)	12336	118	60127

 

2. There is an alarming surge in Covid cases across the State, particularly Bengaluru Urban district, since March 2021. The spurt is observed from 16.03.2021 onwards, while massive surge is observed post 14.04.2021.
3. Even as the cases surge, Covid patients are facing serious hurdles in accessing health facilities and proper treatment as is detailed below in these submissions. Daily newsreports point to the anguish and suffering of people affected by Covid.

Shortage of beds:

4. One of the recurring concerns is the availability of beds, especially ICU beds and ICU beds with ventilators. Most unfortunately the information coming through the media reveals that there are problems in other districts of Karnataka. MirrorTV put out a tweet late last night relaying a video of Covid patients sleeping on streets and pavements outside hospitals in Bidar, while begging the medical authorities to treat them. This, after the hospital, experienced a severe bed shortage and could not accommodate them. A few days ago, Kasturba Hospital in Manipal, Udupi district, was reported to be facing acute shortage of ICU beds. The screenshots of MirrorTV’s tweet and the newsreport is placed as Annexure – A and Annexure – B.
5. The situation is alarming in Bengaluru Urban which, as on 20.04.2021 had 1,14,833 active Covid cases. As per the Covid-19 Hospital Bed Status of the BBMP, as on 20.04.2021, there availability of beds was as follows: Outside of the availability of general beds, the availability of ICU and ICU Ventilator beds was very low. The print-out of the Covid-19 Hospital Bed Status of the BBMP, as on 20.04.2021 available on the BBMP website is placed as Annexure – C.

Government Hospitals (13 in number)

	General	HDU	ICU	ICU+Ventilator	Total
Allocated	621	88	60	70	839
Occupied	557	85	60	70	772
Available	64	3	0	0	67

Government Medical Colleges (4 in number)

	General	HDU	ICU	ICU+Ventilator	Total
Allocated	30	405	73	47	555
Occupied	30	381	71	45	527
Available	0	24	2	2	28

Private Hospitals (58 in number)

	General	HDU	ICU	ICU+Ventilator	Total
Allocated	960	803	126	96	1985
Occupied	570	680	114	92	1456
Available	390	123	12	4	529

Private Medical Colleges (9 in number)

	General	HDU	ICU	ICU+Ventilator	Total
Allocated	1777	1027	67	67	2338
Occupied	642	1022	66	67	1797
Available	535	5	1	0	541

6. It is submitted that these concerns over the non-availability of beds has been repeatedly reported in the media. The major surge is seen in Bengaluru city, which as of 21.04.2021 had 124894 live covid cases. Amid the surge of coronaviruscases in Bengaluru, beds in Covid care centres, government hospitals and private hospitals are filling up fast. This surge has meant that there is shortage of beds especially those patients requiring critical medical attention where there is a shortage of ICU and ICU+ventilator beds. The second wave appears is yet to peak and it is expected to peak by May first week in the state, due to which the number of covid patients will week rising in the coming weeks and an health crisis appears imminent. Here it is also necessary to point out that the Hon’ble Health Minister of Karnataka has been reported admitting to many private hospitals denying beds to Covid-19 patients in light of which the Karnataka government has directed the BBMP to take necessary action. There are already several reports of shortage beds leading to the totally avoidable deaths of covid patients. Relevant press reports are placed as Annexure – D.
    
7. Pertinently this Hon’ble Court vide Order dated 07.04.2020 in this matter has passed the following order:
   1. “19. … The State must also disclose whether any study is made to ascertain how many ventilators are needed in the State and whether any effort is made to procure additional ventilators and to make arrangements for additional isolation beds…”
8. In fact even in Order dated 13.10.2020 this Hon’ble Court passed the following order:
   1. “13. … Therefore, the State will have to place on record whether any exercise has been carried out for deciding the number of COVID-19 beds which may be required in future depending upon the projection of the positive cases. The State will have to also place on record whether any such exercise has been done to ascertain the requirement of ordinary beds, ICU+Ventilator beds and beds with the facilities of Oxygen and Ventilators…”

Shortage of oxygen:

9. Shortage of oxygen is also a serious concern. The Private Hospitals and Nursing Homes Association (PHANA) is reported to have written to Hon’ble Health Minister highlighting an acute shortage of oxygen supply due to the increased demand in Bengaluru. It is reported that the letter communicated that some of the hospitals have close to zero stock and others are soon running out of stocks. One rather alarming pressreport, which needs to be seriously looked into, states that many Bengaluru hospitals are running out of oxygen supply and are having to depend on the ‘black market’. Relevant press reports are placed as Annexure – E.
10. This Hon’ble Court had taken judicial notice of this aspect vide daily Order dated 22.09.2020 and directed the State Government to respond on the status of availability of adequate oxygen in the State and the issue of escalation of price of the oxygen cylinders.Vide order dated 29.09.2020, this Hon’ble Court noted at para 11 that merely stating that adequate supply of oxygen is available in the City of Bengaluru is not sufficient; the question is whether the hospitals in the State which are treating COVID-19 patients are receiving received adequate supply of oxygen. This Hon’ble Court took judicial notice of the high-powered State Oxygen Group vide order dated 06.10.2020. thereafter vide order dated 13.10.2020 this Hon’ble Court directed as follows:
    1. “10. …Therefore, it is the duty of the State Government to create a facility by which the hospitals which are facing shortage of oxygen can approach either the Nodal Officer or the District Level Monitoring Committees. A direction needs to be issued in that behalf to the Nodal Officer as well as to the District Level Monitoring Committees. The State needs to give publicity to the fact that the grievance regarding the non-availability of oxygen to the COVID-19 hospitals can be redressed either by the Nodal Officer or the District Level Monitoring Committees. Compliance on this aspect shall be reported within a period of one week from today.”

Concerns over availability of plasma and Remdesivir:

11. In addition to concerns over the availability of plasma there is the concern about the availability of Remdesivir. Newsreports state that there is a shortage of the said drug and there is hoarding and sale in the black market as well. Relevant press reports are placed as Annexure – F.
12. Under these circumstances the State Government must look into the matter and ensure that plasma, Remdesivir and all other life-saving drugs are available as per requirement.

Need for an effective Crisis Response System/Authority:

13. The lack of any viable authority that could be approached in the moments of extreme crisis and grave need is telling at the present moment. Families who are unable to access beds especially ICU and ICU Ventilator beds despite repeated calls to 1912 literally reach a dead end, and have no options whatsoever.
14. In this regard it is necessary to point out to the daily order dated 07.07.2020 passed by this Hon’ble Court wherein it posed the query which was: “Whether any mechanism is available in the City or whether any authority is nominated which will ensure that a person who is tested positive for novel corona virus is immediately admitted to a hospital wherever hospitalization is necessary and when condition of the patient requires admission in ICU with ventilator, he immediately secures a bed in ICU with ventilator.”. Also vide common order dated 13.07.2020 in W.P. No. 8619/2020 c/w W.P. NO. 8536/2020, 8622/2020 and W.P. No. 8668/2020, this Hon’ble Court reiterated that among the issues remain unanswered was this:
    1. “(vii) In the event ICU bed or a bed with a ventilator is not available, is there any authority with whom a complaint can be lodged, so that immediate arrangement is made for making available beds with ICU and/or with a ventilator?”
15. In the present crisis situation it is submitted that there is a need for such an effective crisis response system/authority so that people have some recourse in the event of not being allocated beds among other grievances. It must be ensured that this system/authority responds to the distress calls immediately and ensures that the allocation of bed or redressal of any life-threatening grievance that is made.

Regarding Ambulances:

16. It is submitted that there is also a need for a centralized mechanism available for getting in touch with the ambulance services for immediately procuring the ambulance for transporting a COVID-19 affected patient to the COVID-19 hospital. Pertinently this Hon’ble Court had vide order dated 13.07.2020 stated as follows:
    1. “… The State Government will place on record all the details on this aspect. Considering the raising number of COVID-19 positive cases, the State will also have to state before the Court whether any scientific assessment has been made about the number of ambulances which will be required depending upon the projected data of the positive cases.”

Increasing burden on crematoriums and burial grounds:

17. Perhaps the gravity of the situation can be understood from the stress on the crematoriums where long queues are reported. In view of this the Hon’ble Revenue Minister, Government of Karnataka has written to the district administrations to identify government land to perform the cremation of COVID-19 victims. These temporary facilities will be established near cities including in Bengaluru. The decision comes after crematoriums in Bengaluru reported long queues and a drastic increase in the number of cremations. The newsreport in this regard is placed as Annexure – G.
18. Incidentally with COVID-19 deaths on the rise, the Christian community in Bengaluru has flagged the issue of shortage of burial places for those succumbing to the infection. The Archdiocese of Bangalore has appealed to the civic body to immediately allot five acres on the city’s outskirts. In Kalpalli cemetery, one of the largest burial grounds for Catholics, 54 bodies were buried in March while 45 have been buried so far this month. In Mysuru Road cemetery, also for Catholics, two burials are taking place daily on an average since March. The Hosur Road cemetery that is open for all denominations is also reporting an average of three or four burials a day. These numbers since March exceed the normal monthly average and the community already faces a huge space constraint. The newsreport in this regard is placed as Annexure – H.
19. Bengaluru has 13 crematoriums, of which till yesterday, only 7 crematoriums were used to cremate deceased Covid victims. It has been reported that the crematoriums are working beyond their maximum capacities. Reportedly, the Summanahalli crematorium, whose maximum capacity is to cremate 16 bodies a day, has, for the past few days cremating more at least 25 bodies a day. This is the case in all crematoriums. There are serious concerns being raised about the furnaces breaking down since there is not enough time being allowed for them to cool down owing to them being overworked. Relevant press report is placed as Annexure – J.

Lack of preparedness on the part of the Central and State governments:

20. One of the important principles incorporated in the Disaster Management Act, 2005 is that all the Authorities concerned should be in the state of preparedness for dealing with the disaster. This Hon’ble Court has repeatedly, as stated supra, sought for the State Government to carry out the exercise for deciding the number of ordinary beds, ICU+Ventilator beds and beds with the facilities of Oxygen and Ventilators, ambulances, etc. which may be required in future depending upon the projection of the positive cases. This Hon’ble Court had observed that: “…It is only after a rational estimation is made that the State will have to take an immediate call for creating more facilities if the same are likely to be required…” (Daily order dated 13.10.2020 in W.P. No. 6435/2020).
21. It is necessary to point out here that according to experts the State is unprepared despite warnings of the second wave having been issued in November 2020 itself. The State’s Technical Advisory Committee (TAC) submitted a report on 30.11.2020 to the government recommending that the State should, by January first week, keep ready the clinical facilities at an October 2020 level in terms of beds, ICUs, ICU-Ventilators, oxygen availability, vital drugs and other infrastructure, both in government and private hospitals, including ambulance services. However, the state government did not consider this report seriously and today there is a veritable public health crisis. The said report of the State’s Technical Advisory Committee dated 30.11.2020 is placed as Annexure – K. The newsreport appearing in the Hindu dated 20.04.2021 in placed as Annexure – L.
22. Atleast now this exercise has to be carried out on a war-footing so that the necessary infrastructure can be put in place to tackle this pandemic and the devastation of lives being caused. Anything less would be in gross violation of the duty of the State to protect the health of its citizens.

Other pressing concerns:

23. Another aspect that needs to be highlighted is that in cases where in patients expire due to COVID-19; there is no mechanism for the family members of the deceased to finally view the deceased and pay their last respects before being buried or cremated. This is especially the case, wherein entire Families have tested Positive and cannot visit the deceased as they are themselves quarantining.
24. The Private Hospitals and Nursing Homes Association has also reported that there is an acute shortage of nurses. This is due to high attrition and the fatigue faced by the nurses. There is a shortage of 25%-30% , compared to last year. The association states that last year the government allowed final year nursing students to join as interns and that must be followed this year as well.
25. The State Government will have to assess the situation comprehensively to identify the various other concerns that is impeding the citizens’ right to life and health and take ameliorative and corrective steps to remedy the same.
26. In the above circumstances it is prayed that:
    1. Direct the State Government to take all necessary measures to address the surge in covid cases.
    2. Direct the State Government to establish an effective and easily accessible crisis response system/authority to receive distress calls pertaining to Covid treatment, and redress the same immediately.
    3. Direct the State Government to ramp up the availability of ICU and ICU beds with ventilators, oxygen availability, ambulances, drugs, plasma and other facilities immediately.
    4. Direct the State Government to ensure adequate distribution of oxygen to hospitals and create a facility by which the hospitals which are facing shortage of oxygen can approach either the Nodal Officer or the District Level Monitoring Committees.
    5. Direct the district administrations/local bodies to identify ad allocate land for the cremation of COVID-19 victims for all communities.
    6. Direct the State Government/local bodies to review the operation of crematoriums and establish additional ones based on requirement.
    7. Direct the State Government to ensure a mechanism for families of deceased persons (Due to Covid-19); to pay their last respects to the deceased.
    8. Direct the State Government to conduct a study/assessment to ascertain the possible extent of impact of the second wave of the pandemic, projection of positive cases, covid patients requiring hospitalization/ICU/ICU+ventilators and requirement of beds, oxygen, ambulance, plasma, drugs, etc.
    9. Direct the Central Government to provide all necessary assistance, including financial, to ensure that the State Government is able to provide the necessary health facilities to tackle the pandemic and provide proper health services to its citizens.
    10. Direct the Central Government and the State Government to ensure that there is adequate supply of oxygen to all hospitals and stock availability for any increased requirement.
    11. Direct the State Government to assess the situation comprehensively to identify the various concerns/hurdles impeding people, especially from poor and disadvantaged sections of society from protecting themselves from covid, including access to testing, treatment, hospitalization and vaccination and take ameliorative and corrective steps to remedy the same.

Place: Bengaluru

Date: Advocate for Applicant