Pat HC | Explore possibility of procuring High Flow Nasal Canula; Speed-up RT PCR testing: HC directs State

Patna High Court

Patna High Court: The Division Bench of Chakradhari Sharan Singh and Mohit Kumar Shah, JJ., expressed that:

[Order dated 15-04-2021]

“Constitutional Courts are duty bound to invoke the powers of judicial review and cannot afford to overlook palpable violation of fundamental rights of life and equality of citizens enshrined under Articles 21 and 14 respectively of the Constitution of India.”

On noting the alarming surge in COVID-19 Cases in the State of Bihar and the lack of facilities and healthcare system to meet the challenges arising out of the surge in cases as reported in print media I.A. No. 1 of 2021 was registered under the Orders of Chief Justice and has been placed before this Court in the Public Interest Litigation.

Newspaper reports, clippings of which are on record, portray a gloomy picture which reflected that on one hand there is a surge in COVID cases on an alarming proportion and on the other end, patients have been reportedly running helter-skelter to find beds in government hospitals.

It has also been reported that, COVID Beds in government hospitals are full in Patna. Newspaper Indian Express reported, based on experience of an individual that patients without contact face umpteen difficulties in getting admission even into private hospitals authorized to treat COVID patients.

Newspaper reports, though depict a very alarming and scary picture of the entire situation, having potential to expose the ground realities of health care system in the State, nonetheless, such reports cannot be made the sole basis for this Court to interfere and issue directions, exercising powers of judicial review under Article 226 of the Constitution of India. 

Bench further remarked that the Court is mindful of the fact that providing healthcare facilities and meeting challenges arising out of spike of COVID cases in the State is an executive function of the State and Constitutional Courts do not step in for the said matters.

Additional Advocate General, Amrit presented certain data and statistics showing availability of infrastructure in various parts of the State of Bihar to take care of COVID patients. To this Court stated that the said data presents a different picture altogether in comparison to the one being reported.

Prima facie, Court opined that it is not satisfied with the said depiction.

Bench added that it has transpired that the COVID Care Centres (CCC), Dedicated COVID Health Centres (DCHS) and Dedicated COVID Hospitals (DCH) are ill-equipped.

Press Briefing by the Government

Adding more to the above, High Court stated that people do not have the requisite information about the availability of the facilities being provided by the State Government, hence Court directed the Principal Secretary, Health Department to bring the said information in public domain through media and ensure that at-least once every day at a fixed time, a press briefing on behalf of the Government is made disclosing facts, illustratively, the number of COVID cases, the infrastructure which are available at various places in the State to admit and treat COVID patients and other cogent information which are required to be disseminated to the general public in public interest.

Black Marketing of Oxygen Cylinders

During the course of hearing, another fact that was noted was that there is scarcity of oxygen in various hospitals in the State of Bihar resulting into a kind of rush among the people of State to procure the same which as a consequence is creating a situation of black marketing.

To the above, Mr Amrit informed that a High Level Committee has been into the said matter and a solution would soon arrive for the same.

In response to Court’s query, Mr Amrit informed that once a person is tested positive after RT-PCR Test, State Government provides the patient with a COVID kit. He also added that earlier, State Government laboratories were not furnishing “Ct” value in the RT-PCR test reports, but now the same is being disclosed.

Elaborating more on his response, Court added that CT Scan Machines/facilities and Pulmonologist are available in Dedicated COVID Hospitals only, which are 11 in number. and steps are being taken to optimise the healthcare facilities to meet the recent challenges.

Bench stated that State Government may consider utilizing the facilities available in the premises of the newly established Medanta Hospital in PPE mode at Kankarbagh.

Assistance of Central Government

Court requested D. K.N. Singh, Additional Solicitor General of India to seek instructions from the Central Government regarding the issues which have emerged, particularly in relation to providing facilities at ESIC Hospital, Bhita, Patna and enhancing facilities at All India Institute of Medical Sciences, Patna as also the mode and manner in which the Central Government is willing to help and assist the State Government to enable it to tide over the prevailing situation on account of the alarming surge in COVID- 19 cases in the State of Bihar.

State Government is directed to ensure that all Dedicated COVID Health Centres are equipped with portable X-ray machines as quickly as possible and initiation of process to acquire CT Scan machines for dedicated COVID Health Centres in each District of State of Bihar should also be considered.

[Order dated 17-04-2021]

Bench noted in its 15th April Order that on one hand, COVID patients were running helter-skelter for admission in COVID Care Centers/Dedicated COVID Care Centers/Dedicated COVID Hospitals, figures presented by the Health Department represented that a large number of the beds available for COVID patients were unoccupied.

To the above, Court stated that no acceptable logic came forth to explain the startling phenomenon, as admittedly patients in the state are being denied admission because of unavailability of beds, though lack of awareness among affected people about the availability of such facilities is being cited as one of the reasons for the mad rush to Patna Hospitals out of a sense of fury.

Another aspect of the data that puzzled the Bench was that admittedly there is a shortage of medical oxygen in the State, but the data of the State Government depicted that huge number of beds with oxygen are available and again the said contradiction remained unexplained.

  • Principal Secretary in the present hearing informed the Court of compliance of certain directions issue don 15th April, 2021.
  • Court directs the State Government to ensure that the portable X-ray machines are positively acquired and installed
  • in compliance of this Court’s observations and direction on 15.14.2021, so as to make the residents of Bihar known about the available infrastructure, the Department has initiated a system of daily media briefing, disclosing all relevant information relating to location wise availability of facilities and infrastructure for treating COVID patients.
  • CT values are being mentioned in the RT-PCR Reports.
  • Steps have been taken for emergency procurement of Remdesivir injection by invoking Section 50 of the Disaster Management Act.
  • Rajendranagar Eye Hospital, which is a government hospital, has been decided to be utilised for admitting patients suffering from COVID-19.
  • Steps have been taken to increase number of beds in All India Institute of Medical Sciences, Patna (for short AIIMS, Patna) to 250 and Indira Gandhi Institute of Medical Sciences to 100
  • Manoj Kumar, the Executive Director, Bihar State Health Society, informed this Court that on an average 40,000 RT-PCR tests are being done in the State of Bihar per day, and steps to establish 9 more laboratories are being taken.
  • Apart from requisitioning liquid gas from the neighboring State of Jharkhand, the State Government and the Central Government are taking sincere measures for installation of Pressure Swing Absorption (PSA) plants in the hospitals connected with various medical colleges in theState of Bihar.

Executive Director, Bihar State Health Society submit a report explaining the progress regarding installation of PSA plants on the next day. He may also explore the possibility of procuring High Flow Nasal Canula (HFNC) and submit a report inasmuch as the same is reported to be effective in improving oxygenation amongst patients with acute hypoxemic respiratory failure.

Respondents to step up the speed/pace of RT-PCR tests in the State.

Court took note of the fact that State- Respondents have failed to regulate testing of such persons who are arriving in the State of Bihar from other States, who have the potential of spreading the disease.

“…minimum what is expected of the State-Respondents is to take all possible measures so as to ensure that persons coming from outside the State are either made to undergo rapid antigen test or they are able to show on the basis of the test reports available with them that they are not COVID positive. In case a person is found to be COVID positive, steps should to taken to ensure that he can reach a designated place for isolation or treatment with adequate and desired care and caution.”

Court while directing the Respondents-State of Bihar to submit a report regarding the available manpower and other infrastructure at listed the matter on 19-04-2021.[Shivani Kaushik v. Union of India, Civil Writ Jurisdiction Case No. 353 of 2021, decided on 17-04-2021]


Advocates before the Court:

For the Petitioner/s: Shivani Kaushik (In Person)

For the UOI: Dr K.N. Singh (ASG)

For the State: Anjani Kumar, AAG-4

For the Respondent 5: Mrs Binita Singh

For Respondent 6: Shivender Kishore, Sr. Advocate

For PMC: Prasoon Sinha

Join the discussion

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.