With daily spike in coronavirus cases in India and less availability of beds in hospitals, the Centre on June 4 told the Supreme court that a large number of temporary make-shift hospitals will be needed in the near future.
The Centre also contended that though hospitals are responsible for implementing the Infection Prevention and Control (IPC) activities, the final responsibility lies with the health care workers to protect themselves from COVID-19. It further said mandatory quarantine for 14 days after rostering duty of health care workers of 7/14 days is “not justified and warranted”.
“It is most respectfully submitted that number of cases of COVID-19 are constantly increasing and at some point of time in near future, apart from existing hospitals, large number of temporary make-shift hospitals will have to be created in order to accommodate COVID-19 patients requiring admission, medical care and treatment,” the Ministry of Health and Family Welfare said in a written affidavit.
The affidavit was filed before a bench of Justices Ashok Bhushan, Sanjay Kishan Kaul and M R Shah on a plea that questioned the Centre's new Standard Operating Procedure(SOP) of May 15 for frontline COVID-19 health care workers by which it ended the 14-day mandatory quarantine for them.
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The court allowed petitioner and private doctor Dr. Arushi Jain's counsels advocate Mithu Jain and Arjun Syal to file the rejoinder affidavit to the Centre's reply within a week and posted the matter for June 12.
The country registered a record single-day jump of 9,304 coronavirus cases on Thursday pushing the total tally to 216,919, while the death toll climbed to 6,075 with 260 new fatalities, according to the Union Health ministry. The number of active COVID-19 cases stood at 106,737, it said.
The ministry in its reply affidavit said health care workers (HCW) are properly protected by Personal Protective Equipments(PPE) in workplace settings and carry no additional risk to their families or children.
It said grievances raised by the petitioner alleging infirmities in the May 15 guidelines of the health ministry are completely presumptuous, vacuous, ill-founded and sans any empirical or medical evidence.
Justifying its advisory and SOPs, the health ministry said it is a step in the right direction and that the guidelines emphasise the role of taking adequate preventive measures by all health care workers in the hospital setting against the likelihood of contracting infection at their work place.
It added that the risk profiling of those exposed has been deliberated in detail in the technical body under the Directorate General of Health Services, the Joint Monitoring Group (JMG), which also has a representative of World Health Organisation(WHO).
“This risk assessment approach is also in line with guidelines issued by Centre for Disease Control, Atlanta, USA that only high risk exposure needs to be quarantined for 14 days. Hence, mandatory quarantine for 14 days, after rostering duty of health care workers of 7/14 days is therefore not justified and warranted,” it added.
The Centre submitted that to successfully create optimum infrastructure to provide best medical care to coronavirus patients it will also have to adequately address human resource issue for this envisaged surge capacity scenario.
“Hence, conserving health care work force is the need of the hour in order to cater to the anticipated patient load in the hour of distress.”
The ministry submitted that while the Hospital Infection Control Committee (HICC) in the health facility is responsible for implementing the Infection Prevention and Control (IPC) activities and for organising regular training for HCWs, the final responsibility lies with the worker to prevent infection and to protect himself or herself.
The ministry further said it is also his/her responsibility to adequately train himself/herself and take all possible measures for preventing the infection and if adequate measures are scrupulously observed, the chances of of the health care workers contracting the infection would not be higher than that of any other person.
“…It is submitted that the current pandemic of COVID-19 is unprecedented and there is no time tested and universally acceptable protocol pertaining to COVID-19 preparedness.
"Furthermore, the biggest challenge to deal with this pandemic is that there are currently no proven therapeutics or vaccines or rapid point of care diagnostic tests, risk assessment and management protocols for COVID-19 and here are major research gaps in many other key areas of COVID patient and hospital management”, the ministry said.
As per the advisory, quarantine of health care workers, other than the two categories -- in case of high exposure to COVID-19 and in cases of health care workers showing symptoms of COVID-19 -- is not warranted, the petitioner had said.
On April 8, the apex court had observed that the doctors and medical staff are the "first line of defence of the country" in the battle against COVID-19 pandemic, and directed the Centre to ensure that appropriate PPEs are made available to them for treating coronavirus patients.Follow our full coverage of the coronavirus pandemic here.