SATURDAY LATEST GUIDELINES ISSUED BY ICMR ON PLASMA, REMDESIVIR 24 APRIL, 2021 1 Remdesivir can be used in patients with moderate to severe disease within 10 DAYS of symptom onset epaper.morningstandard.in facebook.com/TheMorningStandard 2 Plasma can be administered in early moderate disease within seven days of symptom onset; useless after 7 DAYS twitter.com/TheMornStandard SEEKING ACTION 3 REMDESIVIR NOT RECOMMENDED FOR THOSE WITH SEVERE RENAL IMPAIRMENT OR HEPATIC DYSFUNCTION KEJRIWAL ASKS MODI FOR HELP Delhi CM says at meeting neighbouring states blocking movement of oxygen carriers A CAPITAL VIEW OF NEWS PAGE 4 NEW DELHI J8.00 4 Remdesivir must not to be used in patients who are not on oxygen support or in home settings PAGES 12 5 Off-label use of tocilizumab in case of severe disease recommended, preferably within 24 to 48 hours of the onset of the disease or ICU admission 6 Upper respiratory tract symptoms or fever without shortness of breath or hypoxia defined as mild disease, patients advised home isolation | P7 TRAGEDY STRIKES PREMIER HOSPITAL After death of 25 Covid-19 patients, Ganga Ram Hospital and other establishments cry for oxygen, authorities deny casualties caused by low pressure of gas E X P R E SS N E WS S E R V I C E @ New Delhi THERE is tragedy unfolding at Sir Ganga Ram Hospital. As many as 25 Covid-19 patients, who were said to be in the “sickest” category died in the last 24 , hours at one of the biggest private hospitals in the national capital. The hospital said 60 other critical patients are at risk. The crisis came amid a severe oxygen shortage in the national capital’s hospitals. In an SOS statement, the hospital on Friday morning said lives of 60 critical patients were in peril and that the oxygen will last only for another two hours. An oxygen tanker arrived at the hospital after around two hours at 9.20 a.m. “Ventilators and Bipap (ventilators for invasive treatment) not working effectively Resort. ing to manual ventilation in ICUs and Emergency. Major crisis likely Lives of another 60 . sickest patients in peril,” said Ganga Ram Hospitals Director in a statement. Although the hospital did not clearly mention the reason for the death of so many patients, it said, “Catastrophe… Need oxygen to be airlifted urgently . Governments please help.” Sources said the “low oxygen concentration” could be a likely cause of deaths, adding “critical patients need high pressure oxygen supply .” Dr S Rana, Chairman of Sir Ganga Ram Hospital, said, “I would not attribute the deaths to a shortage of oxygen. There are many patients in a serious condition. However, we are facing a severe oxygen shortage and are resorting to manual ventilation to ensure a patient survives.” Around 500 Covid patients are currently admitted in Ganga Ram Hospital and 150 are on high oxygen support. Besides, SRGH, several private hospitals in the national capital are facing oxygen shortage. Many took to social media IAF airlifts O2 tankers, docs IAF deploys transport aircraft C-17, C-130J, IL-76, An-32 and Avro to airlift big, empty oxygen tankers and containers to various filling stations across the country; Chinook and Mi-17 helicopters on standby Flies doctors and nursing staff from Kochi, Mumbai, Vizag and Bengaluru to various hospitals in Delhi Cadila jab Virafin gets nod Ahmedabad-based Zydus Cadila gets restricted emergency use approval from the from drug regulator to use antiviral drug Virafin for the treatment of moderate Covid19 infection. DELHI COVID WATCH APRIL 22 APRIL 23 Positive cases Recovery Active cases Deaths Containment zones Tests Positivity rate 26,169 19,609 91,618 306 22,000 72,208 36.24% 24,331 23,572 92,029 348 23,561 75,037 32.43% for help and many others said they would avoid hospitals as they are out of oxygen supply . There were still others who requested the relatives of patients and government to shift the patients to other facilities. “The Indian Spinal Injuries Centre, Vasant Kunj, with 160 Covid patients is left with another hour of oxygen. We have been waiting for the supply since last night, but no luck. Please help,” tweeted ISIC. Staff of Sir Ganga Ram Hospital after panic strikes over shortage of oxygen | SHEKHAR YADAV FORCED TO REDUCE BEDS For want of oxygen, some hospitals have reduced beds for Covid patients. At the premier Rajiv Gandhi Super Specialty Hospital, the figure came down to 350 from 500. Some hospitals have made short-term arrangements with the help of Delhi Police. But even then, their oxygen will not last long. The Delhi government has appealed to the Centre for help. I won’t attribute the deaths to oxygen shortage. There are many patients in serious conditions. We are resorting to manual ventilation —Dr S Rana, Chairman of Ganga Ram Hospital Crack down on oxygen hoarding, PM instructs CMs E X P R E SS N E WS S E R V I C E @ New Delhi PRIME Minister Narendra Modi on Friday urged chief ministers of the worst Covidhit states to crack down on black marketing and hoarding of medical oxygen and key medicines for SARS-COV-2. Chairing a meeting featuring chief ministers of 11 states and Union Territories from where most Covid cases are reported, he asked them to facilitate seamless movement of medical oxygen.Calling for united response to the runaway pandemic, Modi told the CMs that Air Force and Railways are being pressed into service to transport oxygen. Modi urged states to set up a coordination committee for timely supply of oxygen to different hospitals of the state. “This committee should ensure that as soon as there is allotment of oxygen from the Centre, it can deliver oxygen as per requirement in different hospitals of the state immediately he added. ,” NITI Aayog Member V K Paul gave a presentation in the meeting on raising medical facilities and targeted treatment of Covid patients. The CMs were urged to make district administrations accountable for making available key medicines for treating Cov- id patients. “India’s success during the first wave of the pandemic was our united efforts and strategy . We will have to address this challenge in the same way,” said the PM, assuring Centre’s full support to states. T h e m e e t i n g w a s l ive streamed by Delhi CM Arvind Kejriwal, which drew the PM’s ire. Kejriwal’s office expressed regret but claimed they were not officially informed that the meeting was confidential. P7 K A N U SA R DA @ New Delhi A day after terming the Covid situation as a national health emergency while taking suo motu cognisance of it and demanding an action plan from the Centre in 24 hours, the Supreme Court on Friday abruptly wrapped up its hearing and posted the case for April 27. It took a dim view of the worry of senior advocates that the SC’s intervention could hamper proceedings at six high courts that were already hearing the matter and passing speaking orders. A bench headed by Chief Justice of India S A Bobde, who demitted office later in day, looked visibly angry and told senior advocate Dushyant Dave, “You have imputed motives to us without reading our order. SCARE REPORTS OF GLACIER BREAK IN CHAMOLI IN UTTARAKHAND We never said a word and did not stop high courts. We had asked the Centre to go to high courts and report to them.” “We love my lords. But it was a genuine perception because my lords have done it in the past,” Dave countered. Justice S Ravindra Bhat, who is part of the bench, said, “We never said a word and did not stop the high court. We asked the Centre to go to High Court and report to them. What kind of perception you are talking about? Talk about these proceedings.” When the bench told Dave it expected him to protect the institution, he retorted: “The institution will remain protected with objective criticism.” As for Solicitor General Tushar Mehta, he alleged that a maligning competition was going on in the media. The court concluded the hearing abruptly, as it sensed the building up of a heated exchange between lawyers, and gave time to the Centre to file its reply on a national plan to deal with the crisis. It also asked states and Union territories to spell out their respective stand on supply of oxygen and essential drugs, method and manner of vaccination and lockdown. The bench accepted senior advocate Harish Salve’s request not to be considered as amicus curiae in the case. “I don’t want this case to be decided under a shadow that I knew the CJI from school and college days,” said Salve. Covid deaths quadruple, new cases treble in 10 days in Bengal poll rush E X P R E SS N E WS S E R V I C E @ New Delhi Officials of Border Road Organisation leave for spot. Yet to establish contact with affected area due to snowfall. Scale of damages or loss of lives, if any, not known yet | P8 MUMBAI: At least 13 Covid-19 patients died after a fire broke out at the intensive care unit located on the second floor of the four-storeyed Vijay Vallabh Hospital at Virar, the extended suburb of Mumbai, on Friday. The fire started in the air conditioning unit of the hospital’s ICU due to a short circuit. There were 17 patients in the ICU at that time. The fire brigade rushed to the spot and doused the fire in five minutes. Howerver, within that short period, 13 out of 17 patients died. Maharashtra Chief Minister Uddhav Thackeray announced J5 lakh as financial help to the family of the deceased and J1 lakh to the injured SC postpones hearing, comes down on criticism by lawyers Central govt hospitals in city add 1K Covid beds Medical College, 240 more beds are being created by the CSIR. Union Health Minister Harsh The director of AIIMS, New Vardhan on Friday chaired a Delhi, outlined the expansion high-level meeting to review plans for adding more beds in the preparedness of the four other wards. The total capacity central government hospitals will be enhanced to more than in Delhi amid a continued 1,000 beds for only Covid-19 pashortage of beds, oxytients, said the Union gen and ICU facilities Health Ministry . for a high number of Vardhan said the Covid patients. government directed In a statement, the A decision was also to expedite the instaltaken to install government later said lation of five pressure DRDO-Tata Sons Safdarjung Hospital sw i n g a d s o r p t i o n is augmenting the bed oxygen generation plants at all locations plants at AIIMS, NIC availability with 172 at Delhi hospitals and Jhajjar, Safdarjung, more Covid beds. With asked them to be preLHMC and RML this, the super-specipared with expansion Hospital ality block at the hosplans for providing immediately pital will be fully contimely treatment to verted into a speciality Union Health Ministry the patients in the block for only infected days to come. patients. Besides, 46 beds, in“A decision was also taken to cluding 32 ICU beds, are being install DRDO-Tata Sons oxygen added with help of the Council generation plants at AIIMS, of Scientific and Industrial NIC Jhajjar, Safdarjung, LHMC Research. and RML Hospital immediateAt RML Hospital, the govern- ly,” it said, adding that these ment said 200 additional beds plants will have a capacity to were being created for Covid generate 1,000 litres of oxygen patients. At Lady Hardinge per minute. It is a single dose jab; drug will be available on the prescription of medical specialist for use in hospital/institutional setup, says company 13 COVID PATIENTS DIE IN MAHARASHTRA HOSPITAL BLAZE P R A N A B M O N D A L @ Kolkata Patients at GTB hospital on Friday; (R) kin griefs after a Covid patient’s death at LNJP Hospital | PARVEEN NEGI/ SHEKHAR YADAV ‘Pvt firms to profit from new policy’ S U M I S U K A N YA D U T TA @ New Delhi THE new Covid-19 vaccination strategy is allowing Serum Institute of India to dominate the inoculation pricing and policy and earn super profits, experts have pointed out. It is also in contradiction of an earlier stand by the National Expert Group on Vaccination Administration for Covid-19, which was in the favour of a single point of procurement for vaccines, many felt. The shift in policy by the Centre now means that states and private hospitals can directly procure 50% of the supplies from vaccine makers while the Centre will aim its drive to fund jabs for those above 45 at select vaccination centres. SII whose product, Covishield, has been the linchpin of India’s Covid vaccination drive so far with over 90% share in total 13 crore plus shots administered so far, has said that it will make available the vaccine at `400 per dose to states and `600 per shot to hospitals from May 1 when all adults in the country will qualify for inoculations. The company had signed an agreement to supply nearly 11 crore vaccine doses — between January and April — at `150 per dose to the Centre and its CEO Adar Poonawalla earlier had indicated that it was recovering the production cost at that rate and was even making normal profit. The latest pricing announcement, however, makes it clear that the company is now looking to earn a greater margin on the vaccine, originally developed by AstraZeneca-Oxford University through 97% funding by the UK government and the European Union. SII had earlier announced, pointed out R Ramkumar, an economist with the Tata Institute of Social Sciences in Mumbai said it would want to sell Covishield at `1000 per dose in the private market. “It could not do it in one go but is looking to maximise its profit and the Centre has succumbed under the pressure,” he said. He also stressed that the government, even considering that the vaccine will now cost `400 per dose, will have to spend just `53,000 crore — or 0.2% of the GDP — to incolutate the entire adult population with two doses. Full story on www.newindianexpress.com WHEN horrified people looking at the humongous political rallies with mask-less supporters in West Bengal a couple of weeks ago wondered if such mobilisation was wise, the prompt reply of politicos was the state’s Covid-positive count was far below that of high incidence states. The numbers have since climbed with Bengal reporting a record daily spike of 12,876 positive cases on Friday, as compared to 4,511 on April 12. Within those 11 days, the toll went up four times from 14 on April 12 to 59 on Friday. And at least 80 large rallies were held in the state during that period. On February 26, the day poll panel announced Bengal’s election schedule, the daily positive cases in Birbhum, Nadia and West Burdwan districts were 2, 6 and 10, respectively Almost a . month later, on April 22, the three districts recorded 624, 455 and 596 fresh positive cases respectively, indicating its rapid unspooling in rural Bengal. Two candidates have so far died of Covid-19 and others like state Congress president Adhir Ranjan Chowdhury have been hospitalised. While the Election Commission of India on Thursday after , a stinker from the Calcutta high court, banned roadshows and public meetings with more than 500 people ahead of the last two phases of the ongoing Assembly elections, who should be held accountable for sleeping on the job? “Among other reasons, big political rallies played a crucial role in the spread of Covid-19 in rural areas,’’ said an official of the state health department. Earlier, the poll panel had banned campaigns from 7 pm to 10 am across Bengal and extended the silence period to 72 hours from 48 hours prior to the scheduled poll-day . A BJP leader admitted the health official’s observation was true and said: “In Modi’s Khara gpur rally, we brought supporters from Hooghly district, around 150 km from the rally venue.” Hearing three PILs seeking enforcement of Covid-19 protocol, a division bench headed by C h i e f Ju s t i c e T B N R a d hakrishnan had said on Thursday “The ElC is empowered to , act, but what is it doing about polls in Covid times? The EC just passing circulars and leaving it to the people. But the EC has implementing authority .’’
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