New Delhi: The Delhi government’s demand for a daily supply of 700 metric tonnes (MT) of oxygen to treat critical Covid patients is an overestimation, the central government claimed Wednesday.
Before a Supreme Court bench comprising Justice D.Y. Chandrachud and M.R. Shah, Solicitor General Tushar Mehta said that according to an expert panel of eminent public health experts, which included NITI Aayog member (health) Dr V.K. Paul, AIIMS Director Dr Randeep Guleria and ICMR Director-General Balram Bhargava, Delhi does not need more than 415.43 MT.
Mehta also outlined a formula developed by the panel and Centre to arrive at a pan-India allocation of oxygen amid the Covid crisis.
The bench was hearing the central government’s appeal against the Delhi High Court’s order Tuesday that issued contempt notices against government officials.
The HC bench of Justices Vipin Sanghi and Rekha Palli, which is conducting daily hearings on various aspects related to Covid management in the national capital, had summoned senior officials from the Centre after it was told that the government had not complied with the HC and SC order directing them to give 700 MT oxygen to Delhi’s hospitals.
However, despite the solicitor general’s assertions, Justices Chandrachud and Shah were not convinced with the expert panel’s formula and indicated that it would set up a new panel to derive a new mechanism for oxygen supply.
“There cannot be a general assessment for all states. It has to depend on the emerging situation in each state,” the bench said.
‘Make sure Delhi gets 700 MT oxygen’
The SC bench, meanwhile, did stay the contempt order issued by the high court, observing that recourse to contempt proceedings will not resolve the “crisis and unprecedented humanitarian damage” the country is facing.
“The effort of the court must be problem-solving by involving active co-operation of all stakeholders,” the court said.
The top court, however, reiterated its 30 April order that mandated the Centre to supply 700 MT oxygen to Delhi.
It directed Mehta to present a tabulated chart Thursday morning, containing the modalities of how oxygen supply will be maintained in terms of its order till 10 May, the next date of the hearing.
For this, the court directed a meeting to be held Wednesday evening between the chief secretary and principal health secretary of Delhi with a team of officials from the central government.
Delhi has been facing an acute shortage of oxygen supply and its oxygen allocation increased from 409.38 MT on 29 April to 585.01 MT on 4 May midnight, after the top court’s 30 April order. However, it is still nowhere close to 700 MT, which Delhi government authorities have said is the daily requirement,
“Delhi is quite critical. We all know that even 585 MT is not sufficient. We may be using extra oxygen which may not be economically wise, but we need to save lives,” the judges told Mehta, who provided the data to the bench during the hearing.
New expert panel to determine oxygen allocation
Justices Chandrachud and Shah also agreed with Mehta’s suggestion that an expert panel should be set up to determine the allocation of oxygen to states afresh.
Mehta had asked the court to conduct a formal audit to compute how much oxygen is required by Delhi.
The solicitor general said the “broad-based committee” can consist of officials from the central government, Delhi Government and some medical experts, who can work out a new formula on oxygen distribution.
This, Mehta added, was imperative because an increase in Delhi’s share will only reduce the allocation meant for another state, which can be detrimental.
At the outset of the hearing, he had disputed Delhi’s oxygen demand. Explaining the rationale behind the expert panel’s finding on the requirement of oxygen in the national capital, Mehta said that the calculation was based on how much a non-ICU bed or an ICU bed would need oxygen.
According to the panel. only 50 per cent of non-ICU beds need 10 litre of oxygen per minute, while all ICU beds need 24 litres of oxygen per minute.
“Therefore, the optimal demand of Delhi should be at the rate of 415.43 MT,” he said, adding that this formula was followed pan-India.
Oxygen requirement keeps changing
While the bench did not debunk the formula, it expressed reservations about it and advised the Centre to take a relook at it.
“It needs to be reconsidered,” said the bench, exploring the possibility to set up the new panel Thursday.
“One aspect needs to be underlined. Apart from the requirement of oxygen in hospitals, oxygen is also being made available to individuals who are unable to get beds in hospital. Therefore, to alone determine the oxygen allocation on the basis of ICU or non-ICU beds is not the correct approach,” the court said.
It further noted that the necessity for oxygen may not be the same for every state. It would depend upon the pandemic situation and, therefore, the requirement cannot remain static.
“There cannot be a general assessment for the entire country, irrespective of the state of the pandemic. Different states are peaking at different points of time. We need to have a scientific assessment,” the bench said.
It told Mehta and other lawyers to suggest names of experts who could be part of the new panel.
Follow the Mumbai model to utilise oxygen
During the hearing, Mehta cited Mumbai’s example to argue that 550 MT oxygen is more than enough to meet Delhi’s requirement.
He said that Mumbai had utilised 250 MT oxygen, when it was at its peak with a caseload of 92,000 patients.
On this, the court noted that Delhi government and central government officials must engage with the Brihanmumbai Municipal Corporation (BMC) to understand the administrative modalities that were put in place for the optimum utilisation of oxygen in the city.
The bench said the team of officers should engage with BMC officials and medical experts within three days to understand the modalities followed by them to augment oxygen supply in the city.
Based on those shared experiences, the court added, steps can be taken by the Centre and Delhi government to replicate the administrative arrangements feasible for the national capital.