L-G overrules Kejriwal move to close hospitals to outsiders

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Lieutenant governor Anil Baijal scrapped the Delhi government’s order reserving a chunk of the hospital beds in the city for residents of the national capital and restored federal guidelines on who can be tested for coronavirus disease (Covid-19), overturning a set of recent decisions by the administration that had become a political flashpoint and led to public anger.

Chief minister Arvnd Kejriwal, who issued an order on Sunday reserving beds for people living in Delhi, said Baijal’s decision against it will lead to problems for the people of Delhi but added that the government will try to make adequate arrangements.

“The L-G’s order has created a very big problem and challenge for the people of Delhi. Providing treatment for people coming from all over the country during the coronavirus epidemic is a big challenge. Probably it is God’s will that we serve the people of the entire country. We will try to provide treatment for all,” he said in a tweet shortly after the orders were issued on Monday evening.

Baijal, as the administrative head of the government, reports to the President and is the topmost authority of the Delhi disaster management agency, which is coordinating all matters related to the Covid-19 outbreak. In the order, he acknowledged that Covid-19 has spread in Delhi “in threatening proportion”, but stated that ‘right to health’ has been held as an integral part of ‘right to life’ under the Constitution by the Supreme Court.

Kejriwal’s deputy Manish Sisodia attacked the Bharatiya Janata Party in power at the centre and said that the Union government must involve states in decision-making processes. “Delhi government had drafted a well-planned strategy but the BJP pressurised the L-G into overturning it. What if all beds in Delhi get occupied within 2-3 days by patients from other states and that leads to the death of a Delhi resident who fails to get a hospital bed? Who will take the responsibility,” he said at a press conference.

Concerns over Delhi’s hospital capacity have abounded since last week after an increasing number of people said they were being turned away from hospitals, with some accounts on social media saying that the problems led to deaths among their friends and families. According to the Delhi government’s health bulletin on Monday, the city has roughly 9,000 hospital beds, of which nearly half are vacant.

The capital added 1,007 new infections, taking its total tally to 29,943 on Monday. The bulletin added 62 fatalities, of which 17 were in the 24 hours between Saturday and Sunday. In all, 874 people have now succumbed to the illness in the national capital. The number of tests carried out in this period was 3,700, sharply down from the 6,000-6,500 tests a day seen at the beginning of the month.

Baijal issued a second order in which he reinstated the testing rules for suspected Covid-19 patients in Delhi. The rules had been changed by Kejriwal’s government on June 2 to allow only close contacts of a Covid-19 patient who had symptoms to be eligible for a test, a move that the government said was meant to discourage people with mild or asymptomatic disease from using up testing and hospital resources. The changed guidelines also said asymptomatic direct contacts who were not senior citizens or suffered co-morbidities would not be tested.

“...in order to contain the spread of Covid-19, it is essential to conduct a thorough contact tracing of affected persons, especially in containment zones and as such, the ICMR strategy for Covid-19 testing should be followed without any deviation,” according to the order.

“This deviation from the ICMR guidelines can result in inadequate contact tracing of affected individuals and can result in further spread of Covid-19 in the NCT of Delhi,” the order added.

The Delhi government has also asked 8 of the 40 testing centres in the state to stop testing for alleged irregularities. Delhi remains the state that tests the most people per million in the country. As of Monday evening, it had conducted 12,909tests per million population.

In the first order, Baijal also cited a 2018 ruling by the Delhi high court that quashed a circular of the Delhi government giving preferential treatment to the capital’s citizens by reserving 80% of the beds in the GTB hospital to declare the government’s Sunday order as “impermissible”.

“All government and private hospitals and nursing homes/clinics situated in NCT of Delhi have to extend medical facilities to all Covid-19 patients coming for monitoring/treatment without any discrimination of being resident or non-resident of Delhi,” Baijal’s order added.

“This was a misstep by the Delhi government and was probably done for political reasons. It should have been avoided — throughout the year all hospitals in Delhi get about 45% of their patients from outside the city. In the crisis, with people complaining of not getting beds, the government must have just reacted. A better way to go about it is to have strict criteria for admission to the hospitals or to intensive care units and ensure that it is followed across hospitals,” said Dr MC Misra, former director of AIIMS, Delhi.

Lalit Kant, scientist and former head of epidemiology and communicable diseases, Indian Council of Medical Research (ICMR), said Delhi is at a stage where testing should be scaled up rather than being restricted. “What the Delhi government had ordered was in violation of the ICMR guidelines. At a time when it looks like Delhi has hit the community transmission stage, more and more testing is required for proper contact tracing. If we test more, there will be more positive cases and containment of the infection will be easier,” he said.

“The government’s decision was insensitive. The L-G has done the right thing by overruling it. In this hour of crisis, AAP should refrain from indulging in politics and focus on improving facilities for people. Their decision to stop testing of asymptomatic contacts of Covid-19 positive patients was against ICMR and Centre’s guidelines. As for treatment, we shouldn’t deny treatment to anyone,” said Delhi BJP chief Adesh Gupta.

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