Kerala High Court
Sri.K.C.Naseer vs State Of Kerala on 28 June, 2021
W.P.(C) No. 11670/2021 & batch :1:
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE THE CHIEF JUSTICE MR.S.MANIKUMAR
&
THE HONOURABLE MR. JUSTICE SHAJI P.CHALY
MONDAY, THE 28TH DAY OF JUNE 2021 / 7TH ASHADHA, 1943
WP(C) NO. 11670 OF 2021
PETITIONER:
SRI.K.C.NASEER
AGED 42 YEARS
S/O.AHAMMEDKUTTY, ADVOCATE, KARINGAPARA CHOORAKUZHIYIL
HOUSE, CHUNGAM, PUNNATHALA P.O., MALAPPURAM DISTRICT.
BY ADVS.
C.M.MOHAMMED IQUABAL
ANJALI G.KRISHNAN
P.ABDUL NISHAD
RAIHANATH T.H.
RESPONDENTS:
1 STATE OF KERALA
REPRESENTED BY THE SECRETARY TO GOVERNMENT, HEALTH AND
FAMILY WELFARE DEPARTMENT, GOVERNMENT SECRETARIAT,
THIRUVANANTHAPURAM, PIN - 695 001.
2 THE SECRETARY TO GOVERNMENT
HEALTH AND FAMILY WELFARE DEPARTMENT, GOVERNMENT OF
KERALA, GOVERNMENT SECRETARIAT, THIRUVANANTHAPURAM,
PIN - 695 001.
3 THE DIRECTOR, DIRECTORATE OF HEALTH SERVICES
PALAYAM - AIRPORT ROAD, THIRUVANANTHAPURAM, PIN - 695 035.
4 THE DISTRICT MEDICAL OFFICER
DISTRICT MEDICAL OFFICE, CIVIL STATION ROAD, UP HILL,
MALAPPURAM DISTRICT, PIN - 676 505.
5 THE DISTRICT COLLECTOR,
MALAPPURAM, MALAPPURAM P.O., PIN - 676 505.
6 THE REVENUE DIVISIONAL OFFICER
TIRUR, TIRUR P.O., MALAPPURAM DISTRICT, PIN - 676 101.
W.P.(C) No. 11670/2021 & batch :2:
7 THE REVENUE DIVISIONAL OFFICER
PERINTHALMANNA, PERINTHALMANNA P.O., MALAPPURAM DISTRICT,
PIN - 679 322.
BY GOVERNMENT PLEADER
SRI. GOPALAKRISHNA KURUP, ADVOCATE GENERAL
THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD ON 28.06.2021, ALONG
WITH W.P.(C) NOS. 11709 & 11711 OF 2021, THE COURT ON THE SAME DAY
DELIVERED THE FOLLOWING:
W.P.(C) No. 11670/2021 & batch :3:
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE THE CHIEF JUSTICE MR.S.MANIKUMAR
&
THE HONOURABLE MR. JUSTICE SHAJI P.CHALY
MONDAY, THE 28TH DAY OF JUNE 2021 / 7TH ASHADHA, 1943
WP(C) NO. 11709 OF 2021
PETITIONER/S:
GANESH V.
AGED 49 YEARS
S/O. BALAN (LAATE), VADERI HOUSE, PACHATTIRI POST, THIRUR,
MALAPPURAM DISTRICT.
BY ADV K.RAKESH
RESPONDENT/S:
1 THE STATE OF KERALA
REPRESENTED BY ITS SECRETARY, DEPARTMENT OF HEALTH AND
FAMILY WELFARE DEPARTMENT, GOVERNMENT SECRETARIAT, PATTOM,
TRIVANDRUM 695 001.
2 THE DIRECTOR,
DIRECTORATE OF HEALTH SERVICES, GENERAL HOSPITAL JUNCTION,
THIRUVANANTHAPURAM 695 305.
3 THE DISTRICT MEDICAL OFFICER,
PUBLIC HEALTH DEPARTMENT, COLLECTORATE, UPHILL, MALAPPURAM,
MALAPPURAM DISTRICT 676 505.
4 THE DISTRICT COLLECTOR/CHAIRMAN,
THE DISTRICT DISASTER MANAGEMENT AUTHORITY, COLLCTORATE,
UPHILL, MALAPPURAM, MALAPPURAM, DISTRICT 676 505.
BY ADV GOVERNMENT PLEADER
SRI. GOPALAKRISHNA KURUP, ADVOCATE GENERAL
THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD ON 28.06.2021, ALONG
WITH W.P.(C) NOS. 11670 & 11711 OF 2021, THE COURT ON THE SAME DAY
DELIVERED THE FOLLOWING:
W.P.(C) No. 11670/2021 & batch :4:
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE THE CHIEF JUSTICE MR.S.MANIKUMAR
&
THE HONOURABLE MR. JUSTICE SHAJI P.CHALY
MONDAY, THE 28TH DAY OF JUNE 2021 / 7TH ASHADHA, 1943
WP(C) NO. 11711 OF 2021
PETITIONER:
K.P.A.MAJEED,M.L.A., AGED 71 YEARS,
(ELECTED MEMBER OF KERALA LAGISLATIVE ASSEMBLY FROM
THIRURANGADI, CONSTITUENCY), S/O. AHAMMEDKUTTY, PATHIKKAL
HOUSE, VATTALLUR P. O., MAKKARAPARAMBA,
MALAPPURAM DISTRICT.
BY ADVS.
JACOB SEBASTIAN
K.V.WINSTON
ANU JACOB
RESPONDENT/S:
1 THE STATE OF KERALA
REPRESENTED BY THE SECRETARY TO GOVERNEMNT, HEALTH AND
FAMILY WELFARE DEPARTMENT, GOVERNMENT SECRETARIAT,
THIRUVANANTHAPURAM, PIN - 695 001.
2 THE DISTRICT COLLECTOR,
MALAPPURAM, PIN - 676 505.
3 THE DISTRICT MEDICAL OFFICER (HEALTH)
MALAPPURAM, B3 BLOCK, CIVIL STATION,
MALAPPURAM, PIN - 676 505.
BY ADV GOVERNMENT PLEADER
SRI. GOPALAKRISHNA KURUP, ADVOCATE GENERAL
THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION ON 28.06.2021,
ALONG WITH W.P.(C) NOS. 11670 & 11709 OF 2021, THE COURT ON THE SAME DAY
DELIVERED THE FOLLOWING:
W.P.(C) No. 11670/2021 & batch :5:
Dated this the 28th day of June, 2021.
JUDGMENT
W.P.(C) Nos. 11670, 11709 & 11711 of 2021]
SHAJI P. CHALY, J.
The above batch of writ petitions are Public Interest Litigations
filed by the residents of the Malappuram District and a Member of the
Legislative Assembly from Tirurangadi Constituency in Malappuram
District respectively.
2. The basic contentions raised in the writ petitions are
substantially and materially common in nature in regard to the alleged
inaction on the part of the State Government to provide vaccination to
the residents of the Malappuram District, taking into account the
population, test positivity rate and also seeking to make available the
basic facilities of ventilators and oxygen supported beds for the
treatment of the pandemic Covid-19 in the District and in particular,
the Thirurangadi Legislative Constituency.
3. The petitioner in W.P.(C) No. 11670 of 2021 has contended
that Malappuram District has such a vast area, but it has only two
revenue divisions namely Tirur and Perinthalmanna and it is one of the
largest Districts in the State of Kerala next to Palakkad and Idukki
Districts.
4. The grievance of the petitioners is that, even though it is so,
the medical facilities available in the district are very bleak and not
sufficient enough to cater to the needs of the people in the entire
district. It is predominantly contended that the authorities have not
taken any adequate steps for the administration of Covid-19
vaccination in Malappuram District. Even though Covid-19 vaccination
started in the State of Kerala and a total of 87,87,148 vaccination
doses are administered, only 6,66,687 doses are administered in
Malappuram district as on 26.05.2021, which is only 7.58%.
Therefore, the submission of the petitioner is that the total population
of Kerala as per Ext. P1 statistics report is 3,46,30,192 and out of that,
44,94,998 people are residing in Malappuram district, which is 12.97%
of the total population of the State of Kerala. However, administering
of the vaccine is not in accordance with the population ratio, which
according to the petitioner, is a discrimination to the citizens residing
in that district.
5. That apart, it is also contended that as on 26.05.2021, 4212
Covid-19 positive cases are reported in Malappuram District and the
District has the highest test positivity rate, even though the tests are
very few. Certain newspaper publications are produced by the
petitioner as an attempt to substantiate the contentions so advanced.
The petitioner has also submitted Ext. P5 representation before the
Secretary to Government, Health and Family Welfare Department,
Thiruvananthapuram, seeking a direction to the District Collector and
the District Medical Officer, Malappuram to take necessary steps to
increase the Covid-19 vaccination in Malappuram District. In the
above factual backdrop, the following reliefs are sought for by the
petitioner:
1. Issue a writ of mandamus or any other appropriate writ, order or
direction directing the respondents to administer Covid-19
vaccine in Malappuram District in accordance with the area and
population of the district.
2. Issue a writ of mandamus or any other appropriate writ, order or
direction directing the 2nd respondent to consider and pass
appropriate orders on Ext.P4 representation within a time
stipulated by this Hon'ble Court.
W.P.(C) No. 11709 of 2021
6. The basic contention advanced in the writ petition is also
similar to the one advanced by the petitioner in the afore deliberated
writ petition. Apart from the same, it is contended that the
Government is not providing vaccine and other health facilities to the
district so as to combat Covid-19 adopting a uniform standard, but it is
seemingly done in an irrational manner, which is illegal. That apart, it
is contended that it is the responsibility of the State to take extra care
in the areas where the test positivity rate is high and also taking note
of the number of patients and also the total population of the District.
It was also submitted that the Government is duty bound to ensure
adequate health and medical facilities by discharging its duties and
obligations imbibed under Article 21 of the Constitution of India. In
the above backdrop, the following reliefs are sought for:
1. Issue a writ of mandamus or any other appropriate writs, orders
of directions directing the respondents 1 and 2 to provide
adequate covid vaccin stock to the District of Malappuram
proportionate to its population as soon as possible, to avert a
disaster likely to happen at the wake of this covid-19 wave;
2. Issue a writ of mandamus or any other appropriate writs, orders
of directions directing the respondents to ensure that
availabilities of health care facilities published in the e-portal of
the Government with a close vigil;
3. Issue a writ of mandamus or any other appropriate writs, orders
of directions directing the respondents to complete the covid
vaccination Mission in Malappuram District at a far-footing as
the test positivity rate in the district is increasing in an alarming
trend.
4. Issue a writ of mandamus or any other appropriate writs, orders
of directions directing the respondents 1 and 2 to increase the
stock of vaccine and also the health facilities insofar as the
district of Malappuram is concerned and make available the
same as expeditiously as possible for effective management of
Covid;
W.P.(C) No. 11711 of 2021
7. It is filed by the member of the Legislative Assembly from
Tirurangadi Constituency. The basic contention raised is with respect
to the inadequacy of the ventilators in the Government hospitals in
Malappuram District, particularly in the Tirurangadi Taluk Head
Quarters Hospital. The case projected by the petitioner is that by
virtue of Article 21 of the Constitution of India and the provisions of
the Kerala Municipality Act, 1994, the Government as well as the Local
Self Government Institutions are duty bound to make adequate
facilities to increase the number of the ventilators, intensive coronary
care units and oxygen supported beds in various Government
Hospitals in the Malappuram District. The case projected by the
petitioner is that the Government and the District Administration have
not initiated sufficient action to combat the pandemic Covid-19, which
is causing serious inconvenience to the citizens of the district, and
unless and until the court directs, appropriate action will not be taken
so as to satisfy the requirements of the residents of the Malappuram
District. Hence, the petitioner seeks the following reliefs:
1. Issue a writ of mandamus, order or direction directing the
respondents to increase the number of ventilators, ICUs and
oxygen supported beds in various government hospitals
including the Medical College Hospital, Manjeri in a war footing
so as to provide better treatment for the Covid 19 patients in the
Malappuram District.
2. To issue a writ of mandamus, order or direction directing the
respondents to provide and establish ventilators, ICUs and
oxygen supported beds for the treatment of the Covid 19
patients in the Government Taluk Headquarters Hospital at
Tirurangadi, urgently.
3. To issue a writ of mandamus, order or direction directing the
respondents 2 and 3 to supervise the District Covid Control
Centre of Malappuram District effectively and to provide the
actual and true information regarding the availability of Covid 19
treatment facilities like ventilators, ICUs, oxygen supported beds
and ambulances to the general public.
4. To issue a writ of mandamus, order or direction directing the first
respondent to issue appropriate directions enabling the Local
Self Government Institutions at various levels including Grama
Panchayats, Block Panchayats, District Panchayats and
Municipalities to provide treatment facilities like ventilators and
oxygen supported beds to the hospitals in the respective
jurisdiction or in the district by utilising the plan fund.
8. Petitioners have produced certain documents showing the
statistics in regard to the population, the availability of the bed in the
Government hospitals across the State and have made comparison
basically relying upon the population of the Malappuram District and
thereby, contended that unless and until the vaccine is distributed on
the basis of the population, there is a likelihood of the pandemic
causing serious prejudice to the people of the Malappuram District.
9. Almost typical statements are filed for and on behalf of the
District Medical Officer, Malappuram, in the writ petitions narrating the
facilities made available and the steps that are taken to deal with the
present pandemic situation. According to the third respondent, the
allegations made in the writ petitions cannot be said to be true or
correct, since adequate steps are taken to administer vaccines taking
into account the test positivity rate and sufficient steps are taken to
combat the pandemic situations also. In our view, it would be better
and fruitful, if the steps taken by the Medical Officer are extracted:
"As regards Covid Control Room and Covid War Room
4. In Malappuram district, a District COVID Control Room is
functioning at District Medical Office (Health), Malappuram, whereas a
District COVID war room is functioning under the Control of District
Collector at Planning Secretariat. The nature of functions of the COVID
Control Room and the COVID War Room are different.
5. COVID Control Room was set up in the District Medical Office,
Malappuram, on January 27th 2020. This Control Room provides general
information regarding Quarantine, Testing, COVID treatment, Vaccination
and other general queries. Apart from District COVID Control Room, public
queries and patient management is conducted at 15 health block control
rooms across the district. These health block control rooms handle general
queries as done by the district control room and also specific queries from
patients requiring local intervention. Referral of patients requiring
consultation and admission is also done by block level control rooms
through DPMSU (District Programme Management and Supporting Unit).
The COVID Control Room is functioning with 5 telephone numbers
0483 - 273 3251
0483 - 273 3252
0483 - 273 3253
0483 - 273 7857
0483 - 273 7858
6. COVID War Room was set up in the District August 2020, by
DPMSU (District Programme Management and Supporting Unit), under
the District Collector, at the Planning Secretariat. The War Room
provides information to the healthcare providers regarding the bed status
on a real-time basis, manages admissions to these facilities as required
and arranges transport of patients. The public is instructed in person by
health staff over telephone and through wide publicity in print/social
media to contact local RRT, health staff in public health institutions,
block control rooms, in case of any assistance or queries regarding
COVID-19.
7. Medical officer/health staff/block control room will inform the war
room regarding the requirement of beds. War room staff will verify the
availability of beds in Covid facilities and facilitate the admissions. They
will also arrange transport for the patient to the allotted beds. In
emergencies, the patient will be referred to the Covid assessment-triage-
stabilization units for management. After the patient becomes stable,
they will be discharged, admitted or referred to Covid facilities.
8. Now additional human resources and facilities added to Covid War
Rooms with 22 telephone numbers; each one is intended to separate
purposes and widely published to the media for the awareness of the
general public. Details are given below:
Patient Contact Migrant Oxygen Hospital Ambulance
Management Tracing Labourers Management Infrastructure Control
Control room Room
9846 700 711 9495 291 353
9400 486 058 9446 670 657 9746 183 705
0483-273 0773 0483-295 2950 9846 700 711
0483-273 1523 0483-273 4814 0483-2730775
0483-273 0774 0483-273 1526 0483-2731530
0483-273 1533
0483-273 1530 0483-273 1522
Mental Health
7593843617
7593843625
9. Due to the unprecedented surge in COVID cases in the district, the
District COVID war room facility under DMPSU was enhanced by
assigning separate teams for Patient Management, Infrastructure
Management, Oxygen Management and Transport Management. These
teams work in an integrated manner on a 24x7 basis to ensure timely
updation of resources and thereby to improve efficiency. The patient
management team manages patient bed requirement and admission. To
enable judicious use of scarce resources, incoming requests at District
war room for referral or transfers from hospitals, with ventilator or
oxygen requirement are strictly entertained only based on medical advice
from treating physicians. Incoming calls to the district war room from
periphery by non-medical personnel, which includes patients, bystanders
or voluntary workers are carefully assessed for warning signs and other
vitals by the doctors' panel in the control room and directed to the nearby
block level health facilities, which includes stabilization units and
COVID casualty facilities. A minimum of 25% of total bed strength
(which includes COVID and Non-COVID beds) of all private hospitals
providing treatment for COVID-19 were earmarked for bed allotment
through the District war room, thereby ensuring free treatment through
KASP (Karunya Arogya Suraksha Padhathi).Instruction has been given
to all hospitals to update bed status every 4 hours in COVID Jagratha
portal. This activity is strictly monitored by the Infrastructure team and
timely interfered when updation is delayed from any hospital. The bed
status including Ventilator and Oxygen facilities are thereby updated
meticulously and the information made available to the patient
management team regularly. A proper bed requirement waiting list is
maintained at the war room for efficient bed allotment according to
available bed vacancies.
As regards infrastructure facilities
10. There was an unprecedented surge in cases in the peak of the second
wave (Mid May, 2021). There were efforts to enhance the critical care
beds for COVID in the district. As on 07/06/2021, there are 153
ventilators, 341-ICU beds and 1205 oxygen beds in the District. As per
the 2011 Census, the population of Malappuram district is 4112920. The
total available beds (normal beds, ICU beds and Oxygen supported beds
taken together), as on 07/06/2021, for COVID treatment in the district is
5568. So there is 1 bed for 738 people in the District. The number of
critical care beds (for COVID category C patients) in the district at
present are 1546 (ICU beds (341) + oxygen beds (1205)). Presently the
occupancy in the district as regards COVID ICU beds is 75% and as
regards COVID oxygen supported beds is 52%. 823 Human resources
existed before the outbreak. Additional 1530 human resources were
provided, which means the department has already tried to met the
requirement and succeeded. And there is an overall increase in COVID
beds and critical care beds in the district, as we have addressed the issue
of oxygen availability and oxygen storage facility improvement.
As regards Oxygen Facilities
11. The continuous oxygen supply and oxygen storage in the district
could also be ensured by timely interventions. There was a severe
shortage of oxygen storage cylinders all over the country at that point.
But, the storage cylinders and oxygen tanks could be subsequently
procured and installed at the earliest point of time. Oxygen cylinders,
especially D type cylinders, were really short across the country, as the
system never had such a huge demand in the past. So, the district
administration seized available oxygen cylinders through the Oxygen
Management Committee in the district. 62 D type cylinders were
received through sponsorship. 73 oxygen concentrators were distributed
through KMSCL to various CFLTCs and stabilisation centres. In
Malappuram District, there are 19 stabilisation units covering all 15
health blocks, to address immediate demand of patients at home for
stabilisation and management. Total number of Oxygen beds in
Malappuram district is 1205 as on 07/06/2021 (in both government and
private hospitals).
12. At Government Medical College, Manjeri, the capacity of the oxygen
tank was increased from 4KL to 10 KL and more than 24 hours oxygen
availability, without in-between filling, ensures more ventilator facility
and more oxygen beds. The exchanged oxygen tanks therein (3KL+1
KL) were shifted to Perinthalmanna and Tirurangadi Hospitals. Another
1 KL tank at Daya hospital is also under process of registration. All
Covid hospitals are having 100 D type cylinders and all CSLTCs are
having 80. The District administration restarted the closed oxygen
production unit at Maravattam near Kottakkal and also enhanced the
availability of liquid oxygen through the only major production and
filling unit at Chelari
As regards Ventilator Facilities
13. Sufficient numbers of ventilators are being provided in Government
Hospitals. 25% of ICU, Ventilators and Oxygen supported beds of
private hospitals are accommodated with government quota as per
government directions and hence it is sufficient to meet any alert
situations for the time being. The total number of ventilators available in
Malappuram as on 03/06/2021 is 153
As regards facilities at Trirurangadi Taluk Hospital
14. This hospital is one of the major hospitals in the coastal region of
Malappuram District. 68 centralised oxygen supply knobs have been
established in the hospital. The number of oxygen cylinders has
increased manifolds .These facilities have been implemented on the
second and third floor of the Women and Children hospital building.
15. From April 2021 onwards 68 bedded step down CSLTC have been
started in the District Early Intervention Centre Building. This institution
has COVID casualty, stabilization unit and observation facility. In
addition to this, 2 ventilators have been established in the Tirurangadi
Hospital, which started functioning from 5/06/2021. Further 3 ventilators
have also been provided as of now. Additional works are underwent on
connecting the central oxygen plant to the 1 kilo Litre liquid oxygen
tank, expanding the number of oxygen beds and setting up 8 ICU beds.
Separate dialysis beds have been established for COVID patients
undergoing dialysis in THQH, Tirurangadi. Besides, 9 oxygen
concentrators have been established. This hospital was upgraded from
the old status of having 20 COVID beds to the present scenario of 106
COVID beds. In addition to the above mentioned COVID facility we are
also providing non-COVID deliveries and also non COVID surgeries in
the hospital.
PREVIOUS STATUS CURRENT STATUS
OXYGEN BEDS:20 OXYGEN BEDS:106
(68 CENTRAL SUPPLY + 38
CYLINDER BASED)
OXYGEN CYLINDERS: 10 B TYPE OXYGEN CYLINDERS: 100 D TYPE
+ 59 B TYPE
OXYGEN CONCENTRATOR: 9
STABILISATION AREA AND COVID STABILISATION AREA AND COVID
CASUALTY : ABSENT CASUALTY
12 BED STARTED WITH OXYGEN
SUPPLY
VENTILATOR FACILITY : 0 VENTILATOR FACILITY : 2 + 3
16. Oxygen Tank (1 K) was shifted from Manjeri Medical College as per
the instruction of DDMA, and is in process of installation. Apart from
THQH Tirurangadi, in Tirurangadi constituency, there are Everest
University Hostel with 268 normal beds and 9 oxygen beds, Prasanth
Hospital with 8 Normal beds, 5 ICU beds and 4 oxygen supported beds and
NAHAS Hospital with 19 normal beds, 12oxygen beds for Covid. Earnest
effort is being taken by this office to provide maximum facilities to each and
every COVID hospitals in district including THQH Tirurangadi.
As regards Vaccination
17. Earlier the vaccinations were for health care workers and front line
workers only. Initially, there were some hesitancy from beneficiaries of the
vaccination scheme. But, when COVID surged during April, there occurred
heightened demand for Vaccination. In Malappuram District, there are 116
vaccination centres in public sector and 2 private hospitals in Malappuram
district, as of now. There has been instance of Vaccination sessions being
held in 163 sites in a day. The availability of vaccines, as of now, is
sufficient for the vaccination process undergoing. Additional quantity of
vaccines has ensured from the state as and when the demand is raised.
There is at least one vaccination centre in every LSGD in our district. For a
target population of above 18 years i.e, 3394790, 639576 i.e. 18.8% of
target have been administered the first dose of vaccine, as of now
(06/06/2021). Apart from this, 1,41,588 have been administered second
dose. Now that vaccines are available, a district action plan has been made
to cover maximum beneficiaries in the shortest period."
10. In the reply affidavit filed by the petitioner in W.P.(C) No.
11711 of 2021 i.e., the Member of Legislative Assembly, Tirurangadi
Constituency, stated that there were only 2 ventilators available in the
Taluk Head Quarters, Thirurangadi; however, both are not in working
condition. Taking into account the said aspect also, rejoinder
statement is filed for and on behalf of the Medical Officer, which reads
thus:
"As regards the ventilators in Taluk Head Quarters Hospital (THQH),
Tirurangadi
4. The demand for ventilators increased across the district due to an increase in
the number of C category patients. So, the ventilators at THQH Tirurangadi, as
directed by the District Disaster Management Authority, were necessitated to be
shifted to Government Medical College Hospital (GMCH), Manjeri, which
apart from being the major tertiary hospital in the district catering to the
population from all parts of the district, was also equipped with a 4KL Oxygen
tank. This was life-saving for a lot of patients in the district. In the meanwhile,
oxygen cylinder supply at THQH, Tirurangadi was increased multi-fold and
two ventilators were provided therein on 05.06.2021 and those were made
functional on war footing basis on the same day. In addition, 3 non-invasive
ventilators were shifted from GMCH Manjeri to THQH Tirurangadi on
07.06.2021. Training was given to the doctors and supporting staff on operation
of the said ventilators. It is submitted that the shifting of the three ventilators
from GMCH, Manjeri to the THQH, Tirurangadi has not adversely affected the
ventilator support system in GMCH, Manjeri or resulted in lesser number of
functional ventilators therein, in so far as there are adequate number of
ventilators therein.
As regards Exhibits P6, P7 and P8
5. It is clear from Exhibit P6 that the same speaks about the situation on
05.06.2021, when the installation work of the above referred two
ventilators was in progress. The work was completed and the said two
ventilators were made functional on the same day. That the said ventilators
are functional is clear from Exhibits P7 and P8.
6. As regards the contentions of the petitioner that the said two ventilators
were only functional and not put to use, relying upon Exhibit P8 letter, it is
submitted that in exhibit P7, the petitioner asked whether those two
ventilators were functioning and, as per exhibit P8, it was replied that the
two ventilators mentioned were in working condition.
As regards ventilators in Malappuram District
7. The total number of ventilators in the district, as on 03.06.2021, was
145. This included 74 in Government and 71 in private facilities. That the
total number of ventilators in the district was 145, as on 03.06.2021, was
orally submitted before this Honourable Court on 04.06.2021. As on
07.06.2021, the total ventilators in the district were 153, apart from the
three ventilators which were added to the ventilator capacity of THQH
Tirurangadi, which stood at functional two ventilators then (that is the two
ventilators that were shifted to therein and made functional on
05.06.2021).The statement was dated 07/06/2021. The further added
number of ventilators, as on 07/06/2021, was corrected from 145 to 153.
However, the date of 03/06/2021, which ought to have been corrected as
07/06/2021, was omitted to be corrected. The mistake happened when the
statement was prepared by the Learned Senior Government Pleader. As of
now, there are 156 functional ventilators in the District. Though the
ventilator occupancy is less when compared to the number of ventilators,
the district authorities are making every earnest attempt to increase the
number of ventilators to meet the contingencies of a possible third wave.
8. It is submitted that there are chances of the number of functional
ventilators varying in a day by one or two numbers, as those are
functioning continuously and in between, they may need service or
maintenance. This may be reflected in the Covid Jagratha Portal also.
As regards vaccination in Malappuram District
9. As on 14/06/2021, 7,60,053 (22. 39 %) out of the targeted population
above 18 years in the district, totalling to 33,94,790, have been administered
first dose of the vaccine. 1,55,530 persons have been administered both does
of the vaccine. In the 7 days from 07/06/2021 up to 13/06/2021,
Malappuram district stood in the first position for 3 days among all the
districts of the State in the number of vaccines administered, second
position for one day and in the third position for 2 days.
10. The daily vaccination sites vary subject to the availability of vaccine.
There has been instance of vaccination being given at 163 sites in a day on
12th of April, 2021. Now due to lockdown restrictions and prevalence of
containment zones, too many outreach sessions cannot be conducted.
Earlier, private hospital facilities were also used for vaccination along with
Government facilities. But later, on account of the changed vaccination
policy of the Union Government, the private hospitals had to purchase
vaccines directly from the manufacturers. It is planned to have outreach
sessions/ camps and to involve mobile vaccination units, thereby
vaccinating the people in the district to the maximum."
11. That apart, today, when the matter is taken up, the
statistics of the vaccinations administered is made available to us. The
said statement as on 26.06.2021 is extracted hereunder:
Table 1. Total Vaccination done in the State as on 26.06.2021 midnight
State Summary till 27.06.2021 at 12 a.m.
Districts First Dose Percent- Second Percent- Total Does
age* Dose age Administered
Alappuzha 619661 36% 217159 13% 836.820
Ernakulam 1326486 50% 312445 12% 1,638,931
Idukki 374357 42% 93066 10% 467,423
Kannur 746260 36% 206816 10% 953,076
Kasaragod 429012 44% 121094 12% 550,106
Kollam 813253 40% 229379 11% 1,042,632
Kottayam 666072 44% 200902 13% 866,974
Kozhikode 949101 39% 260444 11% 1,209,545
Malappuram 881325 28% 215043 7% 1,096,368
Palakkad 653447 30% 206708 9% 860,155
Pathanamthitta 558374 55% 195876 19% 754,250
Thiruvananthapura 1237928 47% 368365 14% 1,606,293
m
Thrissur 911972 37% 247291 10% 1,159,263
Wayanad 339840 52% 102824 16% 442,664
Grand Total 10507088 40% 2977412 11% 13,484,500
Percentage of eligible population (>18 years)
Table 2. Covid-19 Vaccination Centre Functional in the State as on 26.06.2021
midnight
Districts 18 + (State 40+ 45+ Total
priority)
a
puram
Table7. Achievement for the day 26.06.21 midnight
District 1st Dose 2nd Dose Total
Alappuzha 2813 10726 13539
Ernakulam 26995 6854 33849
Idukki 2988 3758 6746
Kannur 3798 515 4313
Kasaragod 2517 8034 10551
Kollam 3570 3925 7495
Kottayam 2749 3499 6248
Kozhikode 15163 8266 23429
Malappuram 9770 5645 15415
Palakkad 3464 981 4445
Pathanamthitta 4779 7130 11909
Thiruvananthapur 10621 8067 18688
am
Thrissur 9857 5481 15338
Wayanad 4307 1774 6081
Grand Total 103391 74655 178046
12. We have heard, Adv Sri. C.M. Mohammed Iquabal, Adv Sri.
Rakesh K and Adv Sri. Jacob Sebastian for the petitioners and the
learned Advocate General Sri. K. Gopala Krishna Kurup for the State
assisted by Sr. Government Pleader Sri. Manu V, and perused the
pleadings and materials on record.
13. The deliberations made above makes it clear that the
petitioners are basically submitting that the vaccination for Covid-19
pandemic shall be administered on the basis of the population and
since Malappuram district has highest population in the State,
vaccination is to be administered taking into account the said aspect
and more vaccination should be made available to the people of the
Malappuram District. In one of the writ petitions, it is also stated that
apart from the high density population, the test positivity rate in
Malappuram District is higher and therefore, the State and the District
Administration are duty bound to enhance administration of vaccines
to the people of the Malappuram District to ensure the disease being
infected in an unprecedented manner and causing inconvenience to
the people, and making adverse situations leading to fatalities.
14. Learned counsel appearing for the petitioners have
advanced their arguments on the basis of the pleadings made in the
writ petitions and the discussions made above.
15. Per contra, learned Advocate General submitted that all
precautionary measures are taken by the State and the District
Administration to meet up with any contingencies and to combat the
pandemic Covid-19. It is also pointed out that the evaluation is done
by the State Government on a day-to-day basis through the District
Administration and steps are taken to modulate action, taking into
account the increase in the test positivity rate and the Government
has evolved a policy and plan to administer vaccines. It was also
pointed out that adequate and sufficient steps are taken to provide
facilities in the Government Hospitals and the private hospitals within
the district and the nearby districts.
16. It was further submitted that the State has alerted the
District Collectors and the District Medical Officers to be ready with
necessary machinery and adequate facilities so as to ensure that
suitable and adequate medical facilities are provided to the persons
infected with the pandemic covid disease and also to prevent the
spread of the same by implementing strict lockdown and reasonable
restrictions taking into account the changing situations. It was also
submitted that in order to avoid any apprehensive situation of the
people to acquire essential articles, sufficient steps are taken taking
into account the test positivity rate at the Local Self Government
Institutions level. Therefore, the sum and substance of the contention
advanced by the learned Advocate General was that the relief sought
for by the petitioners deviating from the policy adopted by the
Government in the matter of administering vaccine cannot be
sustained and if any deviation from the present strategy is adopted by
the court, that would overturn the systematic and disciplined steps
taken by the Government in the matter of administering of vaccine.
17. We have evaluated the rival submissions. In order to deal
with the pandemic covid situation, the Government has invoked the
powers conferred under the Disaster Management Act, 2005 and the
Epidemic Diseases Act, 1897. On the basis of the power conferred
under the aforesaid statute, periodic Government Orders are issued
taking into account the situations then and there prevailing in the
State. It is also clear from the documents made available to us that a
policy is adopted by the Government to administer vaccines to the
people of the entire State. Statistics extracted above would also show
that vaccines are being administered on a continuous basis in the
entire State of Kerala. Percentage of the vaccine administered shows
that sufficient progress is achieved by the State in the matter of
administering the vaccine. Therefore, any interference made in the
ongoing process and the mechanisms adopted, would upset, and even
may truncate the functionalities of the embedded system put in place
by the administration.
18. We also find that the vaccine is administered on the basis of
the test positivity rate at the Local Self Government Institutions Level
and where there is more test positivity rate, the vaccine is
administered in that region in order to avoid the pandemic surging
spread to the nearby areas. Since there is a clear policy and strategy
adopted by the Government in the matter of administering vaccines,
we cannot direct the State Government or the District Administration
of the Malappuram District to carry out administering of vaccination on
the basis of the population of the district. It is well settled in law that
when a policy is adopted by the Government in the matter of
discharging its duties, interference of a writ court exercising the power
of discretionary jurisdiction would be very slow, unless from the
pleadings it is manifested that there is patent arbitrariness or illegality
and thus, interference is vitally required to set it right .
19. It is also clear from the statement filed by the District
Medical Officer, Malappuram, that adequate steps are taken to tackle
any unprecedented situation due to pandemic covid-19 and the
surging of the same. We have also found that the facilities in the
hospitals in the Government as well as the private sector are
evaluated by the District Administration and steps are being taken to
enhance the facilities so as to meet up with the requirements of the
people of the district.
20. That being the situation, we do not think, the relief sought
for by the petitioners to administer vaccines on the basis of the
population is not a legally sustainable one and we decline to grant any
relief of such a nature. However, since certain apprehensions are
made on the basis of the test positivity rate in the Malappuram
District, we direct the District Administration as well as the State
Government to ensure that the issues are tackled in accordance with
the policy launched by the Government in the matter of administering
Covid-19 vaccine. We also direct the District Collector, Malappuram and
the State Government to ensure that adequate facilities are made in
the hospitals so as to deal with any vulnerable situations due to the
surge of pandemic Covid-19, especially in the Government hospitals
to tackle the needs of the common man and the downtrodden.
21. Circumstances being so, we do not think that the State
Government will not take appropriate action to protect the interest of
the people of the Malappuram District in the matter of administering
vaccines, providing hospital facilities, and tackling emergent situations
to avoid any fatality.
With the above observations and directions, the writ petitions
are disposed of.
sd/-
S. MANIKUMAR,
CHIEF JUSTICE.
sd/-
SHAJI P. CHALY,
JUDGE.
Rv
APPENDIX OF WP(C) 11670/2021
PETITIONER EXHIBITS:
Exhibit P1 THE TRUE COPY OF THE RELEVANT PAGES OF ANNUAL
VITAL STATISTICS REPORT, 2018.
Exhibit P2 THE TRUE COPY OF THE RELEVANT PAGES OF THE
STATISTICS PREPARED BY DIRECTORATE OF HEALTH
SERVICES, STATE OF KERALA.
Exhibit P3 THE TRUE COPY OF THE COVID 19 DAILY VACCINATION
BULLETIN DATED 26/5/2021.
Exhibit P4 THE TRUE COPY OF THE COVID-19 POSITIVE CASE
REPORTS STATISTICS PUBLISHED IN THE NEW INDIAN
EXPRESS DAILY.
Exhibit P5 THE TRUE COPY OF THE REPRESENTATION SUBMITTED
BY THE PETITIONER BEFORE THE 2ND RESPONDENT
DATED 24/5/2021.
EXHIBIT P6
TRUE COPY OF THE RELEVANT PAGES OF COVID 19
DAILY VACCINATION BULLETIN DATED 12.06.2021.
EXHIBIT P7
TRUE COPY OF THE BASIC DETAILS OF GRAMA
PANCHAYATS IN MALAPPURAM DISTRICT.
RESPONDENTS' EXHIBITS: NIL
/True Copy/
P.S to Judge.
Rv
APPENDIX OF WP(C) 11709/2021
PETITIONER'S EXHIBITS:
Exhibit P1 TRUE COPY OF THE GRAPH THE DETAILS OF
VACCINATION IN THE STATE.
Exhibit P2 TRUE COPY OF THE DASH BOARD OF THE KERALA
GOVERNMENT WEBSITE OF COVID VACCCIANION
CENTRES (CVC).
Exhibit P3 TRUE COPY OF THE LETTER ISSUED BY THE PRESIDENT
OF THE MALAPPURAM DISTRICT PANCHAYATH TO THE
HONBLE CHIEF MINISTER OF KERALA, DATED 27.5.2021
WITH ENGLISH TRANSLATION.
Exhibit P4 TRUE COPY OF THE TABLE SHOWING THE NUMBER OF
COVID VACCINE STOCK AS ON 27.5.2021 , PUBLISHED
IN THE OFFICIAL WEBSITE OF THE GOVERNMENT OF
KERALA.
RESPONDENTS' EXHIBITS: NIL
/True Copy/
PS To Judge.
rv
APPENDIX OF WP(C) 11711/2021
PETITIONER'S EXHIBITS:
Exhibit P1 A TRUE COPY OF THE ORDER NO.31/F2/2020/HEALTH
DATED 28.07.2020.
Exhibit P2 A TRUE COPY OF THE ORDER NO.24/31/F2/2020/H AND
FW DATED 09.05.2021.
Exhibit P3 A TRUE COPY OF THE PRINTOUT OF THE COVID
HOSPITAL DASHBOARD FOR MALAPPURAM DISTRICT
FROM EJAGRATHA PORTAL ON 24.05.2021 IN RESPECT
OF GOVERNMENT HOSPITALS.
Exhibit P4 A TRUE COPY OF THE PRINTOUT OF THE COVID
HOSPITAL DASHBOARD FOR MALAPPURAM DISTRICT
FROM EJAGRATHA PORTAL ON 24.05.2021 IN RESPECT
OF GOVERNMENT AND PRIVATE HOSPITALS.
Exhibit P5 A TRUE COPY OF THE REPRESENTATION DATED
15.05.2021 SUBMITTED TO THE 1ST RESPONDENT WITH
ENGLISH TRANSLATION.
EXHIBIT P6 TRUE COPY OF THE LETTER NO.A1-3581/2021 OF THE
SUPERINTENDENT OF THE TALUK HEADQUARTERS
HOSPITAL, TIRURANGADI DATED 05.06.2021 ALONG
WITH ENGLISH TRANSLATION.
EXHIBIT P7 TRUE COPY OF THE EMAIL MESSAGE SENT BY THE
PEITTIONER TO THE SUPERINTENDENT OF THE TALUK
HEADQUARTERS HOSPITAL, TIRURANGADI.
EXHIBIT P8 TRUE COPY OF THE LETTER DATED 10.06.2021 WITH
NO.A1/3693/2021 ISSUED BY THE SUPERINTENDENT OF
THE TALUK HEADQUARTERS HOSPITAL, TIRURANGADI.
RESPONDENTS' EXHIBITS: NIL
/True Copy/
PS To Judge.
rv
