An interim report of a sub-group, constituted by the Supreme Court final month for the oxygen audit of Delhi, has set off a political firestorm by questioning the Delhi authorities’s demand for liquid medical oxygen (LMO) through the peak of the second Covid-19 wave.
The report, submitted to the Supreme Court, additionally led to division throughout the 5-member sub-group with two members, Delhi Principal Secretary (Home) BS Bhalla and Max Healthcare Clinical Director (Internal Medicine) Sandeep Budhiraja, lodging their dissent, even skipping considered one of its sittings. They flagged their objections in two separate notes.
In a file noting of the Delhi Home Department, Bhalla Friday highlighted that the “interim report seems to have been sent to Government of India without making the requisite changes, without sharing again with the members of the sub-group, and without their formal approval”.
He wrote that his “detailed objections/comments have been added at the end of the interim report just for posterity, leaving it to the reader to make the effort, if he/she so decides, to interpret the entire report together and make his/her conclusions. This is unfortunate and unacceptable.”
“The interim report, as submitted, does not have the approval of all the members of the sub-group,” he wrote.
The different three members of the sub-group are AIIMS Director Dr Randeep Guleria, Jal Shakti Ministry Joint Secretary Subodh Yadav and Controller of Explosives, PESO Dr Sanjay Kumar Singh.
The Delhi authorities, following approval from Chief Secretary Vijay Dev, additionally conveyed to the SC-appointed panel that it was “sad and shocking to note that the sub-group arrived at sweeping conclusions… without any audit in the true sense”.
As particulars of the interim report emerged Friday, the BJP and the Congress focused the AAP authorities, accusing Chief Minister Arvind Kejriwal of “lying” through the peak of the second wave. Kejriwal hit again, saying when “you were addressing poll rallies, I spent sleepless nights to arrange oxygen”.
An in depth studying of the report reveals that the variations within the LMO demand for Delhi through the second wave peak, from the final week of April to early May, are resulting from two separate formulation utilized by the Centre and the Delhi authorities.
Under the Centre’s method, 50% of non-ICU oxygen beds are calculated as utilizing LMO. The Delhi authorities method, alternatively, says all non-ICU oxygen beds use oxygen. The two formulation had been mentioned through the seven conferences of the panel between May 10 and May 21.
While ICU beds include oxygen services by default, hospitals even have non-ICU beds with oxygen for sufferers requiring excessive circulation oxygen with out related ICU help. A separate class of non-ICU, non-oxygen beds can also be maintained.
The sub-group noticed that the Delhi authorities method would result in “overestimation” going by real-life expertise of main hospitals together with AIIMS.
Countering this, Bhalla stated the Centre’s method was unsuitable as a result of most Covid sufferers admitted to hospitals required oxygen. “Doubts can be resolved only through on-ground audit, which the sub-group is yet to do,” he stated.
Bhalla, Budhiraja and Chief Secretary Dev identified that the sub-group had not factored within the requirement of LMO for dwelling isolation sufferers, refillers, ambulances and small nursing properties.
Members of the group affiliated with the Central authorities our bodies advisable that Delhi be supplied 300 MT each day on assured foundation and a further 100 MT by 4 pm on a regular basis primarily based on requirement, whereas Delhi insisted on assured each day allocation of 568 MT.
A “compromise” was labored out on May 15 to allocate 500 MT each day to Delhi, the interim report famous.
The one main level that the BJP picked to criticise the AAP pertains to the LMO consumption demand as on May 12.
The report famous that on May 13, “it was discussed that there is a gross discrepancy (about 4 times) in that the actual oxygen consumption claimed (1140 MT) was about 4 times higher than the versus calculated consumption by formula for bed capacity (289 MT). It was noted that four hospitals in Delhi i.e. Singhal Hospital, Aruna Asaf Ali Hospital, ESIC Model Hospital, and Liferay Hospital have claimed extremely high oxygen consumption with very few beds and the claims appeared to be clearly erroneous, leading to extremely skewed information and significantly higher oxygen requirement for the entire state of Delhi. Actual consumptions were estimated by recalculation after replacing the claimed use figures for these 4 hospitals with expected use figures using the calculation formula.”
In his dissent be aware, Bhalla sought to counter it, saying “requirement of oxygen for oxygen cylinders with home isolation patients, refillers and certain other establishments has also to be taken into account. Also, oxygen for non-Covid requirements and some buffer components need to be factored in while calculating the total oxygen requirement of Delhi. It is further an indisputable fact that 214 is not the sum total of hospitals/medical establishments catering to patients suffering from Covid-19. In fact, the figure is more than 260. Therefore, the entire basis of the assessment/quantification of the LMO requirement in Delhi has been made on incomplete data.”
After factoring in these elements, the oxygen consumption was discovered to be 474 MT, as an alternative of 289 MT as claimed within the report, Bhalla stated.
The remark made by the Additional Secretary, Department for Promotion of Indian Industry and Internal Trade that “it also appears that Govt of Delhi used a wrong formula and made exaggerated claims on 30th April” too was rejected by Bhalla who stated that the “demand for 700 MT was fully in line with guidelines of GOI.”
Bhalla stated: “The manner in which the proceedings of the Sub-Group have been conducted suggests that the purpose of proceedings was to justify a pre-conceived and predetermined conclusion and narrative, to recommend a lower quantity of a LMO to Delhi, and to further portray an impression that the assessment by the GNCTD before the Hon’ble High Court of Delhi and the Hon’ble Supreme Court was exaggerated or not genuine.”
“In our assessment, these fundamental errors in the approach of the sub-group goes to the root of the matter and was, therefore, highlighted from time to time during the course of proceedings of the sub-group. Unfortunately, the draft Interim Report instead of taking cognizance of the said concerns is proceeding to indicate the quantity of LMO to be allocated to Delhi. This, in our considered view, vitiates the entire exercise,” he stated.
According to a file noting connected to the interim report, signed by OSD (Health) Ashish Kundra, hostile observations of the panel had been mentioned with Chief Secretary Dev and “it appears that the committee has not taken the totality of the picture into consideration.”
Dev identified that SOS calls in Delhi stabilised solely after the typical each day provide of LMO crossed 550 MT, together with over 700 MT on someday. He described the proceedings of the group as “perfunctory desktop exercise, conducted hurriedly, without even conducting an audit of a single institution in the true sense”.
Budhiraja wrote, “This (interim report) did not take into account oxygen cylinder refilling and non-Covid requirements of hospitals. It was suggested on the basis of actual consumption and not on basis of formula that O2 allocation for NCT Delhi be kept at 500 MT and then reviewed twice weekly thereafter. In the last subgroup meeting, it was decided not to discuss this agenda in the sub group, as an oxygen commissioner would be taking decision regarding oxygen allocation to states/UT. Also, I did not attend the meeting on May 18 after prior information to the group of the WhatsApp that minutes of the previous meeting on May 15 should be circulated. That was never done,” he stated.