The Centre on Thursday told the Supreme Court that though hospitals are responsible for implementing the Infection Prevention and Control (IPC) activities, the final responsibility lies with the healthcare workers to protect themselves from COVID-19.
The Ministry of Health and Family Welfare told the top court that it is the responsibility of healthcare workers to adequately train themselves and take all possible measures for preventing the infection which not only include COVID but other diseases as well.
A bench of Justices Ashok Bhushan, Sanjay Kishan Kaul and M R Shah allowed petitioner Dr. Arushi Jain’s counsels advocate Mithu Jain and Arjun Syal to file the rejoinder affidavit to Centre’s reply within a week and posted the matter for June 12.
Arushi Jain, a private doctor, in her plea has questioned the Centre's new Standard Operating Procedure of May 15 for front line COVID-19 Healthcare Workers (HCWs) by which it has ended the 14-day mandatory quarantine for them.
In its reply to the plea, the ministry said, “It is submitted that while the Hospital Infection Control Committee (HICC) in the health facility is responsible for implementing the Infection Prevention and Control (IPC) activities and for organising regular training on IPC for HCWs, the final responsibility lies with the HCW to prevent infection and to protect himself/ herself”.
It said that it is also his/her responsibility to adequately train himself/herself and take all possible measures for preventing the infection and if adequate measures are scrupulously observed, the HCWs chances of contracting the infection would not be higher than that of any other person.
“…It is submitted that the current pandemic of COVID-19 is unprecedented and there is no time tested and universally acceptable protocol pertaining to COVID preparedness. Furthermore, the biggest challenge to deal with this pandemic is that there are currently no proven therapeutics or vaccines or rapid point of care diagnostic tests, risk assessment and management protocols for COVID-19 and here are major research gaps in many other key areas of COVID patient and hospital management”, the ministry said.
Justifying the advisory and SOPs of May 15, the health ministry said that it is a step in right direction and the guidelines emphasizes the role of taking adequate preventive measures by all HCWs working in the hospital setting against the likelihood for contracting infection at their work place.
It added that the risk profiling of those exposed has been deliberated in detail in the technical body under the Directorate General of Health Services, the Joint Monitoring Group (JMG), which also has representative of World Health Organisation.
“This risk assessment approach is also in line with guidelines issued by Centre for Disease Control, Atlanta, USA that only high risk exposure needs to be quarantined for 14 days. Hence, mandatory quarantine for 14 days, after rostering duty of healthcare workers of 7/14 days is therefore not justified and warranted,” it added.
The ministry in its reply affidavit said that healthcare workers are properly protected by PPEs in workplace settings carries no additional risk to their families or children.
It said that grievances raised by the petitioner with regard to the infirmities in the new guidelines dated May 15, issued by Ministry of health and family welfare are completely presumptuous, vacuous, ill-founded and sans any empherical or medical evidence.
“It is most respectfully submitted that number of cases of COVID-19 are constantly increasing and at some point of time in near future, apart from existing hospitals, large number of temporary make-shift hospitals will have to be created in order to accommodate COVID-19 patients requiring admission, medical care and treatment,” it said.
The government said that to successfully create optimum infrastructure to provide best medical care to the COVID patients, the Central government will also have to adequately address human resource issue for this envisaged surge capacity scenario.
“Hence, conserving healthcare work force is the need of the hour in order to cater to the anticipated patient load in the hour of distress”, it said.
The top court on May 26, had asked the Centre to file a reply on the affidavit filed by Dr. Jain raising questions on the May 15 advisory which ended the 14-day mandatory quarantine for all healthcare workers in COVID and non-COVID areas.
As per the advisory, quarantine of healthcare workers, other than the two categories -- in case of high exposure to COVID-19 and in cases of healthcare workers showing symptoms of COVID-19 -- is not warranted, the plea had said.
On April 8, the apex court had observed that the doctors and medical staff are the "first line of defence of the country" in the battle against COVID-19 pandemic, and directed the Centre to ensure that appropriate personal protective equipment (PPE) are made available to them for treating coronavirus patients.
While passing a slew of interim directions to ensure safety of doctors and healthcare professionals, the apex court had expressed concern over the recent incidents of attack on them and directed the Centre, all states and Union Territories to provide necessary police security to the medical staff in hospitals and places where patients, who are either quarantined, suspected or diagnosed with COVID-19, are housed.
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