The Delhi High Court on Friday called for strict action against those found violating masking and hand hygiene norms at airports and in aircraft, observing that the COVID-19 pandemic has not abated and keeps springing up its ugly head. 

New Delhi: In 2020, the Government of India set up the Prime Minister’s Citizen Assistance and Relief in Emergency Situations (CARES) Fund that it said would mobilise help to various parts of the country as the country’s first major COVID outbreak was taking shape, and a brutal second one on the horizon.

Under this initiative, the noted Shri Maharaja Hari Singh (SMHS) Hospital, Srinagar, received a batch of 165 ventilators from the Fund. And an application under the Right to Information (RTI) Act has now revealed that hospital authorities found all 165 units to be defective either during tests or when operated with patients.

India experienced a crucial ventilator crunch last year. Severe COVID-19 impairs lung function considerably, which means patients need these devices to be able to continue breathing. The government put out calls for enterprising engineers and doctors around the country to develop and manufacture more ventilators than were available, while groups of scientists also banded together to make their own efforts.

However, the programme was marred by two problems. First, a company to which the PM CARES fund – operated by Prime Minister Narendra Modi and a coterie of senior ministers – awarded a contract for 10,000 ventilators was found to have never made ventilators before.Second, the government didn’t set out any standards that ventilator designs would have to comply with, mixing up the features that were available with each candidate as well as slowing work itself. 

India’s second major COVID-19 outbreak was marked by a shortage of oxygen, not ventilators. Nonetheless, while hospitals may have a sufficient number of ventilators today, their quality remains unclear. And the latest RTI finding is revealing in that regard.As it happens, the Fund’s operators sent the 165 units to the SMHS Hospital even though the Jammu and Kashmir union territory hadn’t asked for them.

The RTI application had been filed by a Jammu-based activist named Balvinder Singh, with the Department of Health and Medical Education. The department’s answers were to 15 questions Singh had had about the ventilators received from the Fund.

And according to the reply received, most of the devices were unable to meet the conditions required to “support patient care management” and that they would “stop automatically”, putting “patients at risk”.Singh told The Wire he was prompted to file his RTI application after he found from conversations with doctors that “a large number of the supplied ventilators were not up to the mark and were not generating the required tidal volume”.

The tidal volume is the amount of air that moves in and out of the lungs when we breathe. A ventilator that doesn’t general the proper tidal volume is a ventilator that has failed to perform its essential function.“But [the doctors] were not ready to speak in the open or provide the correct details about the defective ventilators, maybe due to compulsions or pressure from some quarters,” Singh added.

He said he was encouraged to continue his enquiries after a member of the hospital’s anaesthesiology department “admitted that three kinds of ventilators” that [Srinagar] had received from different sources “were not generating the required tidal volume” nor the fraction of inspired oxygen – the amount of oxygen available to the lungs.

Singh filed his RTI around the middle of 2020. It was only his first appeal that elicited a proper answer, on September 25, when the head of the department of anaesthesiology and critical care at the Government Medical College (GMC), Srinagar, replied with a detailed letter. It confirmed what doctors had told Singh.

First, Srinagar had received from three sources, and they were all defective. Second,  the GMC’s department of anaesthesiology and critical care hadn’t put in a request for ventilators from the PM CARES Fund. But it received some units anyway following a reported requisition request from the superintendent of the SMHS Hospital.The three sources were the following: Bharat Ventilators (37 units), Jyoti CNC Automation Ltd. (125) and AgVa Ventilators (3).

Jyoti CNC had reportedly received Rs 121 crore to supply 5,000 ventilators to HLL Lifecare, the government-owned company tasked with acquiring ventilators for India’s hospitals. The devices AgVa sold to the government were priced at Rs 1.8 lakh apiece.“Bharat Ventilators” likely refers to Bharat Electronics Limited (BEL), the government-owned defence electronics company, according to a different RTI application from August 2020. It sold 30,000 ventilators to HLL for Rs 1,513.92 crore.

So the total cost of the 165 defective units amounts to Rs 304.4 crore. The PM CARES fund as such had set aside Rs 2,000 crore to fund the procurement of 50,000 ventilators; the total bill was Rs 2,332 crore.The anaesthesiology department member wrote that the department received 37 units made by Bharat Ventilators, from the medical superintendent of the SMHS Hospital, and that GMC staff set about testing them.

“However, all these ventilators [were] returned to the medical superintendent of SMHS Hospital due to compressor/heat-up problems, which resulted in sudden shut-down of these ventilators,” the letter that Singh received said.The three units from AgVa ventilators were installed at SMHS hospital but they were typified by non-functional displays or problems with generating a sufficient tidal volume”.

The 125 units from Jyoti CNC – with the brand name ‘Dhaman III’ – were stationed at the DRDO Hospital in Khanmoh, Srinagar. Two that had been tested at SMHS, however, didn’t elicit a sufficient tidal volume and also stopped working “automatically”.Jyoti CNC had said in August 2020 that the Directorate General of Health Services, under the Union health ministry, had tested the Dhaman III and qualified it for service.

The DRDO hospital also has 22 more units made by AgVa Ventilators that are being put through their paces, the letter said.The RTI reply’s revelations reinforce questions that have been hanging over two of the three implicated vendors – Jyoti CNC and AgVa.

AgVa was one of the companies that lost out to the one that had never made ventilators before. Its contract with HLL to supply 10,000 ventilators has also been called into question because of doubts that it was awarded before the technical committee the health ministry setup to evaluate applications was constituted. Similarly, Jyoti CNC received an advance payment for its contract – only for the technical committee to withhold its recommendation for the company.

That the ventilators are now lying unused is not entirely new either. In May 2021, for example, the Aurangabad Medical College said that 58 of the 150 Dhaman III ventilators it had received from Jyoti CNC were “faulty”. All these units had been funded with money from the PM CARES fund.The college also alleged that technicians from Jyoti CNC called in to fix some malfunctioning ventilators were unable to help.

More broadly, in June 2021, the New Indian Express reported that 5,500 ventilators were gathering dust in the health ministry’s warehouses. In the same month, Scroll.in found that health workers in both BJP- and non-BJP-ruled states had problems with the ventilators they had received, and that the ventilators the Centre had purchased from well-known manufacturers weren’t sent to the states but had been retained for its own use.

Singh has now written to the Chief Justice of the Jammu and Kashmir high court requesting “serious cognisance of the ‘defective ventilators’ supplied to J&K UT through PM CARES Funds”.He also sought directions to the UT’s chief secretary – to constitute an expert committee to examine all ventilators received from the PM CARES Fund – and strict action against the offending suppliers. He has also requested disciplinary action against health department officials for endangering patients.

Sao Paulo: In a devastating blow to President Jair Bolsonaro, the report of a senate probe into his government’s handling of the COVID-19 pandemic has charged the Brazilian far-right leader with nine offences, including crime against humanity and crime of responsibility. The report has also indicted the president and some of his top aides for malfeasance in the tainted deal for the purchase of 20 million doses of Covaxin made by Bharat Biotech, which has come under some scathing criticism. Two top executives of Bharat Biotech’s former business partner in Brazil, Precisa Medicamentos, have been indicted for “running an organised crime” besides committing fraud and forgery.

At a tension-filled chamber on Wednesday, the rapporteur of the parliamentary commission of inquiry (CPI), Senator Renan Calheiros, presented his report to the 11-member panel which will vote for its approval on Tuesday (October 26). Reading a summary of his report, which runs into 1,180 pages, the senator named Bolsonaro as the main culprit for uncontrolled COVID-19 infections in Brazil. The president, said the rapporteur, should be held responsible and investigated for nine crimes, including crimes against humanity, which could result in imprisonment; and crimes of responsibility, which may lead to the president’s impeachment. For all the nine crimes together, Bolsonaro can be sent to prison for up to 40 years. “The president has committed many crimes and he will pay for them,” Senator Omar Aziz, president of CPI, said at the beginning of the session on Wednesday.

Televised live on national networks and watched by millions, the CPI report was tabled just six days short of six months of CPI investigation, which has exposed how the Bolsonaro government made little effort to contain the virus. “This inquiry gathered evidence that clearly demonstrated that the federal government chose to act in a reckless manner, deliberately exposing the population [to the virus],” said Senator Calheiros, emphasising that the government allowed the spread of virus in the country as a “deliberate and conscious” policy to follow the so-called “herd immunity” strategy. The number of infections in Brazil, says the report, could have been 40% less and saved 1,20,000 lives if the government acted in time with responsibility.

Though the Brazilian president has been slapped with the maximum number of charges, the report indicts 65 persons – mostly political heavyweights – for 29 different crimes. Those indicted include Bolsonaro’s three sons, federal senator Flavio, federal deputy Eduardo and Rio city councilman Carlos, four federal ministers, three former ministers and three federal deputies. Two Brazilian companies, Precisa Medicamentos and VTCLog, have also been charged with “acting against public interest”. 

Out of 65 persons named by CPI, 11 have been indicted for irregularities in the Covaxin deal. Both the Brazilian firms, too, have been charged for their role in the $300-million contract with Bharat Biotech, which has been in the crosshairs of the inquiry since June.

All about Covaxin   

When the CPI began its work on April 27, the panel had a very broad mandate of looking at the “acts of omission and commission” by the Bolsonaro government. But in June, after a whistleblower exposed corruption in the purchase of Covaxin, the probe turned all its attention to the vaccine deal with India. With the burgeoning scandal, known here as CovaxinGate, becoming a symbol of Bolsonaro’s disastrous response to the pandemic, the panel summoned the maximum number of witnesses to testify about the irregularities in the contract with the Indian vaccine manufacturer. Now, the revelations about the contract make the centrepiece of the report as a 100-pages long chapter, called “The Covaxin Case”, has been devoted just to the deal with the Indian firm.

Scanning all the aspects of the contract, CPI has brutally dissected the whole Covaxin deal. From the details of the report emerges a scandalous picture in which corners were cut at every step of the $300 million contract amid a raging pandemic.

As per the CPI report, the decision to buy the Indian vaccine was a corruption scheme hatched at the highest level of Brazilian government. As Covaxin was not eligible for emergency use authorisation (EUA) by the Brazilian drug regulator (ANVISA), says the report, federal deputy Ricardo Barros, who is the leader of government in Congress, got a bill passed in 2021 that would allow the automatic authorisation of a vaccine in Brazil, if it was already approved in India. “This is serious because there was a warning from the Brazilian ambassador to India, on January 5, about the opaque and rushed approval process of Covaxin, without final efficacy data in that country [India] for emergency use, which caused strong internal distrust both among the specialists and people,” says the report, questioning the way Brazilian government sought an approval for Covaxin.

The CPI rapporteur, Senator Renan Calheiros (left), organises his report before presenting it to the commission at the senate on Wednesday. 

At the heart of the Covaxin scandal, according to the CPI report, is a letter sent by Bolsonaro to the prime minister of India, Narendra Modi, on January 8, 2021, just five days after the vaccine had been given EUA by the Indian drug regulator. In his letter, Bolsonaro told Modi that Covaxin had been selected for inclusion into Brazil’s national vaccination plan. The senate panel found this commitment from Bolsonaro highly incriminating. “It turns out that phase-3 clinical trials of the vaccine had not even been completed in India. During that period, by the way, Brazil ignored the offers from Pfizer, the most used vaccine in the world whose clinical trials were completed in Brazil, as well as those of Janssen (single dose) and Moderna,” says the report.

For his role in the Covaxin deal, Ricardo Barros who is one of the closest allies of Bolsonaro, has been indicted with the very serious charges of “incitement to crime”, “formation of a criminal organisation” and “administrative improbity”. Two executives of Precisa Medicamentos, Emanuela Medrades and Francisco Maximiano, have also been charged with these crimes in addition to the charges of “using false documents”. After signing an MoU with Bharat Biotech in November 2020, the Brazilian firm had represented the Indian company in all its dealings with Brazil’s ministry of health. Emanuela Medrades had also signed the contract with the ministry in February as a representative of the Hyderabad-based company.

Since it came on the CPI radar, the image of Bharat Biotech has been badly sullied in this country. Now, as the senate report has put out its findings and recommendations for action in black-and-white, the vaccine manufacturer’s will be damaged further. The vaccine, says the report, could have caused serious damage to Brazilians had they been vaccinated with it. “First, it is necessary to point out that Covaxin is a vaccine questioned around the world…Furthermore, months after its launch, Covaxin has not got international acceptance and the Indians, the only people who have been vaccinated with it en masse, live the trauma of not being able to travel to most countries as fully vaccinated persons,” says the report in a part of the Covaxin chapter which points out the delay in approval to the Indian vaccine in the US and Europe.

A costly affair

Under the contract between the Brazilian government and Bharat Biotech, the highly-priced vaccine was to be sold at $15 per dose. But as ANVISA refused to grant emergency use authorisation to Covaxin with the CPI investigators looking for the money trail in the deal, the contract came under a cloud. As the scandal became too hot to handle for the Bolsonaro government, the contract was first suspended and then cancelled completely in July this year.

Throughout the CPI investigation, a number of senators raised doubts about the safety of the Indian vaccine, especially because it had not yet received the approval from the World Health Organisation (WHO). The CPI report has articulated the issue of vaccine safety quite forcefully. “WHO has delayed the decision regarding the inclusion of Covaxin in the Covax facility program (sic), which has already been awarded to dozens of other vaccines. Sabyasachi Chatterjee, president of the respected All India People’s Science Network platform, says the WHO’s repeated postponement of granting emergency use authorisation to Covaxin is yet another demonstration that Bharat Biotech has failed to convince the world of that its vaccine is effective and safe,” says the CPI report, quoting an interview Chatterjee gave to Karan Thapar for The Wire, whose link is included in the footnotes of the section.

A screenshot of a page in CPI report which carries the image of a tweet by Bolsonaro in which he had thanked Prime Minister Modi for sending the raw material of hydroxychloroquine to Brazil.

In addition to questioning the safety of Bharat Biotech’s vaccine, the Brazilian inquiry has also severely criticised the Brazilian government for accepting its business model of using shell companies. “The CPI verified that the business model of the sale of Covaxin by Bharat Biotech, passively accepted by the [Brazilian] ministry of health, with the use of “shell companies” in Singapore (Madison Biotech) and in the United Arab Emirates (Envixia), suffered wide international rejection. In the Philippines, the National Task Force against Covid-19 has publicly criticised Bharat Biotech’s demand to sell Covaxin through Madison Biotech,” says the report.

The CovaxinGate became a scandal in Brazil in June when it was revealed that a federal deputy Luis Miranda and his brother, Ricardo Miranda who is a ministry of health official, had met Bolsonaro in March to complain about corruption in the Covaxin contract. The Miranda brothers’ complaint was based on an invoice for an advance payment of $45 million to Madison Biotech, the Singapore-based shell firm which was not part of the contract. But Bolsonaro, says the CPI report, continued to bat for expediting the deal, defended the acquisition of Covaxin and failed to act on the corruption matter brought to his attention. As a police investigation into the contract was opened only on June 30, many days after the Miranda brothers had testified at the commission, the CPI has indicted the president with malfeasance in the Covaxin case.

In addition to crimes against humanity and crimes of responsibility, it is the charge of malfeasance which can politically damage Bolsonaro.

The last laugh? 

The parliamentary commission of inquiry doesn’t have powers to put on trial or punish individuals indicted by it. After its report is approved by the 11-member commission on Tuesday, the report will be sent to the prosecutor-general (PGR) and the Speaker of Congress for further action. The current PGR, Augusto Aras who is considered close to Bolsonaro, is not expected to move an inch on the report. Arthur Lira, the Speaker who is also an ally of the president, is also likely to sleep over it as he has been with more than 100 pleas for Bolsonaro’s impeachment. Aware of the political reality, the CPI may move Supreme Court on whose orders the commission was set up. There is already a discussion about going to the International Criminal Court at The Hague with the charges of crimes against humanity against Bolsonaro. 

Severely damaged by six months of uninterrupted probe into his government, Bolsonaro stands on quite a sticky wicket. But on Wednesday, the president’s camp was showing a brave – and brazen – face to the media. When asked by reporters outside the senate how Bolsonaro would react to the CPI report, his eldest son, Senator Flavio, said his father would receive the report about the crimes with a hearty laughter. Then he broke into a loud laughter, as if imitating his father. Upon learning of Flavio’s reaction during the presentation of the CPI report, Senator Omar Aziz said that Bolsonaro would laugh not out of relief, but out of fear because “there is the justice of men and the Divine Justice”.

Since the virus hit Brazil in February 2020, Bolsonaro attained international notoriety for dismissing it as a “little flu”, urging people to gather in public places without masks, pushing unproven drugs as “preventive treatment” and sowing doubts about the efficacy of globally-accepted vaccines. All this while more than 6,00,000 Brazilians were killed and close to 22 million infected by the virus. Angered by the president’s attitude, the victims’ families have been demanding justice. Now, with the CPI probe done and its report submitted, a fight for justice between the two sides is in the cards.

New Delhi: The Allahabad high court has stayed the second suspension order against Dr Kafeel Khan.On July 31, 2019, the doctor was suspended for the second time while he was already under suspension for allegedly forcibly treating patients at the Bahraich District Hospital and criticising policies of the government.He was earlier suspended following a tragedy at Gorakhpur’s BRD Medical College, where around 60 children had died in August 2017 due to an alleged shortage of oxygen.Hearing a writ petition filed by Khan, Justice Saral Srivastava, however, directed the authorities to conclude the inquiry against him within one month.

The court further directed that the petitioner shall cooperate in the inquiry and in case he does not, the disciplinary authority may proceed to conclude the inquiry ex parte.While fixing the hearing for November 11, the court also asked the state authorities to file a reply in four weeks.The counsel for the petitioner had argued that the suspension order was passed on July 31, 2019 and more than two years have passed but the probe has not been concluded. Hence, the suspension order cannot remain in force in view of the judgment of the apex court in the case of Ajay Kumar Choudhary versus Union of India (2015) 7 SCC 291, the counsel said.

He further argued that since the petitioner is already a suspended employee, therefore, there is no purpose of passing a second suspension order.He submitted that there is no rule which permits the state government to issue a fresh suspension order when the employee is already under suspension.However, state government’s counsel submitted that the inquiry report against the petitioner has been submitted on August 27, 2021, a copy of which has been sent to the petitioner on August 28, asking him to submit objections.He said the inquiry will be concluded expeditiously.

Last month, the Allahabad high court had quashed charges and criminal proceedings against Khan based on a speech he delivered during the anti-Citizenship (Amendment) Act protests at Aligarh Muslim University.As The Wire has reported before, the Uttar Pradesh police has filed a number of cases and even arrested Khan on two occasions for his dissenting opinions and speaking out against government policies.