Lack of clarity and centralisation of procurement exacerbate PPE crisis in Maharashtra

10 May 2020
Worker make face masks to meet their demands in view of the spread of COVID-19 at a private manufacturing unit in Srinagar. The frequent changes in state and central government guidelines have led to both a shortfall of, and a lack of standardisation in, protective equipment for front line health workers in Maharashtra.
Waseem Andrabi/Hindustan Times/Getty Images
Worker make face masks to meet their demands in view of the spread of COVID-19 at a private manufacturing unit in Srinagar. The frequent changes in state and central government guidelines have led to both a shortfall of, and a lack of standardisation in, protective equipment for front line health workers in Maharashtra.
Waseem Andrabi/Hindustan Times/Getty Images

By early May, the tide of the coronavirus pandemic had long overwhelmed a woefully underprepared Maharashtra. On 9 May, Maharashtra recorded 20,228 COVID-19 cases, with 12,864 in Mumbai alone. Even as the state’s healthcare system struggled to accommodate the rising number of the infected, at least two government hospitals and eight private hospitals in the city saw outbreaks of the novel coronavirus among its healthcare workers, due to which some had to be sealed. This brought the desperate need to provide safety gear for front line medical staff into public view. But as the state government failed to address these concerns, doctors and other healthcare workers in hospitals of Aurangabad and Mumbai staged protests against the absence of sufficient personal protective equipment and the substandard quality of the kits supplied.

The catastrophic shortage in PPE had been weeks in the making. The manufacturing has been slowed by vague guidelines issued by the central government and the absence of standardisation in their make, despite the excessively complicated requirements listed by multiple authorities. The state government saw its wing clipped by the central government overriding its decisions and its lack of willingness to recognise the immediacy required in the state hardest hit by the pandemic. I spoke to several PPE manufacturers, who discussed the gridlock of confusion in the government’s requirements and lack of clear estimations of the number and quality of PPE required.

Rajesh Tope, the health minister of Maharashtra, had repeatedly expressed the need for the supply of PPE kits from the central government, since early April, when the state was still in the early stages of the contagion. On 7 April, in a public statement, the state government demanded 3.25 lakh PPE kits and nine lakh N95 masks from the central government. Ten days later, a frustrated Tope told the press, “We are getting supplies of medical essentials from the centre but it is not enough. For instance, we made a demand for 3.5 lakh PPE but received only 30,000.” Meanwhile, the state government itself has not been entirely transparent about its PPE requirements. On 5 April, Tope told the Indian Express that the state had “no dearth of equipment.” But in a video message circulated on 16 April, he said there was a shortfall of equipment in the state because it was not being delivered by the central government.

There has been a consistent lack of clarity about the quantity of PPE Maharashtra needs to deal with the crisis. On 1 May, Tope told the Hindustan Times that as per official estimates the state has 2.82 lakh N95 masks, 80,000 PPE kits and 3,000 ventilators. Five days earlier, Tope told the media publication Free Press Journal that the state government is examining the possibility of reusing PPE kits which points to a persisting shortage. From government reports it is clear that there is a shortfall in PPE and that the state has requested the central government to deliver more kits. It is, however, unclear how much of a shortfall the state faces and how the state is planning to estimate this shortfall. When asked about the shortfall, a senior official in the state’s health department who spoke to me on the condition of anonymity said, “As of now, for today’s need, it is sufficient, right? If you go for one week, 15 days down the lane, then we may need additional requirements. For that we are procuring from government of India or whatever source we can have.” I called and emailed Pradeep Kumar Vyas, the principal secretary of the state’s health department, asking about the shortfall of PPE in the state and the lack of standardisation in procurement, but did not receive a response.

Maharashtra’s issues with procurement of PPE are also due to the vagueness of government guidelines. As early as the first two weeks of April, PPE manufacturers received confusing and contradictory orders from the government. On 3 April, Maharashtra’s public health department released a circular mandating that any manufacturer, distributor or agent selling PPE in the state has to get its quality certified by Haffkine Bio-Pharmaceutical Corporation Limited. HBPCL is a state government undertaking that manufactures drugs and vaccines. An unnamed health official quoted in a Press Trust of India report with reference to the circular, said that the decision was necessary to reduce chances of virus spread among healthcare workers.

Aathira Konikkara is a reporting fellow at The Caravan.

Keywords: COVID-19 Ministry of Health and Family Welfare Maharashtra Mumbai
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