Tamil Nadu health minister M Subramanian sounded confident that the second wave of Covid-19 pandemic will be under control in another ten days. In an interview with HT, he recalled several touch-and-go situations when hospitals made SOS calls for oxygen, but the state overcame such challenges by scaling up infrastructure soon after forming the new government. Subramanian, the former mayor of Chennai, is one of chief minister MK Stalin’s most trusted aides. They have been together since 1976 when Subramanian joined the Dravida Munnetra Kazhagam (DMK) youth wing. At 62, he is known for his fitness. He clocked a 10-km run in little over an hour on the morning of June 2. Edited excerpts
Covid-19 cases have started to decline in Tamil Nadu, but we faced multiple crises. What were the major challenges?
We formed the government on May 7 when there were around 20,000 cases daily and it rapidly increased and went up to 36,000. At that stage there was a huge shortage of beds, oxygen-supported beds and ICUs. Patients were waiting for a long time in hospitals for admission… Almost all patients are requiring oxygen support in the second wave, which spread rapidly and caused more lung damages to patients. Shortage of hospital beds with oxygen was a major challenge.
How did you overcome the crisis of oxygen shortage?
Almost every night, the chief minister’s office received a call from hospitals and residents alike. Complaints received on social media were diverted to us. A hospital made an SOS to the CM that if they don’t receive oxygen within two hours, 20 lives were at risk. We immediately diverted oxygen and avoided any of these incidents from turning into a major disaster, like the one in Andhra Pradesh, where 21 people died. We only had 230 MT of oxygen per day until May 7 in government and private hospitals together. But today, we have 660 MT per day while our requirement is 540 MT. We have created a situation where we have more supply than demand.
The chief minister was constantly in touch with concerned ministers in the Union government and even spoken to the Prime Minister to increase oxygen allocation for Tamil Nadu. One night, we were waiting at 2 am to receive oxygen from Rourkela. Waiting for oxygen and Remedisivir became like waiting for God for us. Now, there is no more oxygen shortage anywhere. As on June 1, the state has 8,072 oxygen beds, 618 ICUs and 16,644 non-oxygen beds available.
Ten days ago, patients were scrambling to find even a single bed and that has now changed to more than 25,000 beds being vacant. In the three-week period, we were able to develop the infrastructure. The CM appealed to the public to turn this into a people’s movement. We have received ₹200 crore in donations to the Chief Minister’s Public Relief Fund to fight Covid-19. Besides, industries, corporates and clubs have donated oxygen concentrators worth crores. In Covid Care Centres, we also offered Siddha, Yunani, Homeopathy and Yoga in 61 centres. Each of them had a 100-bed capacity. Cases are now declining fast in all districts with more patients recovering and getting discharged. The difference between the number of new positive cases and discharges are also increasing. This has given us a huge confidence.
But the death toll in state is still on the higher side with over 400 fatalities every day.
People weren’t vigilant and delayed testing and treatment even if they had symptoms like a fever. Only when they have respiratory distress do they show up. But by then, they develop severe lung infection, which is why deaths are high. The deaths aren’t due to any shortage. Treatment protocol is fine. We have been raising awareness for people to approach hospital during the onset of symptoms.
As cases reduced in Chennai, it began rising in the western region. What are the specific problems there?
Cases are being contained there too. I’ve visited these regions thrice in the past 20 days and the CM went twice and conducted review meetings with district collectors. IAS officers as nodal officers as well as ministers have been appointed in these districts. Forest minister and food minister have been made in-charge in Coimbatore. We are also scrutinising if there is any nexus between private labs and private hospitals. According to complaints, in Tiruppur, a private lab, Medall, had entered 4,000 negative cases as positive. (The department of public health temporarily cancelled Medall’s RT-PCR testing, but the lab explained that it was an encryption error.) In Coimbatore, I made a surprise inspection at a lab. The Erode district collector inspects private labs everyday by randomly selecting 10 positive samples and sending it to a government lab for re-checking.
As compared to the first wave, there have been more problems in terms of shortage of oxygenated beds, ICUs, remdesivir and other drugs. What do you think went wrong during the second wave?
The difference from the first wave is that the virus is more virulent in the second wave. So, the number of cases is high, the virus spreads rapidly, and it has led to more critical patients now. There are more cases of patients with serious lung involvement and respiratory distress. It took a year to contain the first wave. But we have crossed half the well in a month. As far as I know, in another ten days, we will come out of it. The infrastructure we have increased now was not required in the first wave.
Experts say TN should have ramped up testing to 300,000 daily, as against only 170,000 when cases had peaked. Why was it low?
TN’s 170,000 is the highest number of RT-PCR tests conducted in India. There will always be an opinion to do more, that’s natural. We have been able to bring cases under control because we were testing in high numbers.
You had announced suspending vaccine drive on June 1 and that evening the Union government sent more doses. How are you going to address vaccine shortage?
Our only issue is vaccine shortage. Earlier there was vaccine hesitancy and now we are waiting for vaccines. From January 16 until May 7, during the AIADMK government for 103 days, they vaccinated 61,000 people daily on an average. In the last 20 days, we have crossed an average of 100,000 people every day. People’s awareness has increased especially for those in the 18-44 age group. People have come to an understanding that vaccination is the only solution. We have paid ₹85.48 crore for vaccines for those in the 18-44 age category. We have received 1.3 million vaccines and we are yet to receive another 1.3 million.
We were worried earlier that we have to suspend vaccination on June 2, 3 and 4 because we hadn’t received the full supply that the Centre allocated for May. The health secretary and I both told the media about it after which we received 494,000 vaccine doses on June 1 evening. We distributed it to all the districts on the same night. So, vaccination has continued. This will last another few days and before it gets over, the Centre will re-stock. So, we are confident we will continue inoculation. The Centre has also allocated 4.2 million vaccines for us in June.
Is the Centre to be blamed for the vaccine shortage in Tamil Nadu and elsewhere?
This isn’t a time to complain and blame. We have been requesting for more. We are not just solely depending on the Union government. We have released a global tender for 35 million vaccines. On June 5, we will know the tender participants. We have also asked about the integrated vaccine complex in Chengalpattu. If we get a reply from the Centre to hand over the plant to us on lease, it will offer protection for Tamil Nadu on a huge scale.
What about a request on behalf of the state to Jesse Jackson (Sr) of Rainbow PUSH Coalition to request US President Joe Biden to release at least 60 million doses of AstraZeneca vaccines for India including Tamil Nadu?
We haven’t finalised it for now. We are trying all avenues and we will take a call after we review global tenders on June 5.
How is our situation in terms of mucormycosis?
So far, the state has reported 518 cases of mucormycosis, of which 17 patients have died and 20 have been discharged. We have formed a committee of 13 with the best doctors including Mohan Rajan (Rajan Eye Care Hospital), ENT professor Mohan Kameswaran (director of Madras ENT Research Foundation) and doctors from government and private hospitals. They will research this infection’s cause, effects and treatment. Mostly they will submit their report this week and it will be submitted to the CM. We have opened a separate ward for mucormycosis treatment in Omandurar hospital and Rajiv Gandhi Government General Hospital. We have instructed all Tamil Nadu medical college hospitals to open similar wards. Doctors say that if we detect it in the early stages, we can save lives. We are also starting to build awareness among the public, so they do not miss the early symptoms.
Has the new government put in place a mechanism to ensure that Covid deaths aren’t missed and under-reported?
I’ve visited 16 districts so far and inspected rural and urban areas. At the end of it, our advice to the district collectors and all stakeholders is to not hide deaths and positive cases. Only if we know the true numbers will the public also have a combined feeling of fear and awareness. During the previous AIADMK regime (in 2012), it was evident that 21 people had died due to Cholera in north Chennai. I had released a statement. The Greater Chennai Corporation responded to it during a council meeting and lied that they died due to cardiac arrest. We don’t have such intentions in our government. We don’t have to hide anything.
What is your vision for the health sector of Tamil Nadu?
When I finish my responsibility and leave my position, I want to have created a situation where people of Tamil Nadu look towards government hospitals if they are sick. They should have an intention that they will be taken care of well in a government hospital and it isn’t necessary to go to a private hospital.