Coronavirus: India Faces Oxygen Shortage As Cases Rise

Ankit Sethia spent a sleepless Friday night trying to get oxygen for her 50-bed hospital on the outskirts of India’s commercial capital, Mumbai.

Only two of the four liquid oxygen tanks at Mr. Sethia’s SS Hospital and Research Center in Bhiwandi were full. Forty-four of the 50 hospital beds were occupied by Covid-19 patients, many of whom needed oxygen from tanks to breathe.

Each tank was depleted in six hours instead of the usual nine hours, due to the increase in patients. Both of Mr. Sethia’s distributors had run out of supplies.

During the night, he called 10 distributors and four hospitals in and around Mumbai for oxygen. None could help. At around 2 a.m., he finally managed to obtain 20 large cylinders from another hospital, some 18 miles (30 km) away. There were no vehicles available, so his ambulances made five trips overnight to collect the cylinders. Today, four people work around the clock in the hospital to obtain supplies from any manufacturer that can send a truck of liquid oxygen for the tanks or from any distributor that can save a cylinder.

“Now I have enough oxygen for the next 12 hours,” Sethia said Sunday night. “We are fighting fires every day. Anyway, the battle is getting some oxygen.”

About 15% of Covid-19 patients require help breathing, according to the World Health Organization (WHO). Some people do not have obvious shortness of breath, but are found to have dangerously low oxygen levels, a condition called silent hypoxia. A fraction of critically ill patients require a ventilator.

Around 500 factories spread across India extract and purify oxygen from the air. Oxygen for medical use usually represents 15% of total supplies. The remainder, industrial oxygen, is supplied mainly to the steel and automobile industries for blast furnace operation.

Factories ship oxygen in liquid form to hospitals in tanker trucks, which is then converted to gas and delivered directly to beds. Some hospitals also use steel and aluminum cylinders that store oxygen in the form of a gas, but this requires a frequent change of cylinders in each bed.

Portable machines called concentrators are also used in some hospitals, which filter oxygen from the air. All of these are used to treat Covid-19 patients.

Not surprisingly, oxygen demand has increased exponentially. Hospitals and care facilities are consuming up to around 2,700 tonnes of oxygen every day this month, compared to 750 tonnes in April, according to data obtained from the All India Industrial Gas Manufacturers Association.

Oxygen manufacturers say industrial oxygen demand has also skyrocketed because more factories are now reopening. States experiencing a worrying increase in infections (Maharashtra, Madhya Pradesh, Gujarat, Rajasthan, Telangana, Andhra Pradesh) suffer the most. It is a grim question of lives versus livelihoods that India is grappling with now.

“Now 45% of the oxygen we produce goes to industries, while 55% goes to hospitals and nursing homes,” said Saket Tikku, president of the All India Industrial Gas Manufacturers Association. “The government is in a bit of a bind. If we cut off the industrial oxygen supply to the factories, the industry will suffer. On the other hand, if we cannot increase the supply of medical oxygen, then there will be lives in danger.” ” he said.

India will now need to increase capacity to ensure that both industries and patients do not suffer. And that’s not all.

Most oxygen plants are built near large cities and towns. Therefore, supplies to remote districts where Covid-19 patients are filling hospitals must be shipped in special trucks carrying cryogenic tanks; India has about 1,500 of these trucks. Many states, the capital Delhi, for example, do not have a single oxygen manufacturer, and all supplies must come from neighboring regions.

Life-saving gas price controls have not helped and have led to a black market for oxygen. “The government has put a cap on the price of oxygen in cylinders, but it has not capped the price of liquid oxygen. It’s like setting the price of the finished product, but not the price of the raw material,” Tikku said.

Memories are fresh from August 2017, when some 70 children died in a government hospital in the northern state of Uttar Pradesh after the oxygen provider cut shipments because their bills were not paid.

But what is clear is that Madhya Pradesh is struggling with a severe supply shortage. In Chindwara district, a shopkeeper told me over the weekend that he had not received any supplies for a week. Piyush Bhatt, who runs a five-year refilling company, said monthly demand for cylinders in the district has grown more than four times in the last month.

The 1,000-bed hospital in the district has been overrun with Covid-19 patients, and Bhatt, who is the main provider, is down because liquid oxygen supplies from plants in Maharashtra, some 125 km away, have been cut off. stagnant.

With one million registered cases, Maharashtra has the highest number of reported infections in India. Terrified officials, fearing an oxygen shortage, have limited supplies from local factories to other states. “My supplies were stopped because the trucks stopped coming from across the border,” Bhatt said. “I have never faced a crisis like this in my life.”

On Monday, Bhatt was still waiting for supplies. “If the government does not solve this oxygen crisis quickly, we will have a situation like Italy at the peak of the pandemic,” he said.

In a private hospital in Chindwara, doctors found it difficult to provide oxygen to regular patients. “It’s a very tense situation,” said Dr. Danish Khan, who works at the 60-bed Glory Hospital. “If we can’t get adequate oxygen in time, we will have to stop receiving patients.”

Hundreds of miles away, in the Rajasthan city of Jodhpur, the 960-bed Indian Institute of Medical Sciences was slowly becoming overwhelmed by Covid-19 patients. Most of the 400 reserved beds were full Monday morning and 100 of the 110 intensive care beds were occupied. The hospital’s two liquid oxygen tanks are empty due to a supply shortage. “We manage the supply of cylinders from various distributors even when patients arrive,” said NR Bishnoi, a senior official at the hospital.

Back in Bhiwandi, Ankit Sethia is taking calls from desperate hospital owners asking for oxygen. Over the weekend, she gifted a jumbo cylinder to a neighboring private hospital.

“The owner of the hospital told me that five of his patients would die if he didn’t get a cylinder to cover the 30 minutes required before the late supplies arrived,” Sethia said. “The situation is so bleak.”