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Number of active Covid cases has been concerning the medical fraternity in India since March this year. India has recorded the highest single-day count of new cases in the world. But more than that, the severity of the new Covid strain is making them more anxious. The second wave of Covid is hit by the double and triple mutant of the virus which has been identified as more deadly. The death rates have gone high so fast that was never imagined before. More people are getting affected as the new strain is being transmitted quite soon. Patients need more ventilators and oxygen supply to be alive. In that case, with growing oxygen demands, the Indian healthcare system is actually showing failure to provide oxygen to every required patient.

Now, people are asking for performance card from the government that how did they try to improve the healthcare sector in last one year? Could the government develop adequate ventilation system? Did the government build adequate oxygen manufacturing centres and infrastructure to transport it necessarily? The harsh reality of the present time is turning the head down.

India exports medical oxygen less than 0.4% of the annual production capacity domestically. During April-February 2020-21, India has exported 9884 MT metric tonnes of industrial oxygen and only 12 MT of medical oxygen. So, unlike vaccines, the crisis of medical oxygen is not completely due to oxygen exports, rather because of oxygen manufacturing deficiency in the country. The country is facing the pandemic for more than a year. But the healthcare system did not actually witness much improvement. Lack of ICU bed with oxygen supply is lacking and patients are being obliged to stay in cardiac ambulances for treatment.

Manufacturing

The union government is trying to ramp up oxygen supply for medical use following restrictions imposed on the use by industry. The healthcare segment demand about 15% of oxygen supply and the rest goes for industrial use. But amid second wave, nearly 90% of the country’s oxygen supply is being diverted for medical use. In 7,500 MT (daily) of total oxygen supply, 6600 MT is being used for medical use now. Additionally, medical oxygen constituted over a third of the production at the start of the month. But now it went up to around 55%. It is estimated to be 77% more. 

Following the rise in cases across several states, the allocations for states have also been changed. Maharashtra with its increasing cases has started to receive more than 1,425 MT per day which is a 37% jump than the previous level. Maharashtra is also producing more than 1,200 MT of oxygen daily which is being used for Covid patients. But hospitals in other states and UTs like West Bengal, Gujarat, Uttar Pradesh, Haryana and Delhi are also facing a critical shortage of oxygen. 

Transportation

More than 500 factories in India extract and purify oxygen from air to send it to hospitals in liquid form through tankers. These tankers often queue outside the plants for long time and it takes almost two hours to fill a tanker. Transporting the tankers is also a time consuming job. The tankers also have to follow a specific speed limit – within 40 kmph. 

Getting oxygen from the eastern part of India is another challenge. Supply of oxygen in that part is higher because of the industrial areas Orissa and Jharkhand. Transporting huge amount of oxygen from that part to Maharashtra and Delhi was initially a tough job for the government. The union government thus started ‘oxygen-express’ - train carrying oxygen tankers to the required place. Along with it, the Indian Air Force is also airlifting oxygen from military bases.

The union government has also disclosed tender to import 50,000 MT of medical oxygen. The federal health ministry earlier invited bids for new oxygen plants in October last year. A total 162 plants were sanctioned but only 33 have been installed so far. In future 59 plants are expected to be installed by the end of April and another 80 within May. 

Lack of planning

News house Indian Express in an article informed that, the Empowered Group-VI (EG-VI) tasked to coordinate with the “Private Sector, NGOs and International Organisations for response related activities”, in their second meeting on April 1 last year, had red-flagged medical oxygen shortage. The minutes of the meeting states, “In the coming days India could face a shortage of oxygen supplies. To address this, CII will coordinate with Indian Gas Association and mitigate the lack of oxygen supply.”

This meeting was also attended by NITI Aayog, Department for Promotion of Industry and Internal Trade, Prime Minister’s Office (PMO), Ministry of Home Affairs; Ministry of External Affairs Cabinet Secretariat and Central Board of Indirect Taxes and Customs. When the EG-VI emphasised on the oxygen shortage in India, the number of confirmed cases were only around 2000. If the government could focus on building more medical oxygen plants then probably India could avoid the misery it is experiencing now. 

Along with that, the Parliamentary Standing Committee on Health also flagged the issue of ‘availability as well as affordability’ of medical oxygen. The committee requested the union government to ‘encourage adequate production of Oxygen for ensuring its supply as per demand in the hospitals’. The committee also recommended that the Health Ministry should ensure supply of oxygen cylinders with ‘appropriate price caps’. If the ministry has noticed these factors then the ongoing black marketing of oxygen cylinders could be circumvented. 

On the other hand in a hospital in Maharashtra and in a hospital in Delhi consecutively 11 and 25 critical patients died due to poor infrastructure and accidents. Later the government should set up enquiry teams regarding the cases in these hospitals to know what mis-managements called these kinds of distressful accidents.  

India needs oxygen 

Both national and international appeals are gaining importance under the India needs oxygen campaign. Along with the neighbour Pakistan, other countries like USA, UK, Germany are spreading their hands to combat the oxygen scarcity here.