India is running out of oxygen again.This time is worse

Hospitals in Delhi and other states are forced to display signs that they are depleted.

Delhi hospitals are forced to show signs of lack of oxygen

Twenty-five families in Delhi, the capital of India, woke up on Friday morning with news that their loved ones died at the city’s Sagangalam Hospital because their patients did not get enough oxygen.

A serious shortage slowed the flow of oxygen to the 25 most ill patients who needed a stable oxygen supply at high pressure, a hospital health officer said.

The tragedy occurred at the end of the week when several major hospitals in Delhi repeatedly approached oxygen deficiency.It took Tuesday Desperate conviction Intervention from the State Prime Minister and from the High Court for the Federal Government to facilitate midnight replenishment.

The oxygen tank truck finally arrived at Sagangalam Hospital on Friday morning, shortly after a disastrous warning that another 60 patients were on the verge of death. But India’s growing wave of incidents is endangering its healthcare system, from the richest cities in the country to the farthest corners.

Battle of breath

Maharashtra and Gujarat in the west, Haryana in the north, and Madhya Pradesh in central India all face oxygen deficiencies. In northern Uttar Pradesh, some hospitals have “out of oxygen” boards outdoors, and the state capital, Lucknow Hospital, requires patients to move elsewhere. Small hospitals and nursing homes in Delhi do the same. Desperate relatives in some cities line up outside the oxygen supply center. A factory in the southern city of Hyderabad hired a bouncer to manage the crowd.

Many people who have been attacked by the coronavirus are dying while waiting. Hospitals are struggling to deal with patients who are out of breath and are lucky enough to keep their beds alive. Social media feeds and WhatsApp groups are full of desperate charges against oxygen cylinders.

For a week, India relived this nightmare repeatedly, waiting for a horrifying moment with no oxygen left.

From doctors to officials to journalists, this feels like déjà vu to anyone who sees a pandemic happening here. Seven months ago, the country was working on a similar issue Oxygen deficiency as the number of cases increases rapidly.. But this time it’s even worse.

Medical facilities typically consume about 15% of the oxygen supply, leaving the rest for industrial use. However, in the second wave of India, almost 90% of the country’s oxygen supply (7,500 metric tons per day) has been diverted to medical use, said health official Rajesh Bhushan. This is much more than the 2,700 metric tons consumed daily during the peak of the first wave in mid-September last year.

Since then, India has added about 90,000 cases daily. Just two weeks ago, in early April, the daily surge was about 144,000. Today, the daily case load has more than doubled, well over 300,000.

Dr. Siddheshwar Shinde, who runs Covid Hospital in Pune, India’s second most active district, said: The number of cases and the third highest number of deaths from the virus.

Last week, when there were no ventilators left, Dr. Cinde began moving patients to other cities-unprecedented in Pune, where patients usually arrive from nearby districts seeking treatment.

Relatives of Covid patients are lining up in the city to replenish cylinders

Relatives of Covid patients are lining up in the city to replenish cylinders

Maharashtra, where Pune is located, is one of the most affected regions in India, accounting for more than one-third of currently active cases. The state produces about 1,200 metric tons of oxygen daily, all of which is already in use by Covid patients. And with the case, the demand is increasing. Currently, it is 1,500 to 1,600 tons per day, and there is no sign of giving up.

“Usually hospitals like us were able to get enough oxygen, but in the last two weeks, maintaining people’s breathing has become a challenge. A 22 year old patient has oxygen support. “I need it,” said Dr. Shinde.

Doctors and epidemiologists believe that the flood of cases delays examinations and consultations, and many are hospitalized when their condition is severe. Therefore, the demand for high-flow oxygen, that is, the demand for more oxygen, is higher than in the last wave.

“No one knows when this will end,” said Dr. Cinde. “I don’t think even the government foresaw this.”

Scramble to find supply

Some governments have done so. In southern Kerala, we increased supply by carefully monitoring demand and planning to increase the number of cases. Kerala currently has excess oxygen that it is sending to other states. However, Delhi and some other states do not have their own oxygen plants and rely on imports.

The Supreme Court has weighted Prime Minister Narendra Modi’s administration for a national Covid plan to deal with oxygen crunches.

The Federal Ministry of Health has called for a bid for a new oxygen plant in October last year, more than eight months after the pandemic in India began. Of the 162 licensed, only 33 have been installed so far, 59 will be installed by the end of April, and 80 will be installed by the end of May, the ministry said.

A Covid-19 patient receiving oxygen support awaiting admission due to lack of beds at LNJP Hospital in New Delhi on April 22, 2021.

A woman with oxygen availability waits for admission at LNJP Hospital in New Delhi

Scramble to increase supply points due to lack of emergency plans.

Liquid oxygen is a cryogenic gas that is pale blue, very cold, has a temperature of about -183 ° C, and can only be stored and transported in special cylinders and tankers. About 500 factories in India extract oxygen from the air, refine it, and send it to hospitals in liquid form. Most of them come from tankers.

Major hospitals usually have their own tanks where oxygen is stored and then piped directly to the bed. Small and temporary hospitals rely on steel and aluminum cylinders.

Oxygen tankers often line up outside the plant for hours, and it takes about two hours to fill a single tanker. It will take several more hours for these tankers to travel within or across states to different towns. Tankers also have to comply with certain speed limits (25mph (40kmph) or less) and often do not move at night to avoid accidents.

Head of India’s largest oxygen supplier said part of the struggle was the acquisition of oxygen from eastern India, which has a high supply in industrialized countries such as Orissa and Jharkhand, to western or northern India such as Maharashtra and Delhi. Stated. Soaring.

In addition, the demand for oxygen at individual facilities is unpredictable, making it difficult to measure hospital requirements and provide them where they are needed.

Workers will arrange a medical oxygen bomb to be transported to a hospital for Covid-19 coronavirus treatment at a facility outside Hyderabad on April 23, 2021.

Oxygen transport has become a major logistics challenge

“Not all patients need the same amount of oxygen over the same period of time. Patients who need to change oxygen hourly at the hospital,” said Dr. Om Shribastaff, an infectious disease expert at Mumbai Hospital. Number “. “We take as much care as we can, but I’ve never seen anything like this. I don’t think there’s anyone here.”

Too little, too late

Before the crisis of the oxygen crisis The federal government was already facing criticism It was unable to increase the impetus for vaccination by allowing election rallies and large Hindu festivals. Critics have accused various state governments of doing too little to prepare for the devastating second wave that is currently hitting the county.

Doctors and virologists who spoke to the BBC said oxygen deficiency was a symptom rather than a cause of the crisis. With effective security protocols and strong public messages, more people may be at home and repel viruses.

But by January, the plunge in incidents gave the country a false sense of security and created terrible second-wave conditions, they said.

Mr. Modi’s government is now launching an “oxygen express,” with trains carrying tankers where in demand, and the Indian Air Force airlifting oxygen from military bases. They are also considering plans to import 50,000 metric tons of liquid oxygen.

“We’ve told the authorities that we’re ready to build up capacity, but we need financial support to do so,” said Rajabau Sinde, who runs a small oxygen plant in Maharashtra.

“No one said anything, and now suddenly hospitals and doctors are asking for more cylinders,” he said. “This is something that shouldn’t happen. As the saying goes, dig well before you’re thirsty. But we didn’t do that.”

Read more articles about Covid-19