A devastating outbreak of coronavirus infections has exposed India’s dilapidated health infrastructure and a chronic shortage of oxygen – a key treatment for critically ill COVID-19 patients.
A severe oxygen shortage as India battles a fierce new wave means a time of prosperity for profit seekers, although some young volunteers are doing their best to help people on social media.
Here is an overview of the reasons for the shortage:
Why is medical oxygen vital?
Oxygen therapy is crucial for patients with severe COVID-19 suffering from hypoxemia – when oxygen levels in the blood are too low.
“Some clinical studies show that up to a quarter of hospitalized patients (COVID-19) require oxygen therapy and up to two-thirds of those in intensive care units,” community health specialist Rajib Dasgupta told the AFP press agency.
“This is why it is imperative to repair the oxygen supply systems in a hospital setting because it is a disease that mainly affects the lungs.”
Experts have long sounded the alarm over shortages of medical oxygen in India and other poor countries to treat pneumonia, the world’s largest preventable infectious killer in children under five.
But for years, the government has not invested enough money in such infrastructure, experts say.
Does India produce enough oxygen?
The short answer: yes.
Experts say the vast nation of 1.3 billion people produces enough oxygen – just over 7,000 tonnes per day. Most are intended for industrial use but can be diverted for medical purposes.
Bottlenecks relate to transport and storage.
Very low temperature liquid oxygen must be transported in cryogenic tankers to distributors, which then transform it into gas for filling the cylinders.
But India lacks cryogenic tankers. And these special tankers, when full, must be transported by road and not by air for safety reasons.
Most of the oxygen producers are in eastern India, while the growing demand has occurred in cities including the financial hub of Mumbai to the west and the capital New Delhi to the north.
“The supply chain needs to be altered to move medical oxygen from some areas that have a surplus of supply to areas that need more supply,” Siddharth Jain told AFP. of the largest suppliers of medical oxygen in India, Inox Air Products.
Meanwhile, many hospitals lack on-site oxygen plants, often due to poor infrastructure, lack of expertise, and high costs.
At the end of last year, India put out tenders for on-site oxygen plants for hospitals. But the plans were never implemented, local media report.
What do we do?
The government imports mobile oxygen plants and tankers, builds more than 500 new plants, and purchases portable oxygen concentrators.
The government has ordered industries not to use liquid oxygen.
Oxygen supplies are transported to the hard-hit areas by special trains.
The army has also been mobilized to transport tankers and other supplies domestically and from international sources.
Emergency medical supplies – including liquid oxygen, cryogenic tankers, concentrators and ventilators – are flown in from other countries as part of a huge aid effort.
What is happening on the ground?
Oxygen shortages continue to affect hard-hit regions despite measures to boost supply, transport and storage.
There have been reports of hospitals asking patients to make arrangements for their own cylinders and of people dying even after being admitted due to lack of oxygen.
Social media platforms have been filled with posts by desperate families looking for bottles and refills.
At the same time, there is a growing black market for bottles and concentrators sold well above their usual retail prices.
The shortages have sparked outrage and frustration in New Delhi.
“The government did not plan on time,” sales manager Prabhat Kumar told AFP.
“If it had been prepared, we wouldn’t have to suffer like this for beds and oxygen.”