Why oxygen shortage in India

Because the number of cases are huge. Simple. Cases were falling right from 71660 in October to 16110 around end of February. As cases fell, demand for Oxygen fell and nobody thought twice about restocking.

When the cases surged, they surged too fast and the Oxygen stocks in states where cases are surging is getting fast depleted. Maharashtra, Delhi and Uttar Pradesh.

The cases rose so high that even the country could not produce enough Oxygen.

In the first wave – the maximum daily seriously ill load was 589 in Delhi and 605 in Mumbai. The Weekly serious patient load was around 2200 in Delhi and 2600 in Mumbai.

In just 8 days during the second wave, this number rose from a mere 155 to 2750 in Delhi and 231 to 3560 in Mumbai.

Thats a surge of severely ill patients rising by 1600% but Oxygen not rising.

Simply put Cases rose too fast and Oxygen supply did not.

There was no backup , no reserve stock. This was the failure.

Trump under his DMA had ordered 55000 MT as reserve stock because his experts had predicted that there could be a second wave and though Trump acted like a buffoon, he followed the advise.

US have enough for 134000 severe cases per week when their highest has been 27300 a week.

China was short of Oxygen in Wuhan during April 2020 but have a reserve of 64000 MT even after exporting to Brazil.

Sri Lanka has a reserve of 15800 MT of Oxygen

Yet India had no back up, no planning for the future. They saw second waves all over the world but somehow believed they were immune

On 21st March our Stock was 6600 MT of Medical Oxygen and our Reserve was ZERO.

Enough for maybe 12000 severe cases a week. Yet by April middle we had 61000 severe cases a week documented and around 100000 severe cases if you include undocumented cases.

We were caught with our pants down.

The only way out – IMPORT

But Import from whom???

USA – US actively has around 39300 MT and 55000 MT as reserve. Yet Oxygen comes under the DMA which means it cannot be exported. Besides the Average delivery period would be 24 days excluding the period while Biden reconsiders. By then cases could go through the roof.

Noother nation has so many cases to have so much Medical oxygen.

New Zealands reserves are around the same as Delhis was in Feb and lower than Mumbais.

Same with Singapore or Australia or Malaysia. They can barely provide 2–3% of our demands.

Even China can barely give us 20000 MT when we need 90000 MT but they can give us Industrial Oxygen upto even 50000 MT as they are the worlds largest producer for Industrial Oxygen.

Who is responsible?

Why did we not keep reserves? I mean sure it was impossible to predict that we would have 3.45 lakh cases a day but why not follow WHO guidelines and have based on calculations 42500 MT of medical oxygen which would have made sure that around 85000 severe cases a week would have enough oxygen. Enough at least until today.

The reason for this is the Central Govt

They did not think spending on Oxygen was required.

Now Alt Right says that Kejriwal was given PM Cares funds for building Oxygen plants and he built only one.

Lets assume this is true. Why does UP have shortage? Why does Maharashtra? It should only be Delhi right?

This is totally incorrect. The fact is authorization to build Oxygen manufacturing units comes from the Centre from 1.5.2020, not the State.

The States job is to merely allott the land where the Units are to be built.

So no PM cares funds could have been given for manufacturing Oxygen units. Maybe for masks, PPE but not the Oxygen Units.

In Delhi, The Centre demanded land near the Hospitals which the hospitals kept dilly dallying.

They (Centre) did not build Units in UP or Maha or TN or Kerala .

In fact

9/4 RTI – How much PM cares money was spent on Oxygen ?

Ans: REFUSED TO REVEAL, SAYS PM CARES NOT UNDER GAMBIT OF RTI

Not a word that we gave Kejriwal so much.

The Delhi CM.has challenged for the details.

Centre was overconfident. Centre thought cases were over. Centre thought Ram would save India from phase II.

It didnt happen and India was overwhelmed.

It was atrocious planning.

The States share responsibility in indiscipline and rule breaking but in Oxygen and Remdisivir – Centre BUNGLED again.

One of the biggest lessons learnt from the first wave was that oxygen therapy helps patients with moderate and severe Covid get better, and only a handful of them need a ventilator after that.

The government is in the process of building 551 PSA plants to meet the current demand of oxygen, but till then, most hospitals are relying on cylinders or a supply of liquid oxygen.

“There are about 1,171 cryogenic tanks in the country for oxygen, and another 800 for nitrogen and argon. Tankers have varying capacities, from 2 metric tonnes (MT) to 30 MT. We are in the process of converting nitrogen tanks into oxygen tanks so we can ease the supply crunch,” S.D. Mishra, nodal officer of oxygen supply for Covid-19 at the Petroleum and Explosives Safety Organisation (PESO), (The Print)

According to a government statement, the daily production capacity (including for industry use) of oxygen currently is 7,127 MT while the demand is 6,600 MT.

This is several times higher than the demand for medical oxygen in pre-Covid times, which was around 700 MT per day.

“Before, just 10 to 20 per cent of all oxygen supply was for medical use. Now, almost all of it is being diverted for medical use. This kind of demand has never been seen before,” said Mishra.

Among the biggest manufacturers of oxygen are Inox Air Products — which manufactures 60 per cent of the country’s total oxygen supply — along with Linde and Goyal MG Gases. The country also plans on importing 50,000 MT of oxygen.

However, despite this information, the present surge in infections seems to have caught the Indian health infrastructure unawares. Almost all states, particularly in north India, are struggling with the supply of medical oxygen.

Medical gases are regulated both by the Central Drugs Standard Control Organisation (CDSCO) and the Ministry of Industry and Commerce, which PESO comes under.

Earlier, no governments were actively involved or monitored the supply of medical oxygen to hospitals. Hospitals contracted suppliers directly, who would then deliver it every two to four days or whenever stocks needed to be replenished, explained Mishra.

However, since the nationwide lockdown was first announced in March 2020, the Empowered Group 2 — one among the several other empowered groups — was formed under the Ministry of Home Affairs to monitor and ensure availability of essential medical supplies, including oxygen. This is why states must appeal to the central government for allocations.

The Empowered Group 2 has estimated that 12 states will require a total of 4,880 MT, 5619 MT and 6,593 MT on 20 April, 25 April and 30 April, respectively.

These 12 states are Maharashtra, Madhya Pradesh, Gujarat, Uttar Pradesh, Delhi, Chhattisgarh, Karnataka, Kerala, Tamil Nadu, Punjab, Haryana and Rajasthan.

“Sources of medical oxygen and their production capacity was mapped to match the requirement of states and an indicative framework has been developed to guide the states on the sources of medical oxygen,” the health ministry said in a statement.

Mishra told ThePrint that the biggest challenge was transporting oxygen from the eastern and southern states, where demand isn’t growing as quickly to the northern and western states, which are struggling for supplies.

In Delhi, which has been allocated 490 MT of oxygen, the state is rationing its supply by allocating each hospital with a fixed amount.

Despite this, the city has continued to see SOS calls from hospitals because these allocations have been inadequate. The Delhi government, which had appealed to the central government for a larger supply, says at least 700 MT of oxygen is required to meet current medical needs.(How medical oxygen is supplied to hospitals, and why India is facing an acute shortage,SIMRIN SIRUR,theprint)

Unlike the air we breathe — which has only 21 per cent oxygen that is filtered by our lungs — medical grade oxygen is highly concentrated and can be obtained in several ways

Oxygen can also be generated from the air itself by a machine called an oxygen concentrator. According to a note by the Ministry of Health and Family Welfare, an oxygen concentrator is “a self-contained, electrically powered medical device designed to concentrate oxygen from ambient air”.

We have enough production to meet our regular needs. But then, any crisis will create a huge demand for a certain item and that huge demand can not be met easily. That is the only reason we are in trouble now.

Per reports, a few months ago, the government wanted to set up around 135 oxygen plants around the country. On ground, just 33 have been set up & functioning.

• Given reasons can be any but one of the core reasons you can not escape is the “Bureaucratic red tape”.

The oxygen crisis

India has the capacity to produce more than 7,000 metric tonnes of medical oxygen. The major manufacturers are India

The shortage of oxygen cylinder is a major health emergency in India. Why is the Indian Government not able to solve this major problem?

Oxygen is a gas under normal ambient conditions. 22.4 litres of oxygen will have a mass of almost 32 gms in the normal Indian temperature conditions- a little less in summers. Also a gas will flow only under a pressure difference inside the container it is in and the atmosphere at the outlet point( like the mask on a patient’s face/ a gas burner).

So Oxygen has to be transported in cylinders containing the gas at higher pressures than the atmosphere. This also increases the quantity of Oxygen transported. However the cylinders must be strong enough to withstand the high pressure of the gas content

Madras high court too late has lambasted PM and Government on Country needs to be run on experts advice nor ad-hocism.

Second wave has took many times more people in its embrace than earlier one; so Medical oxygen demand has gone up insanely Now the sad part is

Zero planning or foresight whatsoever of Modi and few other state level governments.

World started buying vaccine doses in huge quantities as early as aug-sep 2020; indias first confirmed order was in jan 2021 that too for 10+ million doses or so

When British or UK double mutant strain was reported in India; government simply downplayed it

Covid treatment needs massive amounts of Oxygen. While a normal patient needs 5–6 liters of Oxygen, a single Covid patient might need 250 liters of Oxygen in a single day. One patient in a Delhi hospital is requiring 18 liters a minute which translates to more than 1000 liters per hour! Moreover the peak in the first wave was less than 100,000 and started dropping immediately. Moreover only 40 % of the first wave patients needed Oxygen compared to 54 % of nearly 300,000 patients. So there has been a tremendous increase in Oxygen demand in the last week in particular. Any system would have been in trouble

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