WITH SHORTAGE in supplies being flagged across the country, Delhi Sunday joined the growing list of states that are scrambling to ensure adequate availability of oxygen for Covid patients as the country logged 2,61,500 new cases over the last 24 hours.
The Centre, however, placed the onus of tackling the situation on state governments, with Commerce Minister Piyush Goyal saying that they “should keep demand under control”.
Earlier, Chief Minister Arvind Kejriwal pointed out that Delhi is facing an “acute shortage of oxygen”. “In view of sharply increasing cases, Delhi needs much more than normal supply. Rather than increasing supply, our normal supply has been sharply reduced and Delhi’s quota has been diverted to other states,” he tweeted.
Kejriwal wrote that “oxygen has become an emergency in Delhi”. His tweets come against the backdrop of several states — from Maharashtra to Madhya Pradesh and Uttar Pradesh — racing to secure oxygen supplies.
The Delhi Chief Minister also raised the issue in separate letters to Prime Minister Narendra Modi and Goyal.
Goyal told ANI: “State governments should keep demand (for medical oxygen) under control. Demand-side management is as important as supply-side management.”
He said that “containing Covid spread is the responsibility of state governments and they should fulfil this responsibility”. “We are with the state governments but they need to manage the demand and take concrete steps” to contain the spread, Goyal said.
“There are reports of oxygen wastage and about patients being given oxygen even if they don’t need it. We have urged state govts to keep an eye on it,” he said.
Key element in treatment
The shortage is critical because oxygen therapy is considered the most effective treatment to reduce the severity of disease. An uninterrupted supply is key for surge states to bring their Covid-linked mortality rate under control.
The Centre also announced a series of measures to tackle the situation, including setting up more oxygen plants and starting “oxygen express” trains that will carry tankers through a special corridor following requests from Maharashtra and Madhya Pradesh.
“Madhya Pradesh and Maharashtra state governments had approached the Ministry of Railways to explore whether Liquid Medical Oxygen (LMO) tankers could be moved by Railways. Railways immediately explored the technical feasibility of transportation of LMO. LMO has to be transported through Roll On Roll Off (RO-RO) service with road tankers placed on flat wagons,” the Rail Ministry said.
It said that Maharashtra has assured availability of at least 10 tankers by Monday, which are likely to be moved for loading.
Also Sunday, Union Health Secretary Rajesh Bhushan issued directions that supply of oxygen for industrial purposes by manufacturers and suppliers be prohibited from April 22. He underlined that the Department of Promotion of Industry and Internal Trade (DPIIT) has communicated that supply for industrial purposes has “already reached 60 per cent of the total daily oxygen production, and is expected to rise further”.
“While every effort is being made to meet the rising demand for medical oxygen, including augmenting daily production and stocks, and states are taking appropriate steps for optimum and rationalised utilisation of available stock of oxygen, the present trend necessitates additional measures,” he told states.
Bhushan said the prohibition shall not apply to nine industries: ampoules and vials, pharmaceuticals, petroleum refineries, steel plants, nuclear energy facilities, oxygen cylinder manufacturers, wastewater treatment plants, food and water purification, and process industries that require uninterrupted operation of furnaces.
In his letter to the Prime Minister, Kejriwal wrote: “The Covid situation in Delhi is extremely serious. There is a shortage of beds and oxygen… We need your help… We are also facing an extreme shortage of oxygen. It should be provided to us immediately.” The Chief Minister said he had raised the issue with Health Minister Harsh Vardhan and Home Minister Amit Shah.
Writing to Goyal, Kejriwal sought the uninterrupted daily supply of 700 MT and alleged that the output of M/S INox, a major oxygen supplier to Delhi hospitals, has been “diverted” to other states.
“At this critical juncture, it will not be possible for hospitals to enter into the contractual arrangements with the new suppliers who have now been assigned to Delhi. The disruption is already starting to cause critical shortage across major hospitals,” he wrote while seeking Goyal’s personal intervention on the issue.
Delhi has recorded almost 50,000 Covid cases over the last two days, putting tremendous strain on the health infrastructure. Sources said the Delhi government will discuss the possibility of extending curbs on movement for a few days in a review meeting with the L-G Monday.
In Maharashtra, the worst-hit state in the second wave with an active caseload of 6.70 lakh, up from 4.30 lakh a fortnight ago, the daily oxygen requirement is 1,200-1,300 MT against maximum production of 1,250 MT. The state is receiving additional oxygen, upto 150 MT from Gujarat and 50 MT from Chhattisgarh.
On Saturday, 168 patients from six Mumbai hospitals, which had exhausted their oxygen supply, were shifted in a massive operation by the civic body to jumbo centres and government hospitals. On Sunday, Maharashtra recorded 68,631 fresh cases, its highest daily tally so far.
The Centre, meanwhile, said that 59 Pressure Swing Adsorption (PSA) oxygen plants will be installed by the end of April — PSA units have the capability to separate certain gases from a mixture.
As a short term measure, it said, 4,880 MT, 5,619 MT, and 6,593 MT have been allocated to 12 “concern states” for meeting their projected demand as of April 20, April 25, and April 30, respectively.
The availability of stock from steel plants has also been increased in the last few days, with 14,000 MT coming from CPSU plants, the Government said. For instance, Maharashtra is now utilising surplus medical oxygen on a daily basis from steel plants like JSW in Dolvi (Maharashtra), SAIL in Bhilai (Chhattisgarh) and JSW in Bellary (Karnataka), it said.
Madhya Pradesh is supplementing its oxygen supply from the Bhilai plant, it said.
But reports from several states illustrated the challenge ahead.
In Uttar Pradesh, Chief Minister Yogi Adityanath asked the state’s Medical Education Minister, Suresh Khanna, to monitor the situation and the projected use of oxygen in the next 15 days. Orders have been issued to hospitals to maintain a minimum of 36 hours supply back-up.
In addition, the Director General (Medical Education) has been directed to provide oxygen cylinders to institutions where there are no ICU beds due to lack of oxygen. The state is also moving to set up 10 oxygen plants — a liquid oxygen plant of 20,000 litres capacity was installed in Lucknow Sunday.
Jharkhand has a total of 3,802 oxygen-supported beds of which 2,024 have been occupied.
Goa Chief Minister Pramod Sawant said there was a “slight problem” with oxygen that “has been remedied” with curbs on supplies being taken out of the state and diversion from industrial usage to healthcare services. The state’s Health Minister Vishwajit Rane thanked his Kerala counterpart K K Shailaja for helping transport 20,000 litres of liquid oxygen to Goa.
In Punjab, Principal Secretary (Health) Husan Lal said three government facilities — Civil Hospital (Ludhiana), Civil Hospital (Jalandhar) and Guru Gobind Singh Medical College and Hospital (Faridkot) — have their own oxygen plants and supply to other hospitals, too. “As of now, we do not have any oxygen shortage but it will be required in the coming days, considering the pace at which cases are surging,” said Lal.
Karnataka, Kerala, Gujarat, Odisha and J&K, too, have reported adequate supplies although Covid beds are rapidly filling up. In Bengaluru, for instance, 96 per cent of the 291 ICU ventilator beds were full as of Sunday, while 84 per cent of the 2,673 oxygenated HDU beds and 95 per cent of the 342 ICU beds across 17 government hospitals and 69 private hospitals were occupied. —(With ENS inputs from Maharashtra, UP, Karnataka, Kerala, Punjab, Gujarat, Jharkhand, Odisha, Goa and J&K)