But it hasn’t been enough.
“We have just run out of oxygen. We are currently surviving on some oxygen cylinders. Over the next 10 minutes that will also run out. We are again in a crisis mode,” Sudhanshu Bankata, executive director of New Delhi’s Batra Hospital, said on Saturday afternoon, in a video the hospital released to the media.
Dr. Bankata had already alerted government officials via WhatsApp groups set up to monitor oxygen levels in the capital’s hospitals. The oxygen tanker trucks en route, he said in the video, were “quite far away from our hospital.”
The hospital remained without oxygen for an hour and 20 minutes. He said 12 patients died from a lack of oxygen, including R.K. Himthani, head of the hospital’s gastroenterology department.
“I am broken up,” Dr. Bankata said in an interview. “We are losing our own patients, our own doctors from something that is totally avoidable.”
India is weeks into the fastest rising surge of Covid-19 since the start of the pandemic. On Wednesday, the country reported more than 382,000 new daily cases of infection and 3,780 deaths, India’s highest single-day toll.
The surge has overwhelmed many of the country’s hospitals—particularly in hard-hit cities like New Delhi—and confounded the country’s efforts to address the oxygen supply shortage.
Dr. Bankata said he was worried the hospital could run out of oxygen again on Thursday.
At the peak of India’s last wave in September, the country was consuming 3,000 tons of medical-grade oxygen. Now, Delhi on its own is consuming about 400 tons of oxygen a day, said Saket Tiku, president of the All India Industrial Gases Manufacturers Association, a body that represents India’s industrial gases industry.
Yet the government and industry experts say the problem bedeviling the efforts is the distribution, not the amount of oxygen the country is producing. India is producing between 8,500 and 9,000 tons of oxygen a day, which is sufficient to meet current demand.
Most of the oxygen is being produced far from the hospitals that need it. Transporting medical-grade oxygen requires special cryogenic tankers, which are specially built to store and transport liquefied gases at subzero temperatures.
The tankers have to travel 900 miles, in some cases, along India’s narrow and congested highways. The tankers can’t be airlifted because it is unsafe to transport highly flammable oxygen that way.
The Indian government has turned to its national railway service—with its extensive network of tracks—for help, in an effort that has been dubbed the “Oxygen Express.” Flatcars are loaded with tankers directly from the factories. But once the delivery trucks are emptied, they must travel by road back to the factories. It takes an average of 10 to 12 days for the tankers to reach the factories again. The Indian Air Force is also helping by airlifting empty containers back to eastern Indian cities like Rourkela and Durgapur.
“The entire supply chain is stressed at the moment,” said Mr. Tiku.
One of India’s largest manufacturers of medical-grade oxygen, INOX Air Products, has deployed all of its 550 tanker trucks and 600 drivers to supply oxygen to 800 hospitals across India, said Siddharth Jain, the company’s director. Of its 44 manufacturing locations, 25 are equipped to manufacture 2,700 tons of medical oxygen a day.
A Pennsylvania-based company, Air Products and Chemicals Inc., is sending INOX 20-ton storage containers that can be filled with oxygen. Mr. Jain said the Indian company has already received six of them.
“Today, every drop counts,” he said.
State governments have petitioned the country’s courts in an attempt to press federal authorities for more oxygen.
On Tuesday, the Allahabad High Court in India’s northern state of Uttar Pradesh said those failing to provide hospitals with oxygen were committing a “criminal act and not less than a genocide,” during a hearing for a case about the death of patients from a lack of oxygen.
France, Germany and the U.K. have all sent oxygen generators and ventilators. Emergency supplies have also arrived from the U.S., including 1,000 oxygen cylinders that are used in smaller hospitals and clinics that don’t have the infrastructure to pipe oxygen directly to a patient’s bed.
Early this week, however, officials in multiple states said the donations had yet to arrive, according to reports in the Indian press. On Tuesday, the nation’s health ministry said the government started the distribution of aid immediately and didn’t waste time.
“There are not a lot of great options when it comes to rapidly increasing oxygen in the short-term. There is a temptation to purchase a lot of products, such as oxygen concentrators or oxygen generators, however, many of these will likely not reach India or be set up in time for them to make an impact during this surge. Instead, more can be done to increase the logistics and distribution within the country to ensure oxygen is reaching the places that need it most,” said Mohammad Ameel, who heads primary healthcare, technology and innovations for PATH India. PATH is an international nonprofit focused on health.
In recent days, Mr. Tiku said he has met with other industry leaders and Prime Minister Narendra Modi in online conference calls to discuss building makeshift hospitals near manufacturing plants to cut down on transportation times.
“Whether this is doable, we are looking into that,” said Mr. Tiku.
Some 500 new medical-use oxygen plants would be set up within three months, the health ministry said Tuesday.
Medical-use oxygen was given priority last year when India was battling its first wave. In October, the government said it would build dozens of oxygen plants. Of the 162 that were sanctioned, only 33 have been installed so far, India’s health ministry said.
“Plans were unveiled and foundation stones were laid, but they are nowhere near completion,” said K. Srinath Reddy, president of the Public Health Foundation of India, a think tank based in New Delhi.
“The surge caught the underprepared system off balance,” said Dr. Reddy, a cardiologist.
Temporary Covid-19 care facilities that were built for the first wave were dismantled. During early days of the current surge, authorities didn’t quickly identify problems and amend guidelines. For example, many hospitals until recently required patients to show a positive test result in order to be admitted and home-care guidelines were only recently issued.
“Ignoring the symptoms and insisting on reports meant valuable time was lost in providing help to people,” said Dr. Reddy. “Patients were also not able to get support for management at home, so when their condition deteriorates, the total number of people needing [oxygen] increasingly goes higher.”
Days before Batra Hospital lost patients to an oxygen shortage, Reva Mann’s uncle was admitted to the same hospital on April 24 with a blood oxygen level of 52. A health level is generally considered to be between 95 and 100.
An oxygen concentrator that the hospital was using wasn’t able to provide sufficient support so the family bought a 67-liter oxygen cylinder for $434 on April 26. The hospital also asked them to obtain a meter that regulates the flow of oxygen. These have also been in short supply.
Ms. Mann managed to find one that night with the help of friends. “It’s not just oxygen, it’s everything around it now,” she said.
For a day, it seemed as though her uncle’s condition was improving. On April 28, the family received a late-night call from the hospital saying he wasn’t going to make it. He died an hour later.
The oxygen cylinder was lost in the turmoil that followed his death, as she tried to find a crematorium for her uncle. All of them had a long waiting list. His body was brought to the outskirts of the city and cremated in a field near Ms. Mann’s home.
This story has been published from a wire agency feed without modifications to the text.
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