Only two of the four tanks of liquid oxygen at Mr Sethia’s SS Hospital and Research Centre in Bhiwandi were full. Forty-four of the hospital’s 50 beds were occupied by Covid-19 patients, many of whom needed piped oxygen from the tanks to breathe.Each small tank was getting exhausted in six hours instead of the usual nine hours, because of the surge of patients. Both Mr Sethia’s dealers had run out of supplies.Through the night, he called 10 dealers and four hospitals in and around Mumbai to ask for oxygen. None could help. Around 2am, he finally managed to get 20 large cylinders from another hospital, some 18 miles (30km) away. There were no vehicles available, so his ambulances did five trips through the night to get the cylinders. Four people now work round the clock at the hospital to procure supplies from any maker who can send a truck of liquid oxygen for the tanks or any dealer who can spare a cylinder.”Now I have enough oxygen for the next 12 hours,” Mr Sethia said on Sunday evening. “We are firefighting every day. The battle is to get some oxygen anyhow.”
Some 15% of Covid-19 patients require help with breathing, according to the World Health Organization (WHO). Some people appear in no evident respiratory distress, but are found to have dangerously low oxygen levels – a condition called silent hypoxia. A fraction of the critically ill patients require a ventilator.Around 500 factories spread across India extract and purify oxygen from the air. Oxygen for medical use typically accounts for 15% of overall supplies. The rest – industrial oxygen – is mainly supplied to steel and automobile industries for running blast furnaces.
The factories ship oxygen in liquid form to hospitals in tankers, which is then converted into gas and piped directly to beds. Some hospitals also use steel and aluminium cylinders which store oxygen in gas form – but this requires frequent change of cylinders for each bed.As India opens up its economy and people return to work, Covid-19 cases have been surging through small towns and cities. With more than 4.8 million reported confirmed infections, India’s caseload is the second highest in the world, after the US. Some 600,000 cases were added just last week, and more than 90,000 cases were reported just on Saturday. One newspaper calls it a “scary, runaway phase” of infections.Not surprisingly, demand for oxygen has risen exponentially. Hospitals and care centres are consuming up to around 2,700 tonnes of oxygen every day this month, compared to 750 tonnes in April, according to data obtained from All India Industrial Gases Manufacturers Association.Oxygen manufacturers say the demand for industrial oxygen has also shot up because more factories are now reopening. The states seeing a worrying uptick in infections – Maharashtra, Madhya Pradesh, Gujarat, Rajasthan, Telangana, Andhra Pradesh – are suffering the most. It’s a lives-versus-livelihoods question that India is grappling with now.”Now 45% of the oxygen we are producing is going to industries, while 55% is going to hospitals and nursing homes,” said Saket Tikku, the president of the All India Industrial Gases Manufacturers Association. “The government is in a bit of a bind. If we cut supplies of industrial oxygen to factories, industry will get hurt. On the other hand, if we are not able to augment supplies of medical oxygen, then lives will be in danger,” he said.India will now need to increase capacity to make sure that both industries and patients don’t suffer. And that is not all.Most oxygen plants are built near cities and big towns. So supplies to far flung districts where Covid-19 patients are filling hospitals have to be sent by special trucks carrying cryogenic tanks – India has some 1,500 such trucks. Many states – the capital, Delhi, for example – don’t have a single oxygen manufacturer, and all supplies have to come from neighbouring regions.