How India ensured steady supply of medical oxygen during Covid pandemic
In the pandemic year, India’s use of medical oxygen rose fourfold from 700 tonnes (MT) a day in February, to 3,000 MT in September, when Covid-19 cases peaked. How did India cope with the demand and yet escape the kind of shortages experienced by countries such as Mexico?
The answer: A combination of cutting through bureaucratic red tape to change the rules and synergy between the government and private companies that provided a steady supply of supplemental oxygen across the country, according to stakeholders HT spoke to.
“What if 1 crore people fall sick across the country and need oxygen? How are we prepared? That’s one of the first things the government asked us,’’ recalls Saket Tikoo a member of the oxygen monitoring committee that was set up by the ministry of commerce’s Department of Promotion of industry and Internal Trade (DPIIT). He is also head of the All India Industrial Gases Manufacturers Association (AIIGMA). The question was posed at the first meeting of the panel on April 4 by when 3,569 people had been infected by the virus and 104 had died. Less than a year later, the toll has increased to 11 million cases and the fatalities to 156,000.
“The number of cases was not very high at that time so it was important to take stock of the supply and inventory position and prepare for the future,’’ said DPIIT secretary Guruprasad Mahapatra, who was also heading the empowered group on medical infrastructure set up by the Prime Minister’s Office. “So we set up a control room with 51 people from across the country that would coordinate the problems that were arising and how to tackle them.’’
There were plenty. One of the first ones was how to ramp up the medical oxygen supply that was essential to treat patients of Covid-19.
“There’s no oxygen plant in Delhi, for example, and no medical oxygen plants in Jammu and Kashmir or Bihar and the Andaman and Nicobar Islands. So we suggested to the government that they allow industrial oxygen to be used,’’ said Tikoo.
“Industrial oxygen is actually a purer form of oxygen and so when we realized that it is the main mode of curing Covid, we decided to go ahead after consulting the health ministry,’’ said Sumita Dawra, additional secretary who was put in charge of the oxygen supply.
A day later on April 5, they got emergency clearance from the Drug Controller General of India and the rules were changed to allow industrial manufacturers to produce medical oxygen.
Then came the problem of transporting the oxygen. The post-Covid-19 lockdown started on March 25, transport vehicles were stranded in many places and inter-state travel wasn’t allowed.
An April 6 meeting of the plan resolved to get clearances from the ministry of home, the coordinating ministry for the lockdown, to allow movement of freight vehicles.
“Most of our supply chains are around urban centres where the hospitals are,’’ said Siddharth Jain of INOX, the company supplying a large chunk of India’s oxygen needs. :So supplying to rural centres was a real challenge for us. By June and July (when cases started increasing), our 550 trucks and their drivers had to work 25 hours a day.’’
To be sure, production of oxygen went up by just 5-10% last year and hospitals were able to meet demand only by diverting supplies that were meant for industry. In the initial months of the pandemic until July, this was easier because most industries had been closed, but as time went on, the government told suppliers to prioritise the needs of hospitals instead of steel plants that require the maximum supply.
On September 22. Varanasi commissioner Deepak Aggarwal, who was the Covid-19 coordinator for the district, sent an SOS that while the number of cases of the viral disease was increasing. he neither had the capacity to meet demand for medical oxygen nor the space to store it . Apparently, a local hospital had a signed agreement with a private oxygen supplier a year ago, but had not bothered to put in an order.
“When they asked for supplies, they were told that it was too last-minute,’’ said Tikoo.
That’s when the committee stepped in,persuading the supplier to dedicate a tanker to ply from the plant in Jharkhand to the Varanasi hospital. “They also provided a storage tank to the hospital, so that they could keep a backup supply,’’ Tikoo said. By that time, the government was gratified that it had taken several other measures-- from doing away with state-specific permits for oxygen-carrying vehicles to allowing cryogenic tanks that allow liquid oxygen to be carried at -175 degrees Celsius to ply on the roads. It also bought 675,000 oxygen cylinders when it realized that it couldn’t supply medical oxygen through pipelines in emergency Covid-19 centres like hotels. “It was daily firefighting (from) a leakage in a hospital in Jammu to cryogenic pipes not working in Amritsar. But we found a way around it,’’ said Dawra.
Since October, the need for medical oxygen has been steadily declining. From the peak of 3,095 MT on September 29, demand ell to 1,312 MT last week. Dawra no longer has late-night meetings with stakeholders and Mohapatra said the empowered group’s last meeting was in December.
They now just keep a close watch for any signs of a renewed surge in infections amid talk of a second wave of Covid-19 .
“We have now made a decision to set up eight new plants across the country to take care of India’s growing medical oxygen demand,’’ said Jain of INOX’s plans.