A lot has been manifested about the grim battle between that the Indian healthcare system and COVID in the year 2021. The second bout came with newer and unimaginable implications of the disease, which has left numerous ineradicable impressions. The most precarious conversation has definitely been about the medical oxygen and the sense of predicament around it.
Social media and news channels reported numerous
instances of worried relatives of the COVID-19 patients in hospitals trying to
enter the ICUs to check if their family member is being provided oxygen supply
or not. Further, not only individuals but even hospitals were posting SOS
messages on social platforms asking for help in replenishing the fast-depleting
oxygen supply.
As compared to approximately 10 million
getting infected in over 10 months during the first wave, the country witnessed more than 11 million being infected in just 10 weeks during the second
wave. This sudden rapid rise in daily number of cases resulted in a massive
demand for oxygen for treatment, and immediate lack of supply created an
emergency situation in the country. What followed was a lot of disarray and
turmoil, eventually being overcome by stupendous sacrifices and decisive
innovations.
But it is important for the country to
understand what led to the conundrum, how we overcame it and what we need to do
to be better prepared for a third bout with COVID.
Factors exacerbating the Crisis situation
The country has been fighting
continuously and relentlessly against the virus since its outbreak in early
2020. Interventions like extended lockdowns, stringent health safety measures,
fast-tracking the vaccination rollouts, etc., had put India in a relatively
better position as compared to many other countries across the world. However,
the mammoth crisis of the second wave sweeping across the nation, blew all our
learnings into the wind.
Some of the major factors that created a
sense of panic during the second wave included:
Oxygen demand-supply mismatch: The
impact of the second wave was much more widespread, hitting different regions
almost simultaneously. This raised an abrupt and urgent demand for oxygen
across different geographies almost at the same time. Further, the oxygen
production is disproportionately spread across India with about 70% of the
supply concentrated in the eastern and western part, 20% in southern, and 10%
in the northern region. And the most number of infected cases were being
reported from the north. With news of oxygen shortage amidst rising number of
critical cases spreading like wildfire, people began panic buying of oxygen
cylinders and machines like oxygen concentrators even when not required, which
added pressure to the already depleting stock.
Inadequate cryogenic infrastructure: The
existing liquid oxygen supply chain network faces many challenges, including inadequate
number of oxygen tankers for moving oxygen from distant production facilities to
meet the demand across different regions. Also, where a hospital would usually
require a weekly refill from a 1000-liter tank, the demand spiked to a refill
on a daily basis, putting immense pressure on the supply chain.
Less-equipped healthcare infrastructure: The healthcare infrastructure was not prepared to meet
the sudden surge in critical cases that required oxygenated beds, especially in
case of a prolonged stay. Hospitals in both public and private sector were
found lacking the resources to cater to unexpected increase in oxygen
consumption.
Nation Unified by a Single Objective: Dealing with the Oxygen
Crisis
While the second wave brought to the
surface the stark inadequacies in
our resources and strategies to deal with the challenges of the pandemic, the
stakeholders – the Government, the states, corporates, individuals, and our
allies from across the world came together to offer resilient support and
assistance.
Role of the government: The 6 empowered groups established in early 2020 to deal with the various challenges of the
pandemic reconstituted into ten groups to tackle the issues arising in the second
wave. Additionally, the Commerce Ministry adopted game changing strategies,
including utilizing industrial oxygen as medical oxygen, converting the
nitrogen and argon tankers into oxygen tankers thus increasing the number of
cryogenic tankers by 50%, utilizing all available resources to hasten the
supply of oxygen, etc. The state-owned steel plants reduced their safety stock
from 3.5 days’ worth of oxygen to 0.5 day to
help reduce the oxygen shortage.
Commendable
feat by the Indian Railways that launched “Oxygen Express” to transport oxygen
tankers from farthest parts of the country to places in need.
The
Indian Air Force (IAF), Indian Railways, Indian Army, Navy, and the State
Police, all pooled their resources and collaborated their efforts to ensure
ease of movement of oxygen, setting up of medical facilities, storage
facilities, green corridor, etc. The Supreme Court set up a National Task Force
to ensure effective and transparent allocation of liquid medical oxygen across the
country.
Private sector: The steel
Industry pitched in by increasing the country’s output by 30% in just one
month. Also, within the healthcare sector, not only the frontliners but “back
in the line” workers like ambulance drivers, oxygen tank drivers, etc. worked
24/7 to help in oxygen reaching the patients.
Rest of the World: Countries including the UK, the US, Russia, and
China assisted with medical supplies such as raw materials needed for vaccines,
critical COVID-related medical supplies, oxygen generation equipment, and an
enhanced capability for smoother transportation and storage of oxygen.
Prepare Proactively
The
past few months have taught us some highly vital lessons to meet any furtue waves in a more streamlined and effective manner. The need of the hour is to strengthen
the country’s last mile cryogenic infrastructure. As ASUs take years to set up,
reinforcing storage facilities is essential to meet the oxygen requirements at
the farthest parts of the country. Moreover, we need to lay down viable
strategies to increase the storage capacity at district level, such as the Hub
and Spoke model. Also, it has become important to enhance state-wise fleet of
cryogenic tankers to meet the sudden demand to transport oxygen across
geographies. Lastly, the healthcare system needs to be encouraged be judicious in
its use of oxygen through regular audits.
While the second wave tested the nation’s prowess and we proved the mettle in the end, the brutality of it highlighted some major bottlenecks and shortcomings in our existing action plan to fight the pandemic. However, having learnt our lesson, the hard way, we are geared up to face the next wave. The key to combating this virus is to accelerate mass vaccination efforts as we believe
More Vaccination = Less Need of Oxygen.
