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LOOKING BEYOND THE OXYGEN CRISIS IN INDIA

YB WEB DESK. Dated: 5/8/2021 1:18:00 PM

DEEPIKA BHASKAR As the India oxygen story leaves the world wondering and different versions of the preparedness of the nation make headlines globally, it’s time we start looking at the crisis from a different angle. That the Government should have been better prepared and that they should have seen this coming, has already been said a million times. That we celebrated too early and should have been more careful, is widely acknowledged. While the blame game will continue, it’s time to rethink our priorities. There is no disputing the fact that we were not prepared for the second wave and it just blew away the entire Government machinery. It exposed the fact that our disaster management services were faulty and their plans were not methodical. The Centre-State debates and the blame game took its own toll. It was, however, marvelous to see how various social groups and individuals rose to the occasion and took steps to help out in any way they could. Anthony Fauci, the Chief Medical Advisor to the Joe Biden Administration, in an interview recommended steps to be taken on an immediate, intermediate and long-term basis to overcome this crisis. The immediate steps suggested by him were: Make an emergency group that will visit the situation every day and suggest measures; focus on the immediate need for oxygen, beds and medicines rather than the long-term strategy of vaccination though it should keep going on simultaneously as a longterm strategy; rope in the Army to help with the situation; shut down the entire country for a few weeks. While these suggestions are relevant and have been known to work for both China and the US, we must realise that whenever the lockdown is opened, we will plunge back into the crisis. This is because, the mutability of the virus is unpredictable and we are dealing with a political class and population that doesn’t understand the importance of COVID-appropriate behaviour and the severity of the situation. To keep the economy from crashing; to save the lives of the people; to take all measures to keep them healthy and to keep the stoves burning in their homes so that they can feed their families is tough. Even as we choose strategies to fight one variant, the next one will be ready to play hide and seek with us. What options are we left with, then? India’s National List of Essential Medicines, as also the World Health Organisation’s (WHO’s) model list of essential medicines, lists oxygen as one. As AIIMS Director, Randeep Guleria puts it, “Many of the patients can be saved by giving just one treatment, that is by giving oxygen.” Therefore, a strategy of having more oxygen beds makes a lot of sense. However, there is no official data on the overall requirement of oxygen of the country. Hence, preparedness has suffered and the future demand of oxygen cannot be predicted. Piped oxygen in hospitals is much safer and cheap in comparison to oxygen cylinders which are unsafe, logistically challenging and expensive. The purity of oxygen and whether it is medical grade or not, is equally challenging. Procuring oxygen concentrators from abroad is also being actively pursued to artificially produce oxygen, which is then transported to medical establishments. In large hospitals, liquid oxygen is filled in large tanks and supplied through a network of pipes to the outlet near the patient’s bed. Piped oxygen is more automated and it is easier to control the levels. The Government had created guidelines for management of medical oxygen at the start of the pandemic to ensure that the supplies were enough in hospitals. The first wave was managed well but when the new strain of the virus started infecting more people, the numbers escalated. The demand rose from 1,500 metric tonnes (MT) to 6,000 MT within 72 hours. This led to a panic situation as no one was prepared for it. While India has the capacity to produce 8,500 MT oxygen, it has a stock of 4,000 MT. The crisis also happened due to supply chain management failure. Oxygen transport is not easy due to its highly inflammable nature and the vehicles carrying oxygen cannot run very fast. The availability of cryogenic tankers was limited. However, as usual, we have been resilient and the Government has roped in the security forces to help tide over the oxygen crisis in the country. They have been ferrying oxygen from abroad and the Defence Research and Development Organisation (DRDO) has set up an oxygen generation plant at the AIIMS in New Delhi. Four more plants capable of generating more than 1,000 litres of oxygen per hour will soon start functioning in the RML Hospital, Lady Hardinge, Safdarjung and the AIIMS in Rohtak. The system can cater to 190 patients at a flow rate of five litres per minute and charge 195 cylinders per day. The Medical Oxygen Plant technology has been developed by the DRDO based on the on-board oxygen generation unit of the Tejas light combat aircraft and will help overcome the logistics issues of oxygen transportation. The IAF is making relentless sorties to airlift oxygen from abroad and one of its C-17 aircraft flew 35 hours to fetch cryogenic oxygen containers from England. Earlier, another C-17 flew 14 hours non-stop to get cylinders from Germany. Looking at the serious situation, the IAF has to date brought in more than 60 cryogenic containers and 900 oxygen cylinders from Singapore, Dubai, Bangkok, Frankfurt and the UK, clocking over 140 flying hours. While there are a lot of lessons to be learnt from this crisis, the importance of adding health to the Concurrent List under the Constitution has been pointed out by the Finance Commission. This must be taken up on a priority basis. It is imperative that central health schemes are implemented in States and the Centre and State Governments work in tandem. If all concerned perform their duties in time and there is cohesiveness in functioning, the next crisis during the predicted third wave of the pandemic can be averted. Meanwhile, it is heartening that several startups and corporates have stepped up the fight against the second wave of the contagion in India. The Paytm Foundation is raising over Rs 10 crore to donate oxygen concentrators across India. Zomato Feeding India, in association with logistics firm Delhivery, has started the ‘Help Save My India’ endeavour to source oxygen concentrators. Action Covid-19 Team Grants (ACT Grants) have taken the task of funding ideas that can solve the global health crisis. Google and Microsoft have pledged to support India. Apple has also offered to extend its support to India.