Medical Oxygen Crisis in India

GOVERNANCE/ HEALTH

Topic:

• GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Medical Oxygen Crisis in India

Context: Medical oxygen is a critical component in the treatment of COVID affected patients. A shortage of medical oxygen at hospitals in many parts of the country in the wake of the ongoing second wave of COVID-19 infections has caused multiple deaths across country.

How much oxygen does India produce?

• Union Health Ministry has said that India had a daily production capacity of 7,127 metric tonnes (MT) of oxygen, which it asserted was sufficient given that the countrywide medical oxygen consumption as of April 12 was 3,842 MT. 
• The 7,127 MT capacity that the Ministry referred to was the overall oxygen-producing capacity, including the volumes produced for industrial use, 
• Recently, the Centre has restricted the supply of oxygen for all non-medical purposes, except a list of exempted industries that includes pharmaceuticals, food, oil refineries and oxygen cylinder makers. This has meant that the major share of output has been earmarked for medical use.
• PMO has said in release that the production of LMO [liquid medical oxygen] in the country has increased from 5,700 MT/day in August 2020 to the present 8,922 MT (on April 25, 2021). The domestic production of LMO is expected to cross 9,250 MT/day by the end of April 2021.

What led to the shortage?

• Caught off guard by steep demand: While the Union government did constitute an inter-ministerial Empowered Group (EG2) of senior officers in March 2020 to ensure the availability of essential medical equipment, including medical oxygen, to the affected States, the group appears to have been caught off guard by the sheer scale and speed of the rise in infections. 
• Failure of Demand Forecasting: Oxygen demand projections have woefully lagged behind actual requirements thus causing the crisis. The demand for medical oxygen, which prior to the onset of the pandemic last year was at about 10% of overall output, or 700 MT/day, has skyrocketed in recent weeks, to ~5700MT/day, with the incidence of patients suffering acute respiratory distress having sharply spiked during the current second wave. 
• Increased Demand by States: while Uttar Pradesh doubled its requirement forecast to 800 MT from 400 MT earlier, Delhi said it would need 700 MT as of April 20, a 133% increase from the 300 MT it had previously sought. 
• Poor Logistical Preparation: The logistical preparation for a second wave in India appears to have been wholly inadequate. With just 1,224 cryogenic tankers available for transporting LMO, there have not been enough vehicles to carry medical oxygen in quick time to critical locations. As a result, supplies ran out with replenishment not reaching on time and many seriously ill patients gasping to death

Why are we facing supply challenges?

• Prior to the pandemic, a bulk of the health sector’s medical oxygen requirement had been met with supplies delivered either in form of oxygen cylinders containing the element as a high-purity gas or through dedicated cryogenic tankers that transport the oxygen in liquid form and deliver them to storage tanks at hospitals.
• The stand-alone facilities for the production of oxygen, including the medical variant, have so far been geographically concentrated mainly in clusters in the eastern, southern and western parts of the country, thus necessitating the transportation of the element over distances by road. 

What is being done to boost supply?

The Centre is taking a multi-pronged approach to address the crisis. 

• Diversion from Steel Plants: For one, it has decided to deploy surplus stocks of the element available with steel plants across the country, including Public Sector Units. 
• Logistical Support by Government: The movement of transport tankers for LMO is now being closely monitored and the Indian Railways and the Indian Air Force have been roped in to help ferry tankers by both rail and air 
• Tankers augmentation: The PESO (Petroleum and Explosives Safety Organisation) has also issued directions to oversee the conversion of argon and nitrogen tankers for use as oxygen tankers. Production of additional cryogenic tankers is also underway to augment fleet capacity. 
• Usage of Industrial Cylinders: Separately, industrial cylinders have been permitted to be used for medical oxygen after due purging, and the Health Ministry is placing orders for another one lakh oxygen cylinders.
• Decentralised approach for producing oxygen: Union Health Ministry is also expediting on a war footing the commissioning of 162 Pressure Swing Adsorption (PSA) plants that can generate oxygen from the air at various hospitals across the country.
• International Assistance: For now, the government is also accepting assistance from abroad with several countries, including Russia and Singapore, despatching oxygen equipment.