Oxygen alarm bells in Maharashtra, hospital beds running out, shortage of cylinders

A SEVERE shortage has sent the prices of oxygen cylinders soaring across Maharashtra. Aurangabad, where the positivity rates were the highest in the state March-end, is particularly hard hit, with all oxygenated beds occupied over the weekend, and patients desperately seeking to treat themselves at home.

All 2,214 oxygen beds were occupied over Friday and Saturday in the district, where the positivity rate was 43.8 per cent in the closing days of March. Of a total 15,484 active cases, 4,600 are under home isolation. Most are mild, said doctors, but some are moderately ill, and require oxygen support.

Since March, the demand for medical oxygen has risen across Maharashtra. The current daily requirement of medical oxygen in the state is 700-750 metric tonnes, up from 150-200 until the end of February. In Aurangabad, the daily requirement is 49.5 metric tonnes, up from 15-17 metric tonnes until February end.

There is no shortage of oxygen for patients admitted to hospitals, but hospitals are running short of oxygenated beds. For patients being turned away and advised home isolation, oxygen cylinders have become hard to get.

Given the shortage, the state Public Health Department had last Tuesday directed manufacturers to supply 80 per cent oxygen for medical use and the balance 20 per cent for industrial purposes until June 30.

On Saturday, when Maharashtra counted 49,447 cases, the highest since the pandemic hit the state last March, Chief Minister Uddhav Thackeray acknowledged the shortage of oxygen and said the state was contemplating reserving the entire 100 per cent oxygen production for medical purposes for the next few days.

In Mumbai, the new cases crossed the 9,000 mark for the first time, with 9,108 fresh cases. There were 277 deaths. On Friday, for which numbers are available, 3.28 lakh people were vaccinated, of which 57,390 were in Mumbai.

“Last week, we had decided to restrict the use of oxygen to 20 per cent for industrial purposes, and remaining for the health system. Now, I feel the time has come to use 100 per cent oxygen for the health system. And even if that does not suffice, we will be in a serious situation,” Thackeray said in an interaction with journalists.

Muzammil Khan (40), a nurse in Aurangabad’s GMC hospital, tested positive in March end. A day later his 90-year-old father Mustafa and 40-year-old wife also tested positive. “We had mild symptoms, but my father’s oxygen saturation started dropping. I am a nurse but I could not find a hospital bed for him,” Khan said.

A doctor advised urgent oxygenation. Unable to step out due to home isolation, Khan desperately called oxygen suppliers, NGOs, and friends to obtain an oxygen cylinder. It was only after three tense days, by when his father’s oxygen saturation was hovering at a dangerous 70, that a private hospital official who knew him well agreed to lend one cylinder.

Shaikh Sattar, 51, a lab technician and diabetic, tested positive for Covid-19 on March 30. Soon he developed severe cough and cold. His oxygen saturation dropped to 86. “I went to three hospitals, none had spare cylinders. Oxygen beds have a waiting list,” he said. Eventually on doctor’s advice he took Favipiravir at home without oxygen support.

“One cylinder can help only one patient at home. In a hospital it can serve multiple patients,” explains oxygen supplier Abdul Hakim, owner of oxygen Zainab Enterprise, who stopped supplying cylinders to homes for a week. The demand has increased four times since March— from 200-250 to 800-900 cylinders a day— and Hakim is unable to retain any emergency stock. “Since demand has grown across Maharashtra, the supply is delayed,” he said.

The cost of cylinders has also spiralled. The refilling cost of a 7,000 litre cylinder has more than doubled to Rs 350 from Rs 150. Advance deposit for a cylinder at home is Rs 10,000, up from Rs 5,000.

Manish Mittal, owner of Sagar Gases, that supplies to top hospitals in Aurangabad, said manufacturers have hiked oxygen price from Rs 10 per cubic metre to Rs 18. “The price hike is from the manufacturer’s end. Coupled with this, I need more drivers and labourers to transport and handle more oxygen. If I have to deliver one cylinder specially to someone’s home, additional transportation cost will be around Rs 100,” he said.

Mittal said the government has asked them to prioritise hospitals for oxygen supply which will affect home supply.

“The high cost of oxygen is still manageable but the problem is lack of availability of oxygen for home treatment. If a patient neither gets a hospital bed nor a cylinder at home, how will she get treated?” asks Masihuddin Siddique of NGO Global Foundation that works with Aurangabad district officials to help patients with medication.

Pharmacist Kishore Waghmare said suppliers also demand a doctor’s prescription. in turn, doctors are reluctant to prescribe oxygen for patients in home isolation fearing government action.

“For home treatment, a doctor should be willing to take full responsibility for treatment. And not all private doctors are ready to do that,” said Dr Sundar Kulkarni, Aurangabad Civil Surgeon, denying there was an oxygen crisis in the district.

Aurangabad district has added 3,000 isolation beds for covid patients in the last one month to bring the total up to 20,084 beds. Of these, beds are available for mildly patients, but even for those, admission is given only to those who have no home isolations facilities, officials said.

In GMC, the largest government hospital in Aurangabad, 10 patients are wait listed for Covid treatment. Dr Kananbala Yelikar, Dean, GMC, was admitted to a Pune hospital for Covid-19 treatment during the week.