Second wave: 1,000 tankers out on long road as patients gasp for breath

Not about supply of oxygen alone, it's also about transportation and storage

Anit Sathe will have to use up a tonne of liquid medical oxygen (LMO) just to get his tanker back on the road in Maharashtra. This tonne of oxygen, which otherwise could save the lives of Covid-19 patients, is being wasted because his truck has gone ‘dry’ owing to interrupted supplies.

Sathe runs Nikhil Medico and is an oxygen supplier. “We do not have liquid oxygen which usually comes from Linde in Pune. Now, the problem is, since my tanker has gone dry due to unavailability of oxygen, I will have to waste one tonne of oxygen before keeping the tanker ready for next use. It is a difficult situation,” said Sathe.

When a tanker goes dry, its temperature rises to room temperature. To bring it down to minus 183 degree celsius, the level at which liquid oxygen is needed to be maintained, the tanker has to be washed with it. This oxygen evaporates on coming in contact with the hot surface. The temperature, however, starts dropping in the tanker.

UK-based Linde, which has its India office at Faridabad in Haryana, is bringing a two-truck load of LMO from the Steel Authority of India’s Visakhapatnam plant to Maharashtra on a special train. The train reached Nagpur Friday evening and will be in Nashik and then Mumbai by Saturday.

According to figures from the All India Motor Transport Congress (AIMTC), there were just about 400-500 tankers which used to supply oxygen earlier but now the number has gone up to around 1,000 since medical nitrogen tanker trucks have been pressed into service for transporting oxygen.  

“As demand surges, the issue is no more of supply, it is of transportation and storage,” said Bal Malkit Singh, chairman, core committee of AIMTC. “Despite India producing enough oxygen, patients at covid hospitals are gasping.  The delay in transportation of oxygen to dealers, the conversion into cylinders and the supply to hospitals can very delayed if even a tiny link in the supply chain falters.”  

The limited number of tankers are normally deployed locally but are now running long distances since big steel plants have chipped in to supply LMO following a government directive in response to the severe shortage of oxygen in hospitals.

These specialised tankers involve heavy fabrication costs. They cannot be built at short notice, especially when transporters are suffering heavy losses, said a transporter industry player.

Oxygen moves through tankers to big hospitals where it is put in storage created for the purpose. Smaller hospitals or nursing homes get their supply in cylinders which are also in short supply.

The number of cylinders and tankers required should ideally be double that of oxygen demand because empty ones go for refilling. This situation can be avoided if hospitals themselves host small oxygen plants.

The Union government had floated a tender in October for 150 district hospitals to put up such units but, according to news website Scroll, most of these units have not been set up.

According to a Ministry of Health tweet of April 18, 162 pressure swing adsorption (PSA) plants were sanctioned by the Centre. These plants derive oxygen from atmospheric air which is purified and supplied through pipes to patients. Such oxygen is required to have 99.5 per cent purity.

The Health Ministry said that of the 162 sanctioned, 33 plants were installed, including five in Madhya Pradesh, four in Himachal Pradesh, three each in Chandigarh, Gujarat and Uttarakhand, two each in Bihar, Karnataka and Telangana, one each in Andhra Pradesh, Chhattisgarh, Delhi, Haryana, Kerala, Maharashtra, Puducherry, Punjab and Uttar Pradesh. 

States have asked for additional 100 such units which means a total of 262. 

While the Maharashtra-bound ‘Oxygen Express’ will reach by tomorrow morning, another such train travelling from Bokaro Steel Plant will reach Lucknow on Friday evening.

Besides Linde, Taiyo Nippon Sanso, Inox Air Products and Air Liquide are moving their tankers through these trains to reduce the turnaround time.

For families of patients looking for oxygen supplies at home, cylinders are the best option. The price for medical oxygen gas in cylinders is fixed by the National Pharmaceutical Pricing Authority.

It was Rs 25.71 per cubic metre when last fixed on September 25, 2020, excluding taxes and transportation charges. Cylinder rental, deposit and transportation charges are mutually decided by the buyer and supplier, leaving scope for profiteering.

The fine adjustment valve with a flow meter, humidifier bottles and nasal cannula are also purchased separately.