Gasping for breath

Govt must take responsibility for oxygen supply chain

In many parts of India, particularly in the National Capital Territory of Delhi, hospitals are inundated by patients due to the surge of Covid-19 cases nationwide. This has caused a serious shortage of several medical supplies, particularly oxygen. Some experts have suggested that this wave of the pandemic is causing breathing difficulties among more patients and at an earlier stage of the disease. Oxygen availability has thus become even more crucial. Both those dealing with symptoms at home and hospitals that are close to capacity in their intensive care units and regular wards need oxygen.

It is clear, however, that hospitals are operating on a day-to-day basis when it comes to oxygen availability. Social media is overflowing with appeals from individuals and hospital administrators regarding the sourcing of oxygen. High courts in several jurisdictions, and particularly the Delhi High Court, have also been the location of appeals from large hospitals and hospital chains to get the supply chain moving. The vital nature of this supply chain was tragically underlined on Wednesday when two dozen patients in Nashik city died because the hospital’s oxygen supply ran out due to a leak in the tanker refilling its reservoir.

The country should not have been allowed to reach this point. Recent reports showed that it took over eight months after the pandemic started for a directive to increase the number of oxygen-processing plants to be turned into an actual tender. As a consequence, only 33 of a planned 162 plants have been installed, according to the Union health ministry. This has forced individuals and hospitals to shop around for oxygen, companies to divert and donate their stores of industrial oxygen, and the government to urgently import tens of thousands of metric tonnes of medical oxygen. The health ministry has said 80 plants will be ready by the end of May, but that is already too late — and it is emblematic of the poor state of Indian public health infrastructure. Governments, at both Union and state levels, can have no excuses for their poor level of preparation for oxygen needs. The only explanation can be overconfidence that no second wave of the pandemic would hit India.

The institutional framework to distribute oxygen is collapsing in the face of this scarcity. Big oxygen plants are being prevented from satisfying their contracts to hospitals in other states. This is a problem particularly in Delhi, where hospitals are dependent upon plants in Uttar Pradesh and Haryana. The administrative machinery in these states has actually prevented or delayed shipments of oxygen to Delhi. This cannot be allowed in a well-functioning country. It is unfortunate that high courts had to step in to ensure movements of trucks across state lines, maintaining which is the responsibility of the Union government. The Supreme Court has now taken suo motu cognizance of this problem and called for a national policy. It is to be hoped this will not prevent the high courts from continuing to take necessary action. Overall responsibility for this state of affairs rests with the Union government, which should indeed make it clear immediately how it intends to ease the oxygen shortage, what its estimations of demand and supply are, and how it will preserve the oxygen supply chain to hospitals. At a high-level meeting on Thursday, the prime minister called for strict steps to improve oxygen distribution and prevent hoarding. The government, it is hoped, would finally walk the talk.