Prof K Nageshwar: Why Is India Gasping For Oxygen?

Reports of acute oxygen scarcity are pouring in from several parts of the country with Delhi facing the worse situation. The demand outstrips supply leading to anxious movements for governments and medical fraternity alike. Why is India gasping for Oxygen? What led to this crisis? It requires a closer scrutiny of demand and supply of medical oxygen in India.

It is true that there is sudden and unprecedented rise in the demand for medical oxygen as the severity of second wave was not anticipated.

India has a daily production capacity of 7127 MT [metric tonnes] that includes both industrial and medical use oxygen. On 12th April 2021, the medical oxygen consumption in the country was 3842 MT [metric tonnes], that is 54 percent of the daily production capacity.Additionally, the government claimed there were stocks in excess of 50,000 metric tonnes. On April 12th, there were just over 12,64,000 active coronavirus cases in the country. That number has since shot up by over 70% to over 21,57,000 in just over 10 days. This led to the sharp rise in the demand for oxygen as more number of patients are requiring oxygen support in the second wave.On April 21, the Central government told Delhi High Court that the daily demand for medical oxygen in the country had risen to 8,000 metric tonnes.Even if India’s entire daily production of 7,127 metric tonnes of oxygen is diverted to medical use, the country is still likely to face a shortfall. The current level of demand for medical oxygen (8,000 metric tonnes) already outstrips combined daily production of industrial and medical oxygen (7,127 metric tonnes) by 870 metric tonnes.

Italy’s struggle with oxygen supplies at the peak of its infections early last year should have made our governments cautious. But, administrative incompetence and political short-sightedness failed India.

The government of India which is primarily responsible for regulating the supply of medical oxygen has already initiated series of measures to ease the situation. These include re-routing industrial oxygen to medical needs, running a special train for transporting it across the country, ordering import of 50000MT of medical oxygen, clearing hurdles in the way of interstate movement of oxygen tankers etc.

The oxygen supplies cannot so easily be augmented due to inherent logistic challenges. Oxygen production is unevenly distributed across the country. Government records show that some of the high Covid-19 case-load states in North and Central India such as Delhi, Madhya Pradesh and Bihar have no significant production capacities of their own. According to official data compiled in April 2020, reviewed by Scroll.in, the eight states of Maharashtra, Gujarat, Jharkhand, Odisha, Tamil Nadu, Karnataka, Kerala and West Bengal account for nearly 80% of India’s total dedicated oxygen production.Cryogenic tankers used for transporting liquid medical oxygen are in short supply.Odisha has the fourth-largest production capacity for oxygen among Indian states. With relatively lower Covid-19 case numbers, its medical oxygen requirement is currently lower than 12 states. There is also scarcity of cryogenic vessels and cylinders that are used to store oxygen. Infrastructure cannot be built over night. It requires planning which was in fact lacking due to complacency in dealing with COVID-19 and gross underestimation of possibility of second wave in India due to false sense of national pride and self-adulatory triumphalism on the part of the government aimed at political aggrandisement.

The government could have easily averted such an oxygen crisis if it had gone for localised solutions in the form of small scale oxygen generation plants within hospitals on a war footing. Such solutions help us to overcome the enormous logistic challenges associated with the transportation of oxygen in an hour of crisis.

But, administrative incompetence failed India in this regard. Industry source reveal that it takes four to six weeks to setup such small scale oxygen plant in a hospital that cost around Rs 1.25 crore only. An attempt was made by the government of India. But, its execution was woefully inept. The government took eight months to float tenders for setting up of 162 such oxygen plants with an allocation of Rs 201.58 crores.The health ministry recently admitted that only 33 of the 162 oxygen plants it had commissioned had been installed.For an outlay of Rs 2,000 crore, the country could have added 1,540 metric tonnes of additional daily medical oxygen capacity. Significantly, this capacity would exist on-site and not be subject to the challenges of logistics and transport, says a report in Scroll.in by ArunabhSaikia.

Thus, India’s oxygen crisis is partly due to sudden spurt in demand that was not anticipated and partly the result of ineffective governance.

-By Prof K Nageshwar

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