Crisis of oxygen feared as patients on the rise

The demand of oxygen has multiplied several times for the treatment of the Covid patients, stakeholders have said.

Although there is no oxygen crisis at the moment, there are flaws in the oxygen management.

There may be a crisis of oxygen if the number of Covid patients continues to rise.

Public health experts believe that in these circumstances an emergency plan is needed for oxygen management.

Already there are allegations of Covid patients' deaths due to lack of oxygen in Bogura and Satkhira.

People affiliated with oxygen supply said an efficient management is a must for the smooth supply of oxygen even if there is enough oxygen. At present, there is a lack of tankers for carrying oxygen.

In most of the hospitals, more oxygen is being supplied in the central pipelines than its capacity. A lack of regular maintenance would make oxygen supply in due time more challenging. There is also a shortage of efficient manpower at the moment.

In this situation reducing the transmission of the virus is the most important issue, according to ABM Muksudul Alam, dean of Shaheed Suhrawardy Medical College.

He told Prothom Alo that it is difficult to control the situation only by increasing oxygen production and supply. None of the countries have been able to do that. Therefore, it is very important to ensure a good oxygen management system apart from reducing the transmission.

According to the anesthesia experts, oxygen can be supplied from the cylinders in cases where the patient needs around 15 litres of oxygen each minute. Oxygen concentrators can also be used in place of cylinders. It extracts oxygen from air and supplies it to the patients.

And if the patients need around 30 litres of oxygen, high flow nasal cannulas are used. For this, a central oxygen pipeline is needed. It is also essential for the intensive care units (ICU).

The government took a initiative to establish a central oxygen plant in at least one hospital in each district as coronavirus transmission continues to rise.

However, the move was slowed down as the transmission rate earlier decreased for some time.

Local correspondents of Prothom Alo confirmed that there is no central oxygen plant in 17 districts. UNICEF is working on setting up oxygen plants in these districts.

An UNICEF official said they are working on setting up plants in 30 hospitals at the moment. They have already completed the works of installing five oxygen plants. Of them, two are in operation.

The remaining three plants would be launched this week if the department of explosives gives permission. The construction work of 11 oxygen plants is nearly finished. The work of placing the pipelines is finished in 14 oxygen plants.

As soon as the tanks arrive from India, the installation work will be completed. The work would have been completed much earlier if the health department had not delayed their work order by a year. Now they are finishing the work on priority basis in areas where the number of patients is increasing.

Speaking to Prothom Alo, public health expert Abu Jamil Faisal told Prothom Alo there is a crisis of manpower to monitor every step of government projects. There should be a strong follow up system. An integrated plan is needed as there is a crisis time ahead.

According to the district correspondents of Prothom Alo, the Covid related casualty is the highest in Khulna. There was a demand of 35 to 40 cylinders every day at Khulna Medical College Hospital. However, as many as 350 oxygen cylinders are being used every day at present. Apart from this oxygen tanks are being used regularly.

Qazi Abu Rashed, the spokesperson of Covid dedicated 250-bed General Hospital, said they have a tank capable of containing 6,000 litres of oxygen. At the moment, they are refilling the tank once a week. They used to refill the tank once every two months during normal times.

The daily demand of oxygen in Chuadanga was between 100 to 200 litres, which have increased to 1,000 litres now.

Kudrat-e-Khuda, superintendent of Satkhira Medical College and Hospital, said the daily demand of oxygen was 1,500 litres. But now the demand has increased to four to five thousand litres per day now. The demand of oxygen has increased to three to four thousand litres per day now.

Before the outbreak of coronavirus, the demand of oxygen in the country was between 100 and 120 tonnes. There was no need to import oxygen that time. However the demand for oxygen in the country has increased to 200 to 220 tonnes per day now. Earlier, there was such a demand for oxygen at the beginning of last April. At that time, some 100 tonnes of oxygen were imported from India. The remaining was produced in the country.

However, oxygen import from India was stalled after 21 April. That time there was no crisis as the number of patients was decreasing. Now there is a concern regarding this as the number of Covid patients is growing. Even the government has restarted importing oxygen from India to some extent.

Mainly three organisations supply oxygen in the country. Among them Linde Bangladesh Limited is providing 100 to 120 tonnes of oxygen each day. Their production capacity is around 90 tonnes in the country. The remaining is being imported from their own factories in India. They are also purchasing oxygen from the Abul Khair group when needed.

A senior official of Spectra Oxygen said during the days of highest demand they even supplied more than 50 tonnes a day. Apart from producing, they also import oxygen from India and purchase oxygen from two groups in Chattogram.

The Islam Oxygen Company is providing around 40 tonnes of oxygen daily. Speaking to Prothom Alo, Mustain Billah, chief executive officer (CEO) of Islam Oxygen Company, said, "As of now we are still capable of meeting the demand of the private sector. But I could not say for sure what would happen if the number of patients continues to increase exponentially."

Officials of oxygen supplying committees said a top ranking private hospital of the country needs three and a half tonnes of oxygen on an average a day.

So the country needs to increase production. The three organisations are working under an extreme pressure. If one of these companies shuts production, there might be a deficit.

Farid Hossain Mia, director (hospital) of Directorate General of Health Services (DGHS), told Prothom Alo that as of now, there is no shortage of oxygen. If imports and domestic production continue, there will be no shortage of oxygen.

Although Abul Khair Group and GPH Ispat of Chattogram have the capacity of producing 510 tonnes of oxygen, they can supply only 55 tonnes daily. Abul Khair Group supplies oxygen to Linde and Spectra. They sell about 20 to 25 tonnes of oxygen to them. Apart from this, the Abul Khair Group is supplying 500 cylinders of oxygen daily.

Muhammad Abdullah, CEO of Abul Khair Steel Plant, told Prothom Alo that they can supply up to 30 tonnes of oxygen daily. Oxygen is being supplied in the northern districts. Besides, the process has also started procuring necessary equipment to increase the oxygen supply in cylinders.

GPH Ispat is supplying around 25 tonnes of oxygen per day. Spectra oxygen purchases from them. Besides, they are supplying oxygen to different hospitals free of cost.

An official of GPH Ispat’s oxygen plant said they supplied some 100 cylinders of oxygen to different hospitals free of cost on Sunday.

However, transport is still a big obstacle in oxygen supply. Oxygen is being supplied to various districts by tankers. As a result, a shortage of tankers has emerged as well. Despite having the opportunity, Linde is not able to bring more oxygen from India due to lack of tankers.

The number of newly detected Covid patients has been more than 8,000 on average for the last one week. The suppliers are facing difficulties in supplying oxygen to hospitals.

The DGHS said in its news bulletin on Sunday that there is no crisis in producing and supplying oxygen. However, it can become challenging if the number of patients continues to grow.

Former director of the diseases control unit of the DGHS, Be-Nazir Ahmed said while speaking to Prothom Alo that the prime minister’s instruction to install an oxygen plant in at least one hospital in each district has been neglected. Now an emergency plan is needed to be adopted for oxygen management.

*This interview appeared in the print and online editions of Prothom Alo and has been rewritten in English by Ashish Basu