Why Are Hospitals In India Running Out Of Oxygen For Covid Patients?

India posted a world record of 346,786 new cases of Covid on Saturday, as the country grapples with B. 1,617, a potentially more contagious variant of the virus. More than 192,000 people have died from Covid-19 so far, according to the nation’s Ministry of Health. India hit another grim record on Monday morning with 2,812 deaths over a 24-hour period, its highest figure yet. The dizzying caseload is overwhelming the country’s hospitals, which now face a crucial shortage of supplies, especially oxygen.

But one of the largest medical oxygen companies in the country says the reason for the shortage isn’t the supply, it’s getting oxygen where it’s needed. “In the same way that the pandemic has hit us once in 100 years, similarly, no one expected the oxygen requirement to move such great distances to happen,” says Siddharth Jain, who oversees the Inox Air Products. “That’s why this infrastructure wasn’t built.”

Oxygen is a crucial treatment for many patients with severe Covid-19, as the disease affects lung function. One of the telltale symptoms is shortness of breath, which can be followed by pneumonia, as the lungs fill with fluid. If a person cannot get enough air into their lungs, this means that oxygen cannot travel to the other organ systems, which may begin to fail.

The vast majority of oxygen-producing factories in India are located in the eastern part of the country, more than a thousand miles from major cities such as New Delhi and Mumbai. Inox Air Products, part of the Inox Group industrial conglomerate founded by 92-year-old billionaire Devendra Jain, has been able to increase its oxygen production from 1,800 metric tons to 2,300 metric tons a day in recent weeks, says Jain, which is more than a third of the 7,000 metric tons produced in the country each day. Inox Air Products is a joint venture with Air Products, headquartered in Allentown, Pennsylvania. The other two major global manufacturers—Air Liquide, based in France, and Linde, based in the UK-have also been working to increase the supply of medical oxygen in India.

One of the biggest obstacles is that oxygen is not so easy to transport. Compressed gas tanks can only travel on roads or trains and cannot be flown on airplanes. (Oxygen concentrators, on the other hand, which suck oxygen from the air to achieve high concentration, can fly safely.) And now these tanks have to travel further than ever to keep up with the growing demand in the northern and Western states of India that have no oxygen manufacture at all.

Another bottleneck for oxygen where cryogenic tanks containing compressed oxygen are needed cannot be manufactured quickly. Each tank takes four to six months to produce, Jain says. “We export a large number of them all over the place. But there was never such a demand.”One solution has been for the Indian Air Force to fly empty tanks to production sites to try to reduce transportation time, says Jain.

Despite the increase in the number of cases and India’s status as one of the world’s largest pharmaceutical manufacturers, the country cannot expect to contain the pandemic through vaccination anytime soon, highlighting the staggering inequalities between vaccine distribution in high-income countries versus the rest of the world. India, which has more than 1.3 billion residents, has registered fewer than 141 million vaccines. “Scientists developed several vaccines for Covid-19 in record time,” World Health Organization director Tedros Adhanom Ghebreyesus wrote in an opinion piece recently published in the New York Times. “However, of the more than 890 million doses of vaccines that have been administered globally, more than 81 percent have been administered in high-and upper-middle-income countries. Low-income countries have received only 0.3 per cent.”

Adar Poonawalla, the CEO of India’s largest vaccine manufacturer, the Serum Institute, also criticized the Biden administration for banning the export of certain raw materials, which he said was slowing vaccine production outside the United States. On Sunday, the administration seemed to give in and reverse its protectionist stance. National security adviser Jake Sullivan said the United States would make the specific raw materials needed to manufacture vaccines “immediately available,” in a discussion with his Indian counterpart Ajit Doval, according to a White House reading. Sullivan also said the United States was ” looking for options to provide oxygen generation and related supplies on an urgent basis.”

Jain says every oxygen manufacturer in the country has been in daily contact since the government first established a medical oxygen committee in April last year. “The entire oxygen industry has done a great job of delivering oxygen, but there’s only so much you can do to catch up with this virus,” says Jain. “And if it’s uncontrollable, it’s uncontrollable. I hope no other country has to go through that.”

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