The deaths of seven patients including four COVID affected, at a Government Hospital in Vellore district, due to the alleged shortage of oxygen has created a widespread panic and fear in state. However, the district administration in Vellore has clarified that the patients had died of co-morbidities and not because of the shortage of oxygen.
The incident happened at Vellore Government Medical College on April 19. Even as the government authorities claimed there is no shortage of oxygen, the relatives have alleged otherwise. There were many eye-witnesses who saw hospital officials spraying water on the frozen oxygen plant to melt it.
Deaths caused due to the lack of oxygen have taken place in the state in the past. These incidents were reported in Tiruppur in 2020, in Madurai in 2019 and in Chennai in 2015. In all the cases, hospital authorities and the government had denied the allegation that it was caused by oxygen shortage. However, all these cases have one thing in common: frequent power cuts.
For the last couple of days, the people across the state have been witnessing intermittent power cuts ranging between 15 minutes to half an hour and at least twice or thrice a day. In rural areas, the power cuts extend for hours. For example, in Vellore there have been incidences of power cuts for more than six hours.
Tiruvallur, Chennai’s neighbouring district has been witnessing continuous power cuts for the last one month. In most parts of the district, people are getting just three hours of power in a day. Do these power cuts play a role in the oxygen supply in hospitals?
“There is no clear facts on what happened in the hospital. But first of all, there is no oxygen plant in Vellore. What the relatives of the deceased saw was the liquid storage tank. The oxygen can be stored in the form of liquid only when it is maintained in cold temperature. When it is released under pressure, the liquid turns into gaseous state. Pouring water to melt the frozen oxygen is just a normal process,” said Kannan, chief executive officer of a Chennai-based oxygen supplier company.
However, power cuts affect oxygen production, he said. “Oxygen production is a continuous process. But if a plant shuts down, say on a Sunday, it will take at least eight hours to produce one cubic metre of oxygen with sufficient purity on the next day. While that is the case, if there is a power cut even for 10 minutes, we cannot produce oxygen for another half an hour even after power has been resumed,” he said.
Kannan however said that government should relax their regulations on the purity of oxygen to make another 10 per cent of oxygen supply available.
“For portable oxygen concentration, the government has set a purity level of 93 per cent. But for gas cylinders, 99 per cent purity is required. No patient is going to inhale such pure oxygen. So, if the purity level can be lowered to 93 per cent, there would be more oxygen available,” said Kannan.
According to Tamil Nadu Medical Services Corporation (TNMSC), even in the worst case scenario, the state would not need more than 900 metric tonnes of oxygen.
“There are seven companies producing oxygen in the state. Of which, three companies supply to government hospitals. Even if we have patients in all the 27,299 normal beds and 7,771 beds in emergency wards, we don’t need 900 metric tonnes of oxygen. But we have sufficient storage facilities to store oxygen more than the required number. Even if we need more oxygen, we will stop the oxygen supplied to industries,” said P Umanath, TNMSC managing director, while addressing the media recently.
However, on April 15, the Centre has put Tamil Nadu on the list of 12 states, which has high oxygen demand.
Dr K Senthil, president, Tamil Nadu Government Doctors Association, however, explained that the listing doesn’t necessarily mean the state has an oxygen shortage. “The listing is based on total positive rate and population and that is the reason the Centre expects the state will need more oxygen in the near future,” added Dr Senthil.
“During the COVID-19 peak last year, we had increased the capacity of oxygen storage facilities. In Tamil Nadu, we have liquid oxygen storage facilities in seven places like Chennai, Madurai, Salem, etc., each with a capacity of nearly 20,000 kilo litres. However, the challenge is that there are only a handful of liquid oxygen producers in the country. For entire South India, there may be just one or two companies supplying oxygen,” he said.
The liquid oxygen is transported by lorries specially designed for that purpose. These lorries refill storage facilities once in two or three days.
“In a worst case scenario, the storage can be utilised fully in one day. At that point, we need more such lorries. Suppliers need to organise such lorries which take time. This kind of infrastructure and administrative delays needs to be addressed,” Senthil added.
He further stated that since the supply of oxygen to the patient is almost mechanical, the role of electricity is low. “To convert liquid oxygen into gas, you need power. If there is power cut, it can be solved by generators and the hospitals should be equipped with such facilities. So power cuts are not really a big issue. In many hospitals, even a patient who doesn’t need oxygen, starts wearing oxygen masks thinking that it can give them some advantage. In some cases, the doctors get confused whether they prescribed oxygen for that patient or not. We need to create awareness about this as well,” he concluded.