The Indian social media has been inundated with SOS messages in recent weeks, with hospitals tweeting about the acute shortage of oxygen supplies and doctors watching helplessly as patients die of preventable deaths. A journalist who was refused a hospital bed took to Twitter to document his rapidly deteriorating condition before his death. Overburdened crematoria are operating around the clock to keep up with the influx of bodies; furnaces have melted due to overuse, and new funeral platforms are being constructed outside. These are some of the tragic messages and eerie images that illustrate the devastating second wave of the coronavirus pandemic sweeping the world.
India set a new world record for new coronavirus cases this week, surpassing 330,000 new cases on Friday, as deaths in the past 24 hours reached a new high of 2,263, according to the health ministry. On January 8, 2021, the United States set the previous one-day high with 300,669 new incidents.
Since late last year, the joy of overcoming the virus had been building. Politicians, policymakers, and some members of the media claimed India had finally emerged from the jungle. Officials from India's central bank reported in December that the country was "bending the Covid infection curve." They said there was proof that the economy was "breaking out amidst winter's lengthening shadows towards a position in the sunshine," in poetic terms. Prime Minister, Narendra Modi has been dubbed a "vaccine guru."
The second wave of Covid-19 has shown glaring flaws in the country's health system as well as the government's preparedness to deal with a crisis that had plenty of warning signs. Nowhere is this void more apparent than in hospitals across Delhi, Mumbai, Bangalore, and other major cities, where patients have been unable to obtain even the most essential medical oxygen supply and oxygen concentrators. For extreme COVID-19 patients with hypoxaemia – when blood oxygen levels are too low – oxygen therapy is critical. "Some clinical studies show that up to a quarter of hospitalised (COVID-19) patients require oxygen therapy and upwards to two-thirds of those in intensive care units," community health specialist Rajib Dasgupta told the AFP news agency.
What is causing these shortages?
Because of the dangerous nature of the substance, all liquid oxygen must be shipped in a small number of specialized tankers, necessitating advance preparation to ensure timely deliveries, according to a gas industry source. As the race for oxygen among states intensified in recent days, local officials in some areas disrupted tanker traffic in an attempt to keep supplies for themselves. Due to the blockades, Delhi only received about 177 tonnes of oxygen on Wednesday, despite a 378-tonne allocation, according to an official. This delay is due to the location of production facilities, a stretched distribution network, and, according to critics, poor planning.
The Delhi government has been accusing the governments of Haryana and Uttar Pradesh for not allowing a smooth supply of oxygen to Delhi from private oxygen plants in the states. In Madhya Pradesh, politicians held oxygen cylinders for over two hours for photo-ops. According to physicians, hospitals should have a buffer supply of oxygen for at least 48 hours. However, after the city's record high in COVID-19 cases, hospitals have been operating with less stock and refilling on a regular basis.
Does India have enough oxygen?
India has at least 7,100 tonnes of daily oxygen production potential, including for industrial use, which appears to be sufficient to meet current demand. Prime Minister Narendra Modi's office said on Thursday that the government allocated 6,822 tonnes of liquid oxygen per day to 20 of the country's worst-affected states this week, compared to their total demand of 6,785 tonnes.
As of April 12, India's total medical oxygen demand was just 3,842 tonnes, as the increase in cases really took hold. During a pandemic, states are usually assigned supplies by an inter-ministerial body of bureaucrats tasked with monitoring and facilitating the flow of critical medical equipment.
Who is to blame for the oxygen shortage in Delhi?
Government sources have blamed the Arvind Kejriwal government for delaying proposed oxygen plants in the capital as part of the Centre-New Delhi spat over the oxygen shortage in hospitals. The accusation has been dismissed by the Delhi government as an "outright lie."
According to central government sources, the Delhi government failed to send "site readiness certificates," which caused the planned oxygen plants in four hospitals to be delayed, leading to the Delhi oxygen crisis. According to sources in the Railway Ministry, the Delhi government has yet to provide cryogenic tankers for the 'Oxygen Express.'
The Delhi government claims that the Centre is making "blatantly misleading statements" in order to "cover its abject failure in establishing oxygen plants in Delhi."
According to the Centre, eight pressure swing absorption (PSA) oxygen generation plants are being built in Delhi with the aid of the PM CARES fund, which will increase medical oxygen capacity by 14.4 tonnes.
As the ferocious second surge of Covid rips through the district, the fact that Delhi lacks an oxygen plant has come to light.
The Delhi government has accused BJP-run states in the region of obstructing medical oxygen. The Centre accused the Delhi government of "mismanaging oxygen distribution and sensationalizing the matter" as the crisis was heard in the Delhi High Court.
What is India doing to solve this problem?
The Indian railways have been activated by the federal government to transport multiple tankers from refilling plants to where they are most needed. The government is also using Air Force cargo planes to fly empty tankers to production centres, in collaboration with industrial gas major Linde India and others. The oxygen tankers will then return by lane, having been refilled.
23 mobile oxygen generation plants are being imported from Germany by the armed forces. Several other companies provide oxygen to hospitals, and Tata Group, a salt-to-software conglomerate, is importing 24 specialized containers for liquid oxygen transport. The government has given orders for argon and nitrogen tankers to be converted to oxygen tankers. However, with some experts predicting a tripling of daily infections in a matter of weeks, India will need to significantly increase both oxygen production and distribution systems.
Even before the court suggested the government pursue Tata's assistance, the salt-to-software conglomerate Tata Group declared on April 20 that it would import 24 cylinders of liquid oxygen to help tackle the country's crisis. On April 24, the first of four such cylinders arrived in India from Singapore.
The government diverted all industrial oxygen for medical use on April 22. The government has authorized tankers carrying liquid argon to transport medical oxygen in order to increase vehicle numbers. Several of the country's largest steelmakers are diverting oxygen from their plants to hospitals. JSW Steel's Ballari plant is supplying 400 tons of medical oxygen to Karnataka, according to the company. To supply badly affected states, it plans to increase oxygen production at its three plants in Karnataka, Tamil Nadu, and Maharastra to 600 tons per day.
Meanwhile, the Modi Government has been reaching out to its allies around the world for medical supplies. "An order of ten thousand oxygen concentrators has been placed and oxygen concentrators import will start from next week from United States America (USA)," government sources told ANI. The Centre has directed the customs department to clear import consignments relating to COVID-19 as quickly and efficiently as possible. USA has also lifted, partially, the ban on the export of raw materials to produce COVID-19 vaccines, to India.