In today's Finshots we discuss why medical oxygen is so hard to come by these days.

The Story

You’re probably thinking that the oxygen crisis is being precipitated by a mismatch in demand and supply. After all who knew we’d need this much oxygen in such a short span of time, no?

Well, that isn’t necessarily true. Take for instance the absolute numbers on production and consumption. As a report from the Times of India notes—

“The national demand before COVID-19 outbreak last year was about 700 MT/day. This jumped to 2,800 MT/day in the first spike of COVID-19 last year and currently the demand is estimated at about 5500 MT/day in the second wave.

As per government sources and EG II, India’s daily production capacity of medical oxygen is 7,287 MT and there is an availability of a buffer stock of approximately 50,000 MT.”

So it seems then that the problem isn’t necessarily stemming from a mismatch in demand and supply. Instead, it looks as if we are no longer able to map demand and supply accurately. We don’t know where to send what. And even if we do know how to allocate this precious resource, it seems every state has its own priorities. Some have even refused to part with their supplies.

Which brings us to the next point — Who is responsible for allocation?

Well as it stands, we have the Empowered Group II (EGII) making decisions. The group has members nominated from all the states, along with representatives from all major oxygen manufactures. It is headed by the secretary in the department for promotion of industry and internal trade, mandated by the Union government. However, the committee was only reconstituted once again in March 2020. And we didn’t have a lot of time to plan and arrive at a consensus. Delays on this front have costed us dearly. And so, when a state doesn’t get what it thinks it deserves, there is conflict. Which is why you’ve been seeing several chief ministers urge the PMO to allocate more oxygen to their home states.

Next, there is the logistical problem. Transporting oxygen from one place to another isn’t easy. You have strict protocols on the kind of safety measures you’ll have to have in place before you’re allowed to ferry oxygen. And since we weren’t prepared for the onslaught, we didn’t think much about the tankers and trucks we’d need to meet the stringent logistical needs. So now ministers are scrambling to figure how to move oxygen safely from point A to point B with the limited resources that we have. The only upside is that manufacturers of industrial oxygen have now stepped up to divert their supplies in a bid to fight back. However, fine-tuning production methods to switch from industrial oxygen to medical oxygen can take some time. So that’s a bottleneck as well.

But beyond this, we have other issues with storage. Medical infrastructure in India isn’t state of the art. This means an uninterrupted supply of oxygen is a luxury for the most part. Government hospitals don’t have copper pipelines to seamlessly supply oxygen in most places and they simply use cylinders as an alternative. And while cylinders work well for some use cases, they aren’t very efficient when you are tending to multiple patients at the same time. As one formal Covid-19 nodal officer pointed out — “We had to keep replacing cylinders for patients. It takes two people to replace one cylinder and is a laborious task. There was also a shortage of empty cylinders.”

And that last bit exemplifies everything that has gone wrong. We currently don’t have enough cylinders going around because those in power simply didn’t think we’d need them en masse. And since we don’t have enough cylinders right now, we can’t supply enough oxygen. And you don’t need us to explain what happens when people don’t get oxygen.

It’s a tragedy what’s happening.

The only silver lining perhaps is that there are attempts being made to ramp up production and storage.

Orders for one lakh oxygen cylinders are now in the pipeline. There are plans to meet the logistical challenges by setting up dedicated corridors and free interstate movement. Hopefully, the EGII will also be able to map resources effectively and divert oxygen to critical areas before all else. And we pray that the coming days are better than the horrid few days we’ve had so far.

Until then…

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