Tessa Quinn
Hospitals are running out of oxygen due to a combination of surging demand, logistical challenges, and inadequate healthcare infrastructure. The COVID-19 pandemic has significantly increased the need for medical oxygen, particularly in countries like India and Ukraine, where hospitals have struggled to meet the demand. In India, the surge in coronavirus cases overwhelmed the healthcare system, breaking medical supply chains and leading to critical shortages of oxygen, hospital beds, antiviral drugs, and test kits. Similarly, Ukrainian hospitals faced oxygen shortages due to the dual crises of COVID-19 and the Russian invasion, with the World Health Organization (WHO) warning of dangerously low oxygen supply levels. Logistical challenges, including the time-consuming process of filling tankers and long-distance transportation from oxygen-generating plants to hospitals, further exacerbate the situation. Additionally, inadequate healthcare infrastructure and insufficient investment in public health have contributed to the oxygen shortage crisis in India.
| Characteristics | Values |
|---|---|
| Country | India, Ukraine |
| Reason | COVID-19, Russian invasion |
| Demand | 700% increase |
| Supply | 40% of demand met |
| Location of oxygen-generating plants | Eastern and southern states |
| Location of demand | Northern and western states |
| Transportation time | 18 hours |
| Transportation speed limit | 25 mph |
| Time to fill a tanker | Several hours |
| International aid | Oxygen cylinders, concentrators, generators, tanks, ventilators, testing kits, antiviral drugs |
| Delays | Customs |
| Hospital capacity | Hospitals asking patients to leave |
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What You'll Learn
Oxygen demand increased by 700% in some areas
The COVID-19 pandemic has highlighted the inequities in availability and access to medical oxygen, especially in low- and middle-income countries. In India, the surge of coronavirus cases has overwhelmed hospitals, causing a dire need for oxygen concentrators, COVID tests, masks, hospital beds, antiviral drugs, and test kits.
The demand for oxygen has skyrocketed in some parts of the capital, with a 700% increase in certain areas. Hospitals in Delhi are requesting close to 1,000 metric tons of liquid oxygen daily, but only 40% of that amount is being supplied. This discrepancy between demand and supply has led to a critical situation, with hospitals scrambling to provide oxygen to their patients.
The geographical distribution of oxygen-generating plants further exacerbates the issue. Most of India's oxygen-producing facilities are located in the east and south, while the current demand is concentrated in the north, necessitating lengthy 18-hour journeys by tanker trucks.
To address the oxygen shortage, the Indian government has mobilized various resources. The Indian Air Force has been airlifting empty tankers back to factories to expedite the refilling process, and they have also been procuring additional containers from abroad. The Indian Navy has joined the efforts, with a ship arriving in Kuwait to collect donations of liquid oxygen. Moreover, the Indian Railways has operated special “Oxygen Express” trains, delivering over 1,500 metric tons of liquid oxygen to multiple states.
The crisis in India has prompted a global response, with countries like the United States, the United Kingdom, France, and Thailand providing ventilators, liquid oxygen, oxygen concentrators, testing kits, and antiviral drugs. However, logistical challenges and customs delays have hindered the immediate distribution of this aid, underscoring the urgency of the situation and the need for efficient coordination to ensure that critical supplies reach those in need without delay.
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Supply chain issues caused delays in oxygen deliveries
The COVID-19 pandemic has disrupted supply chains worldwide, and oxygen supply chains are no exception. In India, the United States, and Ukraine, hospitals have struggled to secure sufficient oxygen supplies due to various supply chain issues.
In India, the surge in COVID-19 cases led to a sharp increase in the demand for medical oxygen, straining the existing supply chain. Most of India's oxygen-generating plants are located in the eastern and southern parts of the country, while the demand was mostly in the north. This mismatch in supply and demand resulted in lengthy transportation times, with tanker trucks facing 18-hour trips to deliver oxygen to the hospitals that needed it the most. The Indian government, which started regulating essential medical supplies in March 2020, faced challenges in coordinating the distribution of oxygen to hospitals. Local governments were relatively new to this task, and the sudden increase in demand further complicated their efforts.
Additionally, the time required to fill tankers with liquid oxygen and the strict speed limits imposed on these vehicles due to safety concerns added further delays to the delivery process. The Indian government took steps to expedite oxygen deliveries, with the Indian Air Force airlifting empty tankers back to factories and the Indian Railways running special trains, known as "Oxygen Express," to deliver oxygen to various states.
Similarly, in Ukraine, the COVID-19 pandemic and the Russian invasion created a dual crisis that severely impacted the oxygen supply chain. Hospitals faced life-threatening shortages of oxygen, and the World Health Organization (WHO) warned that the situation was "nearing a very dangerous point." The ongoing conflict also threatened electricity and power supplies, further exacerbating the challenges in maintaining a steady oxygen supply to hospitals.
In the United States, hospitals also faced oxygen supply chain issues during the COVID-19 pandemic. While the specific reasons for the shortages in the US context are not mentioned in the sources, it is clear that the pandemic's strain on healthcare systems and supply chains led to disruptions in oxygen deliveries to hospitals.
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Hospitals in some areas had to source oxygen themselves
The COVID-19 pandemic has placed unprecedented demands on healthcare systems worldwide. In India, hospitals have been overwhelmed by the sheer number of cases, with medical supply chains, including oxygen, breaking under the pressure. This has resulted in hospitals in some areas having to source oxygen themselves.
Ordinarily, hospitals do not have to worry about oxygen supply, as it is typically procured by the government and delivered to hospitals as needed. However, with the surge in COVID-19 cases, the demand for oxygen has skyrocketed, outpacing the supply. Hospitals in Delhi, for instance, were asking for close to 1,000 metric tons of liquid oxygen per day, but only 40% of that was being supplied.
The oxygen supply challenge is further exacerbated by the geographical disparity between demand and supply. Most of India's oxygen-generating plants are in the country's east and south, while the demand is currently concentrated in the north. This means that it takes 18 hours for tanker trucks to transport oxygen to where it is needed the most.
The situation has become so dire that hospitals have had to issue desperate appeals for oxygen. Holy Family Hospital in Delhi, for instance, came within 30 minutes of running out of oxygen. They had to make frantic calls to local government officials and triage patients to determine who would receive oxygen. Similarly, Shanti Mukand Hospital in Karkardooma had just two hours of oxygen left for 110 COVID patients. They were forced to put new admissions on hold and ask patients to arrange for their own oxygen cylinders.
To address the oxygen shortage, India has imported oxygen concentrators from the USA, and other countries have also offered donations of oxygen generators, tanks, and cylinders. The Indian Air Force has also been airlifting empty tankers back to factories to cut down on travel time.
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Oxygen is produced in factories and then transported to hospitals
Oxygen is produced in factories using two main methods: air separation through cryogenic distillation and pressure swing adsorption (PSA). Cryogenic distillation involves compressing, cooling, and liquefying atmospheric air before separating its components by distillation. PSA, on the other hand, uses a molecular sieve to adsorb nitrogen, leaving an oxygen-rich stream of air. This process can be further enhanced using vacuum pressure swing adsorption (VPSA), which maximizes adsorption and desorption.
Oxygen produced in factories is then typically stored in large containers and transported to hospitals via cylinders or tankers. In small and medium-sized hospitals, a central oxygen supply system is used, which includes a device, a decompression device, a transmission pipeline, and a terminal. The oxygen is decompressed and then transported through the pipeline to the operating room, intensive care room, and ward.
During the COVID-19 pandemic, hospitals in various countries, including the United States and India, faced shortages of oxygen tanks and cylinders. This was due to increased demand and disruptions in supply chains. In some cases, hospitals had to use oxygen tanks in intensive care unit rooms as wall-mounted oxygen units were unavailable.
To address the oxygen shortage, countries like the United States provided shipments of oxygen cylinders and concentrators to India. Additionally, the Indian government utilized its Air Force to airlift empty tankers back to factories and pick up additional containers from abroad. The Indian Railways also delivered liquid oxygen to various states through special trains, known as "Oxygen Express" trains.
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The COVID-19 pandemic increased the need for medical oxygen
The COVID-19 pandemic has significantly increased the demand for medical oxygen in hospitals. Patients hospitalised with severe COVID-19 often require supplemental oxygen due to the inflammation and damage caused to the lungs by the virus, which makes it harder for them to absorb enough oxygen. As coronavirus cases have soared, medical oxygen consumption has surged as well. This has led to dozens of hospitals in India, Ukraine, and other countries reporting critical shortages of oxygen supplies, putting the lives of their patients at risk.
In India, the COVID-19 pandemic has placed immense strain on the healthcare system, with hospitals struggling to meet the oxygen demands of their patients. The country has been reporting a high number of coronavirus cases, with over 300,000 daily cases for consecutive weeks. This has resulted in a break in medical supply chains, leading to shortages of not just oxygen but also hospital beds, antiviral drugs, and coronavirus test kits. The situation has been exacerbated by the uneven distribution of oxygen-generating plants across the country, with most plants located in the east and south while the current demand is concentrated in the north. This requires long-distance transportation of oxygen supplies, often involving 18-hour trips by tanker trucks.
The Indian government has been coordinating efforts to address the oxygen shortage. Hospitals, which previously procured oxygen directly from suppliers, now rely on the government to regulate essential medical supplies, including oxygen. The government has been working to streamline logistics and coordinate the distribution of oxygen to ensure equitable access. Additionally, the Indian Air Force has been airlifting empty tankers back to factories to reduce travel time, while the Indian Navy has been dispatched to procure donations of liquid oxygen from other countries.
The oxygen shortage in Indian hospitals has had severe consequences. Holy Family Hospital in Delhi, for instance, came dangerously close to running out of oxygen, prompting frantic efforts to triage patients and secure additional supplies. Similar stories have emerged from other hospitals, with healthcare workers and families of patients pleading for answers and support. The situation has highlighted the decades-long neglect and inadequate spending on public health in India, which has been hit by one of the biggest coronavirus waves in the world.
The COVID-19 pandemic has also contributed to oxygen shortages in Ukrainian hospitals. The ongoing conflict in the country has further exacerbated the situation, with the World Health Organization (WHO) warning that oxygen supplies are "nearing a very dangerous point". The WHO is working to secure medical supplies and has released millions of dollars in medical aid to address the crisis.
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Frequently asked questions
Hospitals are running out of oxygen due to the surge in COVID-19 cases, which has increased the demand for medical oxygen.
India and Ukraine have faced hospital oxygen shortages.
The Indian government has been involved in regulating and coordinating the supply of medical oxygen. The Indian Air Force has also been airlifting empty tankers back to factories and picking up oxygen donations from abroad.
Hospital oxygen shortages have led to a dire situation where patients' lives are at risk, and hospitals have had to turn away patients or reduce oxygen supply, posing a serious threat to patients' lives.
