A number of private hospitals, especially small and medium-sized facilities treating COVID-19 patients, are anticipating a scarcity of oxygen.
While government and corporate hospitals in Chennai have an adequate stock as of now, a few smaller ones have run out of oxygen, while a few others are staring at the possibility of scarcity in the absence of timely augmentation.
Enquiries with doctors working at medium-sized hospitals revealed that there had already been instances of a few hospitals running out of oxygen. Several doctors said they were expecting a scarcity in the coming days, given the continuous rise in the case-load.
“A few small hospitals have already run out of oxygen. In our hospital, we are anticipating scarcity next week. So we are making arrangements,” said a doctor working at a private hospital.
Doctors pointed to cases of hospitals seeking support from other institutions by referring patients as there was no oxygen supply or by requesting cylinders.
Another doctor said they were feeling the pressure already. “Ventilator and high-flow nasal cannula consume much oxygen. The demand for oxygen is high right now, and we are definitely anticipating oxygen scarcity… if the situation continues for the next few weeks. In fact, scarcity has already happened at a few centres. So we think twice before taking such patients,” he said.
Anticipating shortage, they were hesitant to take in already intubated patients. “Though we have beds, doctors and nurses, it will be of no use if we take in patients without adequate oxygen. Unlike last year, when the State was under lockdown, there is no breathing space now. Hospitals are flooded with patients, and we are in a dire need of a breather,” he said.
“Right now, oxygen supply is not a major issue. We are in a quite comfortable position as far as liquid oxygen is concerned. But we can anticipate issues if it is not augmented in two to three days. Oxygen is directly transported through the companies. The problem is that the demand is so high that delivery may take longer. So the issue is not short supply of oxygen but probably transportation due to the vast supplies,” T.N. Ravishankar, senior practitioner and director of Sudar Hospitals, which has 35 beds each at three different places around Tambaram. Oxygen suppliers, he said, could provide for major hospitals that required large volumes every month.
Some of the corporate hospitals in Chennai are in a better position. One hospital official said, “We have close to a month of supply as of today. But the Central and State governments’ prospective regulations may create a crunch.”
A rational use of available oxygen was important, said K.R. Vijay Chakkaravarthy, a critical care specialist. “Sick patients can be maintained at an oxygen saturation of 92 to 94. We will need three to four litres of oxygen to maintain this level. Patients on ventilator or high-flow nasal cannula need plenty of oxygen, at least 50 to 60 litres per minute. These patients with severe pneumonia can be maintained at an oxygen saturation of 88 to 92, which is universally recommended. If we target a higher saturation, it may lead to a higher unnecessary oxygen consumption. We are focussing on oxygen targets, depending on patients, for which we are training our nurses and doctors,” he explained.
Dr. Ravishankar added that the discharged patients might require oxygen at bed time or if they exerted themselves. “For this, they could get oxygen concentrators available in the market and use them at home. There is an acute shortage of hospital beds. Such persons could be at home and need not come to hospitals for oxygen supplementation,” he said.