Unless the government acts fast, the country could face a colossal tragedy.
The images on Indian television news in the past two weeks have been unprecedented. People queuing up for oxygen cylinders or refills, large hospitals tweeting in panic about their depleting oxygen tanks, patients in intensive care units dying due to a lack of oxygen. How did it come to this? Has a nuclear power with the ambition to build a $5-trillion economy really run out of oxygen? If so, by how much? Before the pandemic began, India’s requirement of liquid medical oxygen was 700 metric tonnes per day, according to industry estimates. During the peak of the first Covid-19 wave, in September 2020, this went up to 2,800 metric tonnes. At the time, the country was adding around 100,000 new cases every day. In the second wave, since April ’21, India has seen more than 3 lakh new cases every day, even crossing the 4 lakh-daily-cases mark on May 1. A simple extrapolation shows our requirement of liquid medical oxygen will be at least three times the amount we needed during the first wave, which comes to 8,400 metric tonnes. But as of April 21, according to Union health secretary Rajesh Bhushan, the daily allocation of medical oxygen to states was 6,600 metric tonnes. The Central government calculated the requirement at 6,600 metric tonnes per day using a formula of 10 litres per minute for a non-ICU bed and 24 litres of oxygen per minute for an ICU bed, according to an affidavit that it filed in the Supreme Court on April 29. As per the conversion rate of liquid oxygen,860 litres is equal to 1 kg. Accordingly, the requirement comes to 16.7 kg for a non-ICU bed and 40.2 kg for an ICU bed per day per patient. But when the government calcuated the requirement, it appears to have taken the figure out 14.7 kg for a non-ICU bed and 45 kg for an ICU bed. We have used the same figures in our calculations. By April 26, India had almost 29 lakh active Covid-19 cases. The World Health Organisation says that 80% of Covid-19 cases are mild,15% need oxygen support, and 5% need ICU beds. However, in its April 29 affidavit in the Supreme Court, the Central government said an empowered group of medical experts has determined that 80% cases of all Covid-19 cases in India are mild and do not need oxygen,17% need hospitalisation, of which only 50% or 8.5% of all patients need oxygen support, and the remaining 3% need ICU beds. Even based on this assumption, India needed 7,473 metric tonnes of daily oxygen on April 26. However, on April 20, the Central government had allotted just 6,600 metric tonnes. This means, assuming a lag of six days between allocation and use, given the time it takes to fill and transport oxygen across long distances, India was short of at least 873 tonnes of liquid medical oxygen on April 26. Here it is worth noting that the demand for liquid oxygen projected by states itself rose rapidly, as per the Centre’s affidavit in the Supreme Court. On April 15, in their communication with the Centre,12 states had projected a demand of 4,880 metric tonnes of liquid oxygen for April 20.
