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#Thread To understand India's #OxygenCrisis better (Various sources. See last tweet)
-Generally about 30% admitted patients need O2 in hospitals but rn 90-95% are COVID postive. Demand is up by 9-10x.
-Different COVID patients need different volumes (anywhere frm 6-30 litres)
-Generally about 30% admitted patients need O2 in hospitals but rn 90-95% are COVID postive. Demand is up by 9-10x.
-Different COVID patients need different volumes (anywhere frm 6-30 litres)
-Hospitals trying all to optimise incldn keeping SpO2 at 88/90 instead of the ideal 93 or more
-On site hospital plants with central supply were supposed to be provided under the $1.3 billion PM Care fund but that didn’t happen. Donations were raised in the name of the pandemic
-On site hospital plants with central supply were supposed to be provided under the $1.3 billion PM Care fund but that didn’t happen. Donations were raised in the name of the pandemic
-An average O2 plant makes 150 cubic metres/hr, bigger make more
-14000 cubic metres lasts 1-2 days in big hospitals currently
-7000 metric tonnes: India's total capacity of medical O2 production
-India needs to import 50 000 tonnes
-14000 cubic metres lasts 1-2 days in big hospitals currently
-7000 metric tonnes: India's total capacity of medical O2 production
-India needs to import 50 000 tonnes
-The Indian govt has reportedly asked diplomats around the world to identify vendors from whom it can purchase 100 000 oxygen cylinders
-Liquid oxygen, extremely cold (-183C), can only be transported in special cryogenic tankers and cylinders. India doesn't have enough tankers
-Liquid oxygen, extremely cold (-183C), can only be transported in special cryogenic tankers and cylinders. India doesn't have enough tankers
-Oxygen supplying areas are in Odisha and Jharkhand. Demand is high in states like Delhi, UP, or further away: Maharashtra, Gujarat and MP. Transport is a prob.
-Road route slows down distribution as tankers cannot travel more than 40km/h, don't travel at night to avoid accidents
-Road route slows down distribution as tankers cannot travel more than 40km/h, don't travel at night to avoid accidents
-Solution would be railways but wagons have to be converted so that the container can move on to the carriage
-Not enough containers available
-Some tankers being carried by trains now
-Not enough containers available
-Some tankers being carried by trains now
-An average O2 plant makes 150 cubic metres/hr, bigger make more
-14000 cubic metres lasts 1-2 days in big hospitals currently
-7000 metric tonnes: India's total capacity of medical O2 production
-India needs to import 50 000 tonnes
-14000 cubic metres lasts 1-2 days in big hospitals currently
-7000 metric tonnes: India's total capacity of medical O2 production
-India needs to import 50 000 tonnes
-Medical grade O2 is made by concentrators from ambient air. Large tankers hold liquid O2, gas cylinders hold O2 under pressure.
-The carbon dioxide, nitrogen, other gases are removed from ambient air.
-The carbon dioxide, nitrogen, other gases are removed from ambient air.
-One benefit of liquid gas is that it is 99 percent pure oxygen, whereas cylinders filled at a plant using pressure swing adsorption (PSA) technology generally average 93 percent pure oxygen. However, from a medical point of view, there are no serious issues with the latter.
-Govt announced O2 supply for industrial use to be prohibited and diverted to address shortage of supply for medical use starting 22nd April. 9 industries will be exempt. O2 is consumed by industry as onsite or merchant sales.
-Onsite are for process-driven industries (incldn the 9 exempt) which account for 75-80% manufactured in India. 20-25% is merchant sales (called liquid oxygen) through cryogenic tanks and cylinders. The healthcare sector consumes 10% of merchant sales.
-Health Ministry said on Sunday 162 Pressure Swing Adsorption PSA plants have been sanctioned by the Centre for installation in public health facilities.
-Govt took 8 months to invite bids for 150+ plants. 6 months later only 33 installed.
-PSAs take 4 weeks to set up.
-Govt took 8 months to invite bids for 150+ plants. 6 months later only 33 installed.
-PSAs take 4 weeks to set up.
-Medical O2 supply is centrally allocated, monitored by EG II (Empowered Group) headed by Secy DPIIT (Dept for Promotion of Industry & Internal Trade) mandated by GOI. Nominated members are from states + all major manufactures + Ministry of Road Transport & Indian Railways etc.
-Some oxygen concentrators can bought in the market to be plugged at home. These were available before this wave for INR 50k approx. Now being sold for several lakhs. These can generally help people with 80 SpO2 but lower levels need high pressure flow.
Sources: Researchers, BBC, Washington Post, BMJ, Indiamart, CNBC-TV18, Scroll, NDTV, Forbes India, The Week
This report by @yogital should be a lesson to people to stay indoors when they can, mask up. (However, not a fan of piece to cameras being shot inside hospitals). https://twitter.com/nicolacareem/status/1385798149948669955
Delhi High Court hears another plea on Oxygen Shortage by Maharaja Agrasen Hospital [LIVE UPDATES] https://www.barandbench.com/news/litigation/delhi-high-court-oxygen-shortage-maharaja-agrasen-hospital
India's #OxygenCrisis (thread contd.)
-Air Force's cargo planes to fly empty tankers to production hubs. Refilled tankers will then move by road. Industrial gas major Linde India & others involved
-Armed forces importing 23 mobile O2 generation plants from Germany.
[Livemint]
-Air Force's cargo planes to fly empty tankers to production hubs. Refilled tankers will then move by road. Industrial gas major Linde India & others involved
-Armed forces importing 23 mobile O2 generation plants from Germany.
[Livemint]
-Tata Group importing 24 specialised containers to transport liquid oxygen.
-Industry source to Mint: Delhi had dragged its feet on planning ahead. "This problem wouldn't have happened if they had acted 2-3 weeks ago," the source said.
[Livemint]
-Industry source to Mint: Delhi had dragged its feet on planning ahead. "This problem wouldn't have happened if they had acted 2-3 weeks ago," the source said.
[Livemint]
India's #OxygenCrisis (thread contd.)
“Our supply was delayed by 7-8 hours on Friday night & the stock we received last night is only 40% of required supply”: New Delhi's J. Golden Hospital’s med superintendent, Dr. D.K. Baluja (20 pple died Friday night at the hospital)
[AP]
“Our supply was delayed by 7-8 hours on Friday night & the stock we received last night is only 40% of required supply”: New Delhi's J. Golden Hospital’s med superintendent, Dr. D.K. Baluja (20 pple died Friday night at the hospital)
[AP]
India's #OxygenCrisis (thread contd.)
French gas giant Air Liquide SA has diverted O2 supplies for industrial clients in India to hospitals.
One “oxygen express” with 30,000 litres arrived in Lucknow at dawn; armed guards were waiting to escort trucks to hospitals
[Al Jazeera]
French gas giant Air Liquide SA has diverted O2 supplies for industrial clients in India to hospitals.
One “oxygen express” with 30,000 litres arrived in Lucknow at dawn; armed guards were waiting to escort trucks to hospitals
[Al Jazeera]
India's #OxygenCrisis (thread contd.)
ICYMI #IndiaNeedsOxygen was trending on Pakistani Twitter on Friday with users urging PM Imran Khan to aid Indian hospitals amid the current Covid crisis and oxygen shortage.
[NDTV, Khaleej Times]
ICYMI #IndiaNeedsOxygen was trending on Pakistani Twitter on Friday with users urging PM Imran Khan to aid Indian hospitals amid the current Covid crisis and oxygen shortage.
[NDTV, Khaleej Times]
India's #OxygenCrisis (thread contd.)
IAF aircraft with 4 cryogenic oxygen tanks from Singapore to reach India today aboard C-17 aircraft of the Indian Air Force.
[Hindustan Times]
IAF aircraft with 4 cryogenic oxygen tanks from Singapore to reach India today aboard C-17 aircraft of the Indian Air Force.
[Hindustan Times]
India's #OxygenCrisis (thread contd.)
Necessary digression. Let's not forget
"Nearly 86% of all medical visits in India are made by ppl in rural areas, most travelling >100 km to avail health care of which 70-80% is born out of pocket landing them in poverty"
[NCBI-NIH 2014]
Necessary digression. Let's not forget
"Nearly 86% of all medical visits in India are made by ppl in rural areas, most travelling >100 km to avail health care of which 70-80% is born out of pocket landing them in poverty"
[NCBI-NIH 2014]
India's #OxygenCrisis (thread contd.)
An order of 10 thousand oxygen concentrators has been placed, import will start from NEXT WEEK from USA," govt sources to ANI. [Livemint]
In the meantime hospitals such as Batra, Delhi, have 352 patients and acute shortage RIGHT NOW
An order of 10 thousand oxygen concentrators has been placed, import will start from NEXT WEEK from USA," govt sources to ANI. [Livemint]
In the meantime hospitals such as Batra, Delhi, have 352 patients and acute shortage RIGHT NOW
India's #OxygenCrisis (thread contd.)
Six patients die of oxygen shortage at Amritsar private hospital. “We repeatedly asked the district administration to provide us oxygen but we got no response,” said the hospital's managing director.
[Indian Express]
Six patients die of oxygen shortage at Amritsar private hospital. “We repeatedly asked the district administration to provide us oxygen but we got no response,” said the hospital's managing director.
[Indian Express]
India's #OxygenCrisis (thread contd.)
Customs duty on import of COVID-19 vaccines and medicines, medical oxygen waived for three months. (Customs duty exemption extended to O2 concentrators, cannisters, filling systems, storage tanks, ventilators, compressors, etc.)
[The Hindu]
Customs duty on import of COVID-19 vaccines and medicines, medical oxygen waived for three months. (Customs duty exemption extended to O2 concentrators, cannisters, filling systems, storage tanks, ventilators, compressors, etc.)
[The Hindu]
India's #OxygenCrisis (thread contd.)
The Delhi govt’s counsel said city did needs 480 metric tonnes of oxygen on a daily basis. Delhi High Court: "We will hang anyone who obstructs oxygen supply" [Scroll]
(Court speaking of to death penalty this way is appalling, acc to me)
The Delhi govt’s counsel said city did needs 480 metric tonnes of oxygen on a daily basis. Delhi High Court: "We will hang anyone who obstructs oxygen supply" [Scroll]
(Court speaking of to death penalty this way is appalling, acc to me)
India's #OxygenCrisis
UP's medical education minister Suresh Khanna has claimed that there were no deaths due to oxygen shortage. NITI Aayog predicting 120,000 new cases of COVID-19 in UP by the end of April
[The Wire dot in]
UP's medical education minister Suresh Khanna has claimed that there were no deaths due to oxygen shortage. NITI Aayog predicting 120,000 new cases of COVID-19 in UP by the end of April
[The Wire dot in]
India’s #OxygenCrisis
"I know my responsibility. I know many things but not saying anything. Let's try and not be a cry baby," Solicitor General Tushar Mehta in response to Delhi govt lawyer complaint that the centre not complying with the guidelines for O2 allocation.
[NDTV]
"I know my responsibility. I know many things but not saying anything. Let's try and not be a cry baby," Solicitor General Tushar Mehta in response to Delhi govt lawyer complaint that the centre not complying with the guidelines for O2 allocation.
[NDTV]
India’s #OxygenCrisis (thread contd.)
AIIMS emergency dept admissions restricted for an hour as #oxygen pipelines reorganized due to increased requirement of oxygen for COVID-19 patients.
AIIMS emergency dept admissions restricted for an hour as #oxygen pipelines reorganized due to increased requirement of oxygen for COVID-19 patients.
[All India Radio News]
[Taking a break from updating this thread for a bit].
India’s #OxygenCrisis (thread contd.) https://twitter.com/ndtv/status/1386017996108222465
India’s #OxygenCrisis (thread contd.)
Small mercies. https://twitter.com/faheemyounus/status/1386005248976867335
Small mercies. https://twitter.com/faheemyounus/status/1386005248976867335
India’s #OxygenCrisis (thread contd.) https://twitter.com/shoaibdaniyal/status/1386036730294276097
India’s #OxygenCrisis (thread contd.) https://twitter.com/ani/status/1386137778967126016
