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What’s behind Delhi’s O2 crisis? A critical calculation Kejriwal & Modi govts forgot to make

This missing crucial element is why central govt’s policy for allocation of medical oxygen to states and UTs was labelled flawed by Supreme Court, which called for a 'complete revamp'. 

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New Delhi: The Delhi government didn’t account for the oxygen requirements of Covid patients in home isolation, and only took hospital beds into count, and thus got its entire quota calculation wrong amid the second wave, ThePrint has learnt. 

Even the Union government did the same thing. A high-powered committee comprising AIIMS director Randeep Guleria, Niti Aayog member V.K. Paul and ICMR DG Balram Bhargava and the directorate general health services, formed to calculate the oxygen requirement for states/union territories, devised a formula on the basis of hospital beds alone.

This was one of the reasons why the central government’s policy for allocation of medical oxygen to states and union territories was Thursday labelled flawed by the Supreme Court, which called for it to be completely revamped. 

Graphic: Ramandeep Kaur | ThePrint

With the absence of this calculation stoking chaos and leaving several patients gasping for breath, the Delhi government has now begun working to streamline the process.

Rahul Mehra, counsel for the Delhi government, told the Delhi High Court Friday that each district in Delhi had a capacity to supply 20 cylinders for those in home isolation, which was not a sufficient number. He said the Delhi government hopes to have at least 500 cylinders available for each of the 11 districts. 

Mehra also told the court about the possibility of engaging technology giants Amazon and Google for the delivery of cylinders to Covid patients at home.

On Wednesday, the Aam Aadmi Party (AAP) government issued a notice stating that those in home isolation will now be able to apply for oxygen on an online portal launched by the government. While Amazon and Google, if engaged, may ensure home delivery of oxygen cylinders, for now, applicants will have to physically get the oxygen cylinder from the suppliers/vendors/shops listed on the portal.

The portal currently has a list of 94 shops from where oxygen may be sourced.

Also read: India could see 1 million deaths due to Covid by August, Lancet says

‘Things sped up now’

According to those in the administration, the crisis in Delhi was because the government was not prepared for the massive surge in hospitalisation, or the prolonged hospital care required by patients.

“Owing to this, one doesn’t have enough hospital beds and hence the condition of many people at home is also becoming critical, both because of the more virulent strain of the virus and because of those being forced to undergo treatment at home, needed hospitalisation,” an official from the Delhi oxygen war room told ThePrint.

As a result, the demand for oxygen was growing not just at hospitals, but even among patients who are at home.

“We never expected this wave [the Covid second surge] to blow up the way it did, or the virus strain to be so virulent that nearly every second patient would need oxygen,” said a senior civil servant in the Delhi government who didn’t wish to be named.

The problem was getting further aggravated, he said, since “patients are having to stay in hospital for longer during this wave, which was leading to a shortage of hospital beds — and oxygen”.

Dr B.L. Sherwal, director of the Delhi government’s Rajiv Gandhi Super Speciality Hospital, agreed. “Earlier, according to government guidelines, patients [critical ones who needed hospitalisation] had to stay in hospital for 14 days. This was later reduced to seven days.” 

Now, there are no such guideline, but, said Sherwal, “This time, the average patient coming in is so unwell that even if we want to discharge him/her, we can’t since he/she requires critical care in hospital.”

The government, said sources, were also not prepared for so many needing hospitalisation.

Vijay Bidhuri, nodal officer for internal distribution of oxygen in Delhi, said “it [the oxygen supply in the city] is a very dynamic situation wherein we decide who will get on what basis the daily allocation or how much Delhi receives each day”. 

Asked how the requirement of those in home isolation is being addressed, he said he did not have any such details and disconnected the call.

Ashish Kundra, Officer on Special Duty, Health, Delhi, said the “formula that has been derived by the Delhi government to look into the oxygen requirement for home isolation patients came about only recently”. 

Asked what the formula was exactly, he reiterated the point made by Bidhuri. “It is very dynamic and the allocation changes every day depending on the requirement of beds in hospitals, Covid care centres, testing numbers and the severity of the disease among patients.” 

Kundra has been closely monitoring coordination with district magistrates for filling and refilling of oxygen cylinders at authorised shops 

Suneela Garg, a member of the Delhi Covid taskforce and professor of excellence at Maulana Azad Medical College, said “things have been sped up now”. 

“Directions have been issued to districts to identify local shops” that can supply oxygen to patients being treated at home, she added.

The need at home

Chestha Yadav, district magistrate, Northwest Delhi, said she had finalised one supplier in Sector 13, Rohini, for patients in home isolation who would require oxygen.

“We have figured it out manually and the divisional commissioner in the district is working out the details,” she added.

The identified shops will function as refilling units for the districts. Another district magistrate confirmed that cylinders will have to be provided by the family requiring oxygen.

Kundra has also been urging people to contact their respective DMs and provide empty cylinders if they have any. A list of depots where residents can access empty or filled cylinders was also provided on Twitter and will be updated, the government said.

But at least five other district magistrates in Delhi, contacted by ThePrint to check if they had managed to shortlist any oxygen supplier for home Covid patients, did not respond to calls or messages till the time of publishing this report.

Meanwhile, sources in the Delhi government said the Union Territory is in the process of procuring more oxygen tankers though foreign aid.

(Edited by Sunanda Ranjan)

Also read: No, the Western media isn’t biased in reporting Indian Covid. Here’s why


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