SC-appointed task force says India must have strategic oxygen reserve for 2-3 weeks like petrol

The 12-member National Task Force praised the Modi government’s efforts, saying it took proactive steps since last year to control the spread of the pandemic and on oxygen management.

A worker fits medical oxygen cylinders at an oxygen plant | Representational image | PTI

New Delhi: The Supreme Court-constituted National Task Force (NTF) has proposed an “equitable formula” by which a 100-bedded hospital should be allocated about 1.5 metric tonnes of liquid medical oxygen every day to treat patients, in case there is a surge in Covid infections again.

The task force, however, added the formula will be part of a dynamic, evolving process and open to modification and consultation with states as the situation evolves.

The NTF’s proposed formula is part of the central government’s affidavit filed before the Supreme Court Thursday.

Prepared by the Union Health Ministry, the affidavit was filed in a matter related to the Centre’s appeal challenging a Delhi High Court order directing the central government to ensure supply of 700 MT liquid oxygen to Delhi. The HC order came when the city was battling the sudden spike in Covid cases and witnessing deaths due to alleged lack of oxygen supply.

The task force also suggested a slew of measures that should be taken to prevent a repeat of the crisis that hit several states in April and May, as Covid infections spiked and caused deaths in the lakhs.

The 12-member task force has, however, lauded the central government’s efforts, saying it took proactive steps since last year to control the spread of the pandemic and on oxygen management in the wake of the recent surge in cases.

But it also said the authorities must maintain strategic reserves for oxygen for 2-3 weeks, just like it is done in the case of petroleum.

A bench of Justices D.Y. Chandrachud and M.R. Shah had on 7 May constituted the NTF to devise a new formula for allocation of oxygen, after Delhi disputed the Centre’s methodology to supply the gas to states.

The methodology had been devised by an expert group on the premise that 50 per cent of non-ICU beds need 10 litres of oxygen per minute and all of the ICU beds require 24 litres per minute.

This expert group comprised NITI Aayog member Dr V.K. Paul, All India Institute Of Medical Sciences (AIIMS) Director Dr Randeep Guleria, Indian Council of Medical Research (ICMR) Director General Balram Bhargava, and Director General of Health Services Sunil Kumar.

In its 7 May order, the Supreme Court too had found flaws in the Centre’s formula to link allocation of oxygen to only the number of beds in the hospitals of a state and its active cases, without considering the requirements for patients at homes and other Covid care centres.

The NTF formula

The NTF has stated, in a report, which is part of the Union Health Ministry affidavit, that its formula to determine oxygen needs for the country takes into account all levels of care.

“The formula needs to be developed for the calculation of oxygen requirement for the primary, secondary, and tertiary-level hospitals based on the number of Oxygen beds and ICU beds,” states the report.

As an example, the task force cited the breakup of a 100-bedded hospital with 25 per cent ICU beds, which, it said, would need 730 litres per minute that translates into 1.5 MT of liquid medical oxygen every day.

Reserving eight beds for invasive ventilation, the bench said 240 litres of oxygen would be needed for such patients every minute.

For non-invasive ventilation, the task force said 10 beds under this category would need 300 litres of oxygen.

And for other treatments given to patients under ICU, the task force has recommended allocation of 90 litres of oxygen every minute. Around 100 litres, it has advised, can be reserved for wards and the operation theatre.

‘Have told states to make PSA mandatory’

The affidavit also details the steps the Centre has taken to augment oxygen supply in states, one of which also includes making it mandatory for medical colleges to install PSA (Pressure Swing Adsorption) oxygen generation plants within their campuses.

In its affidavit, the health ministry said it has advised the states to appropriately amend the Clinical Establishment Act, 2010, to make PSA plants mandatory for all clinical establishments. It added that gas generation has begun in 115 PSA plants.

The affidavit further states that over 1,600 PSA plants are being established, which together will generate nearly 2,000 MT of oxygen.

States have also been advised by the Union health ministry to prepare an action plan expeditiously for the establishment of PSA plants in all public and private hospitals on a priority basis.

Apart from this, the National Medical Commission has amended its regulations to make it mandatory for all medical colleges to establish PSA plants within six months.

(Edited by Arun Prashanth)