Bengaluru/New Delhi: A political slugfest erupted between the Aam Aadmi Party government in Delhi and the Modi government Friday over an interim report of a sub-group constituted by the Supreme Court to audit Delhi’s oxygen requirements during the peak of the second Covid wave.
The sub-group in its report, accessed by ThePrint, noted that during its fourth meeting on 13 May, “it was discussed that there was a gross discrepancy (about 4 times) in that the actual oxygen consumption claimed (1140 MT) was about 4 times higher than the versus calculated consumption by formula for bed capacity (289 MT)”.
Following the release of the report, the BJP and Congress accused Chief Minister Arvind Kejriwal of “lying”, and demanded that a criminal case be filed against him. Kejriwal replied to the salvos by tweeting in Hindi: “My crime is I fought for the lives of Delhi’s 2 crore people.”
मेरा गुनाह-मैं अपने 2 करोड़ लोगों की साँसों के लिए लड़ा
जब आप चुनावी रैली कर रहे थे, मैं रात भर जग कर Oxygen का इंतज़ाम कर रहा था। लोगों को ऑक्सिजन दिलाने के लिए मैं लड़ा, गिड़गिड़ाया
लोगों ने ऑक्सिजन की कमी से अपनों को खोया है। उन्हें झूठा मत कहिए, उन्हें बहुत बुरा लग रहा है
— Arvind Kejriwal (@ArvindKejriwal) June 25, 2021
Members of the sub-group included AIIMS director Dr Randeep Guleria, Controller of Explosives, Petroleum & Explosives Safety Organization (PESO) Dr Sanjay Kumar Singh, Jal Shakti Ministry Joint Secretary Subodh Yadav, Delhi Principal Secretary (Home) B.S. Bhalla and Max Healthcare Clinical Director (Internal Medicine) Sandeep Budhiraja.
At the centre of the conflict are two different formulae used by the Modi and Delhi governments for calculating Delhi’s oxygen requirement.
While the formula used by the Centre assumed that only 50 per cent of the non-ICU beds used oxygen, the Delhi government assumed that all non-ICU beds used oxygen.
As the BJP and AAP spar over the audit panel report, ThePrint explains the different formulae, what members of the sub-group said, and what experts opine.
What the report says
A total of 260 hospitals were sent standardised pro forma by the sub-group regarding their Liquid Medical Oxygen (LMO) requirements and responses had initially been received by 183 hospitals.
The four-time “excess figure” as quoted by the report refers to the difference between the actual oxygen consumption of 183 hospitals according to data from the Delhi government and the recommended oxygen consumption according to the central government’s formula.
The report noted that the “actual oxygen consumption” of 183 hospitals according to the data from the Delhi government was 1,140 metric tonnes, but, this was a result of “erroneous reporting” by four hospitals, namely Singhal Hospital, Aruna Asaf Ali Hospital, ESIC Model Hospital, and Liferays Hospital.
So, the report said, the actual oxygen consumption “after correcting erroneous reporting by 4 hospitals” stood at 209 metric tonnes (MT) and the “recommended oxygen consumption as per GOI Formula” was pegged at 289 MT. Meanwhile, the recommended oxygen consumption as per the Delhi government’s formula was noted at 391 MT.
As data from more hospitals was factored in, the oxygen consumption was computed at 474 MT (of 214 hospitals).
The report added that the formula used by the Government of India “was devised by a group of experts and is used for making LMO allocation to various states”.The Delhi government, in its comments on the minutes of the meeting held on 19 May, had added that its formula was based on the Indian Council of Medical Research (ICMR) guidelines.
The interim report by the SC-appointed panel led by Guleria, however, while noting this added that “no such guidelines were placed before the sub-group”.
Behind the GoI’s formulation was the assumption that “Covid-19 patients admitted in a patient care facility are at various stages of treatment and not all would require oxygen administration, even when they are occupying an oxygen bed”.
However, on 31 May, the Delhi government raised an issue on the draft interim report as it argued that “the assumption that only 50% of non-ICU beds use oxygen is not correct in the context of respiratory disease like Covid-19.” It added that almost all hospitalised patients need a regular supply of oxygen and these doubts “can only be resolved through an on-group audit of hospitals, which the Audit Sub-Group is yet to do”.
Moreover, the Delhi government and Budhiraj pointed out that the oxygen consumption by home isolation patients, ambulances and small nursing homes hadn’t been factored in.
The Delhi government in its comments to the draft interim report had also said that a buffer of 75 MT could be added after considering these requirements.
“However, the Interim Report seems to have been sent to Government of India without making the requisite changes, without sharing again with the members of the Sub-Group and without their formal approval,” Bhalla highlighted in a file noting by Delhi government’s home department Friday.
What experts say
ThePrint reached experts to understand where they stand on the issue.
Dr B.L. Sherwal, medical director, Rajiv Gandhi Super Speciality Hospital, maintained that he wouldn’t go into the details of the oxygen audit. He, however, said, “What we cannot debate over is that there was a major issue with the supply of oxygen…All beds need oxygen as we weren’t admitting patients if there was no oxygen requirement,”
He added that the hospital’s oxygen supply had been dependent on a truck that came from Uttarakhand of which they would sometimes only get 1 MT or 2 MT and the rest would go to GTB hospital.
Interestingly, Bhalla had also informed the sub-group that while data had been procured from 214 hospitals, it still lacked additional data from two to three big hospitals, including GTB and LNJP which had added 500 additional beds each for Covid-19 patients.
“If in the second or third week of April, someone mentioned a shortage of oxygen, my heart would skip a beat. We know what we have seen,” Sherwal said.
Meanwhile, Dr N.N. Mathur, Professor of Excellence ENT, Lady Hardinge Medical College & Hospitals and Additional Directorate General of Health Services said while he wasn’t aware of the matter of how oxygen consumption was computed, but “as a frontline health worker he was aware of the oxygen shortage” the city had seen.
“It was sometime in April and I had to call the Union health minister post-midnight asking for oxygen, that’s how grave things were,” Mathur, who was the medical superintendent of Lady Hardinge Medical College during the peak of the second wave, said.
On Saturday, however, AIIMS chief Dr Randeep Guleria in an interview with a news channel said it wouldn’t be correct to say that Delhi had exaggerated its oxygen. “Delhi oxygen audit is an interim report. We should wait for the final report.”
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