Oxygen Availability: As of now it is OK, BUT…
Do we have sufficient medical Oxygen available in Jammu and Kashmir to tackle the challenges and threats posed by the second wave of the pandemic, which is showing a worsening impact with each passing day? Since Oxygen is a crucial treatment for many Covid patients because the virus affects lung function, this question is frequently asked and largely debated by one and all these days.
Experts, while referring to the situation in several states and cities across India, where amid the collapsing health infrastructure the second wave of the pandemic has created havoc; say that in the given situation health sector in UT cannot afford the burden of patients beyond a certain limit and any amount of available Oxygen might prove to be less if the pandemic goes out of control like it did in many cities across the country.
The authorities, however, strongly deny any shortage of medicines and Oxygen in J&K. Baseer Ahmad Khan, Advisor to Lieutenant Governor, in a hurriedly called press conference on Thursday evening, told reporters there was no shortage of Oxygen and medicines in the UT. He said that 20 tons of Oxygen was available in the UT, which according to him was sufficient to meet the demand of Covid patients.
Pertinently, Jammu and Kashmir has seen a surge in Covid cases and deaths, particularly for the past fortnight. An overall view of the present situation in J&K can be gauged from the fact that in just the last 10 days of April as many as 27,875 new cases with 220 deaths were recorded in the UT. From April 27 onward, more than three thousand fresh cases and mortality in two digits are registered daily. With this spike in cases and deaths, many people, in recent days have been complaining about the shortage of drugs and non-availability of medical Oxygen.
KASHMIR IMAGES spoke to several experts and concerned people to know about the magnitude of the ongoing wave of the pandemic, and preparations by the administration — particularly in terms of the production and availability of medical Oxygen. Here is what they told us:
As of now we have more than sufficient Oxygen supply in Kashmir, as we have enhanced the Oxygen production by installing additional plants at as many as 17 stations across Kashmir. I am, therefore, in a position to assure people that we are in a comfortable situation as far as the demand for Oxygen is concerned.
Not only that we have sufficient capacity to face the present challenges, but we would also be able to cater to the demand even if God forbid the situation gets worsened.
I am saying this because we have many hospitals across the Valley that have not been yet notified for the Covid patients. For example, we have numerous hospitals — having sufficient facilities and staff — which can be notified for the Covid patients the way we did in Srinagar. Here in Srinagar we kept JVC as standby after notifying it for the Covid treatment; raised the number of beds at SKIMS for the Covid patients, and also added more Covid wards at the SMHS hospital. We have also Kashmir Nursing Home within the reach. There are 50 beds and we are trying to add more beds in this nursing home. The augmentation of the staff and equipment at every place is also going on.
We have also enhanced the availability of Oxygen cylinders and concentrators. Presently, we have three levels of Covid care centres with different level of facilities available at most of the places across Kashmir. That means we can accommodate a lot of patients in case of need. Briefly, we have enough facilities and sufficient availability of Oxygen in Kashmir at this point.
That said, I would appeal to the people that they need to play smart to ensure the virus is not spread further. People have to take care of their lives and everything else is secondary. Unfortunately, many people do not follow the SOPs. Some of them do not go for testing even after feeling symptoms of the virus. They not only endanger themselves but also put others around them at risk. People should wear face masks, ensure social distancing, and maintain hygiene to stop the spread of the pandemic.
I want to conclude this on a positive note that as per our experts, the surge in the Covid cases is going to end next month, and we expect a fall by the end of May.
Since Covid spoils the respiratory system of many patients, Oxygen is one of the most important components for treating the disease, and we require more Oxygen this time simply because of the high patient inflow compared to last year. In the previous year, the virus spread at a slow pace, but this time we see a very high spike. Most importantly, unlike past year, the virus affects the younger generation as well. Earlier, mostly the elder people and those with weak immunity would get involved. However, in this second wave of the pandemic, we have seen young people equally getting severely infected by the virus, and most of them need Oxygen support during their treatment.
Furthermore, it looks that the new Covid variant is more vicious than the previous one. Therefore, I say people must strictly follow the SOPs. Any robust healthcare system cannot help much if the virus spreads beyond a limit. It is our social responsibility to ensure the chain of infection breaks. For that, we need to take extreme precautions, and we have to do this for quite a long time because the virus is not going away overnight.
We at SKIMS have as many as three Oxygen concentrators in place. One of them generates 750 liters per minute, and the other two produce 1250 liters per minute each. That means we have a total of 3250 liters per minute Oxygen generating capacity here. In addition, we use 5 to 6 hundred cylinders containing 3300 liters of Oxygen, per day; enhancing the total availability of Oxygen up to more than 6 thousand liters. Also, we have two more concentrators with a capacity of 1250 liters per minute each, coming up in the near future. The installation process of these concentrators is going on. Presently, we are meeting the demand. That means we have equivalence in the availability and consumption of Oxygen at our hospital.
As for as the availability of Oxygen beds at SKIMS is concerned, we have 700 beds with an oxygen facility here; and, we have as many as 45 ventilators in use. Twenty of these ventilators are operational for the Covid patients. Also, we have as many as 20 high-flow Oxygen devices available for the Covid patients.
With all these facilities in place, I can say that we are handling the pandemic crisis smoothly at this point in time. Whether we will be able to continue dealing smoothly with the crises or not will depend on the magnitude of the crises in the future.
We have dedicated as many as 203 Oxygen beds to the Covid patients at SMHS hospital. Of them, eleven are intensive care. The Oxygen supply to these beds comes from as many as 5 Oxygen generation plants installed here, which are producing 4080 liters per minute. Two of them, which produce 1040 liters per minute, are there for a long time. However, in recent months and weeks, we have installed 2 more plants. One of these generates 1000 liters per minute and other 600 liters per minute. Additionally, we installed one more Oxygen plant just a day ago on a trial basis. It produces 1000 liter of Oxygen per minute. We will commission it for permanent use in the coming few days. All these plants cater to various portions of the hospital, including the Covid wards.
Additionally, we also use hundreds of Oxygen cylinders containing 1830 liters of Oxygen in the hospital daily. As of now, we do not lack Oxygen.
As of now, we do not face any shortage of Oxygen cylinders and concentrators to meet the demand. However, if demand increases, we will not be able to help much.
Usually, we receive more than a hundred calls a day from people requesting the cylinders and concentrators and we are always in a position to help out most of them. Even we send out team members to the homes of the patients, if needed, to help them fit these cylinders and concentrators.
Besides a large number of Oxygen cylinders, we have more than 220 Oxygen concentrators, 25 of them providing high flow Oxygen, available to us. Also, we have as many as 35 Non-Invasive Ventilation Machines readily available with us. We get our Oxygen cylinders refilled from an Oxygen unit at Rangreth in Srinagar on a daily basis. Another company assists us in the maintenance of our concentrators.
Mostly, the Covid patients who are discharged from hospitals and sent for home isolation on Oxygen support seek our help these days. We have around half a dozen NGOs active in Kashmir, who provide Oxygen cylinders and concentrators to such patients as we do to ease the burden on hospitals. Even the doctors ensure that the patients get Oxygen cylinders from us before they are relieved from the hospital.
At this point in time, I can tell you with my experience and observation that this situation in terms of providing Oxygen to the Covid patients is manageable. However, there would be a huge crisis if the number of cases goes up further.
We have been supplying medical Oxygen gas cylinders to various hospitals in Srinagar for quite a long time, but there has never been such a huge demand in the past as we are seeing for last three weeks. Presently, we supply as many as 1200 Oxygen-filled cylinders to the hospitals in the city. Of them, we provide 650 to SKIMS, 450 to SMHS, 50 to JVC, and 50 to others daily. Until just a few weeks ago, we would supply only 200 cylinders to SKIMS and around 150 to SMHS. The rest of our Oxygen production used to go to private sector. We have stopped supply to the private sector since the demand went up from the government sector hospitals. We are working hard to meet the demand.
However, there is no scope for raising production further at our unit. No matter how much demand goes up, we would not be able to supply more Oxygen than we do at present.
We must understand the magnitude of the crises before we talk about the availability of Oxygen and our preparedness to tackle the situation. The scale of crisis can be gauged by the fact that only a few weeks ago we had Covid patients coming every day in just two-digit numbers. Now we see thousands of new cases coming up every day. We are not only witnessing increase in the number of cases but in fatalities too. Oxygen and intensive care beds in hospitals are already occupied. Today, I was making round and I found so many people who require ICU beds, but we do not have any to provide them. Similarly, some patients require ventilators, and we do not have any of them vacant. Worst, the cases are rising with each passing day and so are the deaths. We have been seeing this much mortality for the first time since the pandemic outbreak, last year.
The resurgence of the second wave of Covid is much worse than the earlier one. In the first wave, we saw only elderly people and those who had underlying medical conditions getting badly affected and then many of them dying. In contrast, now we have more young people getting affected and many of them dying. This scenario makes us understand that we are dealing with a different mutant virus this time, and as the result, we have got a large number of positive and suspected cases. Why suspected? Because even RT-PCR tests sometimes miss showing these variants. That is why we might even have to send more samples to Genome Sequencing to know whether we have a variant here, which causes a spike in cases and deaths. All this is happening at a time when 98 percent of our population is not vaccinated, and thus vulnerable.
Keeping this scenario in mind, we cannot claim that we have sufficient Oxygen available here. Any amount of Oxygen would prove less and any healthcare system can collapse if a pandemic goes out of control. That is why I have been asking for the imposition of a strict lockdown. We cannot afford to allow people to be negligent.
Our hospitals are full of Covid patients. Moreover, people carrying big Oxygen cylinders on their shoulders while accompanying their patients are also an indication that we are already in a crisis. We must, therefore, tell the people truth even if it creates fear among them. Because, if we continue to lie and tell them that everything is fine, they would become more careless and negligent. People must know that we cannot do much in terms of enhancing healthcare facilities at this point in time. We cannot prepare while the fire is already on. We have lost that chance, even after experts had warned about the second wave of the pandemic. We should have prepared before this wave hit us.
To conclude, I would say that to avoid a catastrophe, we have to contain the virus by containing people. Otherwise, as an expert, I can confirm that we will be facing a situation like in Delhi and Mumbai here too. Continue the lockdown and enforce it strictly.