Around 7.45 pm on Monday night, Chandramohan KN, deputy director of Ayushman Bharath Arogya Karnataka, received a call from the Karnataka Health Commissioner Pankaj Kumar Pandey to dispatch ambulances to the Kempegowda Institute of Medical Sciences (KIMS) in Bengaluru. The call meant that health authorities were dealing with the worst-case scenario.
Earlier on the same day around 4 pm, Chandramohan was briefed about the lack of liquid oxygen supply for patients at KIMS. He was told that the oxygen supply in their hospital will be exhausted in a few hours between 9 and 10 pm. "There was a panic call after the tanker to refill the oxygen supply did not arrive on time on Monday. The supplier had been informed on the previous day itself but we had to be ready for an inter-department operation to shift patients," Chandramohan says.
The call to shift patients was made at 7.45 pm and 45 ambulances were arranged to shift 47 patients who depended on oxygen supply to other government hospitals including Victoria Hospital, Bowring Hospital, and Rajiv Gandhi Institute of Chest Disease (RGICD).
The operation was not over. Many more patients were reserved beds in private hospitals like the Sakra Hospital, Prashant Hospital, Apollo Hospital and a team of doctors were put in place to take care of the patients. But before the patients were shifted, an oxygen tanker arrived at KIMS and refilled the centralised oxygen supply at the hospital.
"The rest of the patients who were to be shifted continued to stay at KIMS. All the patients are currently stable," Dr. Regina Joseph, cluster head at the BBMP war room reported.
The officials managed to avert a disastrous situation by ensuring the patients who were at risk were shifted. Twenty of the 47 patients shifted on Monday night were in the Intensive Care Unit (ICU) while there were also patients who tested positive for coronavirus.
The delay in refilling liquid oxygen
Medical Education Minister Sudhakar K visited KIMS Hospital on Tuesday morning. Addressing reporters, he attributed Monday's scare to the fact that the production of liquid oxygen was unable to cope with the high demand in the last few months. "Instead of trying to find fault with the supplier, I would say that the supplier is unable to meet the demand as they have contracts to provide liquid oxygen for 4-5 private hospitals," Sudhakar said.
Interestingly, Sudhakar said that the state government did not anticipate that there would be a requirement of liquid oxygen during the pandemic. "We cannot pin this as anyone's fault. We did not estimate the need for liquid oxygen," he added.
Doctors told TNM that the demand for oxygen supply has increased in hospitals in Bengaluru. "Most hospitals use high-flow oxygen therapy and it consumes a lot of oxygen. It is pumped like a blower and there is also a lot of wastage of oxygen and therefore it is getting exhausted quicker," Chandramohan KN said.
In big hospitals like KIMS, the oxygen supply is regulated through a centralised system connected by pipelines and not through a system of refilling cylinders.
High demand for liquid oxygen
Government officials said that the demand has increased by five times in Karnataka since the start of the pandemic and that steps were being taken to address shortages. "We need new liquid oxygen units. There is a demand for it. We have estimated what is needed in government hospitals and we have ensured the supply is there. There is no shortage in government institutions. We will now look into arranging the supply for private hospitals too," Sudhakar K said.
He added that the cost of liquid oxygen has also increased and that the state government will approach the central government to regulate prices set by vendors from other states. "Our government will regulate the prices if it is feasible at the state level. The cost has naturally increased due to increase in demand," Sudhakar added.
The state government is also considering setting up more liquid oxygen plants in Bengaluru, where the demand is higher than other districts.