On April 17, the Bangalore Institute of Gastroenterology (BIG), a hospital in Bengaluru’s Jayanagar, decided to shift out COVID-19 patients from their ICU after they ran out of oxygen supply. The situation at the hospital was a rarity at that time. While many instances of oxygen shortage have emerged from Delhi and other places, Karnataka, like its other southern counterparts, has not encountered a major shortage thus far. However, there is a rising concern that the state may face an imminent shortage – which is why the government has been shooting off letters to the Union government – asking for more allocation.
The Karnataka government has requested the Union government for a daily allocation of 1,500 metric tonnes (MT) of oxygen. The state’s allocation was increased from 300 MT to 800 MT per day on Saturday night, however it is unclear when this supply will begin and how it will be distributed. Though the state is managing with its oxygen resources for now, a look at its production and storage facilities and the increase in COVID-19 cases makes it clear why the requests have been sent to the Union government.
Karnataka has seven liquid oxygen manufacturing units – all owned by private companies – with a total daily production of 812 MT. The oxygen is manufactured in cryogenic air separator plants and supplied to cylinder filling units and hospitals.
The major manufacturers of liquid oxygen in Karnataka are Bhoruka Gases (65 MT per day) and Universal Air Products (50 MT per day) in Bengaluru, Praxair (225 MT per day) in Koppal and Ballari, Air Waters India (92 MT per day), Ballari Oxygen (80 MT per day) and JSW Industrial Gases (300 MT per day), all based in Ballari.
The storage capacity of the major manufacturers is 5,780 tonnes with Praxair (2,730 tonnes), Air Waters (1,000 tonnes) and JSW (1,000 tonnes) having the highest capacities. All three manufacturers are based in Ballari in the northern part of the state.
Additionally, the state has also been allocated 300 MT per day from the Union government.
TNM has accessed an internal report prepared by the Petroleum and Explosives Safety Organisation (PESO) on March 26, 2021, which details the production and storage capacity in Karnataka. Like other states, in Karnataka too, almost all the production is by the private sector. However, unlike Tamil Nadu or Kerala, Karnataka does not seem to have created government storage facilities or production units.
TNM has also accessed an internal report prepared by the Karnataka Drugs Control Department on April 14. According to this report, 9,830 patients out of the total active COVID-19 cases in the state (85,480) required oxygenated beds. This was 11.5% of the total active cases at the time. 295 others required ICU beds, which was 0.34% of the total active cases at the time. The oxygen consumed daily at this point was 197.2 MT.
Since then, the number of active cases in the state has more than doubled to 2,34,483 patients as of April 24. The number of COVID-19 patients in the ICU has also increased by more than four times to 1,280. The need for medical oxygen could fluctuate during the day and hospital administrators say that there are non-COVID patients who need oxygen as well.
On April 23, the Karnataka Chief Minister told the Prime Minister during the meeting chaired by the latter that the current consumption of medical oxygen in the state is 500 MT per day. The state government expects the demand for oxygen to increase up to 1,142 MT per day by April 25 and 1,471 MT tonnes per day by 30 April. This is referenced in a letter by Jagadish Shettar, state Minister for Large and Medium Scale Industries, to Piyush Goyal, Minister for Commerce and Industries in the Union government. “The estimated requirement would be up to 1,471 tonne as on 30th April, 2021 (projected COVID-19 cases to 3,24,944 cases),” reads the letter.
It is not just a question of the supply keeping up with the demand. Even if all oxygen production is diverted to be used for medical purposes, there is a massive logistical challenge of transporting and storing the oxygen. This is because the production is not evenly distributed in Karnataka. Nine districts do not have oxygen manufacturing units – Gadag, Chikkaballapura, Chitradurga, Bidar, Yadgir, Chamarajanagar, Kodagu, Mandya and Udupi – while three of the biggest manufacturers are based in Ballari.
Dr Rajshekar, Secretary of the Private Hospitals and Nursing Homes’ Association (PHANA) in Karnataka, says that few private hospitals in the state, mostly in Bengaluru, have reported a shortage of oxygen levels so far.
“Now, these hospitals have come together to set up mutual self-help groups to share resources and even shift patients when there is a delay in supply of oxygen. PHANA has also set up a WhatsApp group with all oxygen manufacturers and when any hospital has an issue with supply, they will be added to this group and allowed to put in their request to manufacturers,” Dr Rajshekar says.