Bangladesh’s demand for medical oxygen far exceeded its production about a month ago with import meeting a part of the additional demand as hospitals are facing a steady onrush of Covid patients requiring oxygen.
With the daily Covid death figure breaking record almost every day of late, major oxygen producers in the country warned about a likely drop in their supply with oxygen import from India getting increasingly difficult as Covid cases are surging there.
Frequent power- and gas-supply disruptions deepened the crisis by obstructing the operation of oxygen plants in Bangladesh at their full capacity, oxygen producers complained.
Bangladesh has never officially released an estimate of its daily oxygen requirement though limited intensive care access and other signs have always been there to suggest a shortage in the supply of oxygen.
A global initiative tracking daily Covid oxygen needs put Bangladesh’s requirement on Tuesday at 2,37,700 cubic metres after considering the country’s daily Covid cases and other data.
‘We are already depending on import and have asked for more in the face of an abnormally increasing oxygen demand,’ Directorate Geneal of Health Services director for hospitals Farid Hossain Miah told New Age without specifying the country’s daily medical oxygen requirement.
Currently, government hospitals get 180 tonnes or 1,26,000 cubic metres of oxygen daily from two suppliers, Linde Bangladesh Limited and Spectra Oxygen Limited, he said.
But the government estimate does not match the supply of about 140 tonnes or 95,200 cubic metres from the two producers.
The overall daily medical oxygen supply in the country, together with the output from a third oxygen producer, Islam Oxygen Limited, is about 170 tonnes or 1,19,000 cubic metres.
‘The country’s medical oxygen demand has increased 10-fold after March which in no way can be met with the local production,’ said Islam Oxygen chief executive officer Mustain Billah.
Every week Islam Oxygen could import only 15 tonnes from India.
Islam Oxygen produces 33 tonnes daily against its capacity of 54 tonnes as its plant can never operate at full capacity because of either power cuts or other technical problems.
Spectra Oxygen deputy general manager Moklesur Rahman said that their daily medical oxygen supply rose to 50 tonnes from 30 tonnes in March, adding that they are also importing the gas to meet the increasing demand.
‘But import has become too uncertain and it may stop any moment,’ said Mokles.
India has sharply restricted the industrial use of oxygen since Wednesday as Covid cases kept surging in the country.
The daily medical oxygen demand has shot up abnormally in many Indian states diverting their entire output to hospitals.
For instance, Mumbai, with a population of about 13 million, is already using 80 per cent of the daily production of 1,250 tonnes at hospitals.
Maharashtra has diverted 80 per cent of its daily production of 1,200 tonnes to hospitals after the demand touched 700 tonnes.
Madhya Pradesh, with 59,193 active Covid cases as of April 16, estimated their daily medical oxygen need at 250 tonnes while Gujarat with over 49,737 active cases at 500 tonnes, according to Indian media.
The number of active Covid cases in Bangladesh was 89,081 on Tuesday and the Institute of Epidemiology, Disease Control and Research has recently revealed that 44 per cent of the newly infected people require hospitalisation.
The hospitalisation rate following the second wave of the pandemic that started in March is far higher than the usual situation when Covid dedicated hospitals handle about 20 per cent of the Covid cases, 5 per cent of whom turn severe, according to the IEDCR.
The IEDCR has already reported a rapid fall in oxygen saturation level among Covid patients during the second wave giving physicians far less time than ever before to save a life.
But hospitals in Dhaka are turning away Covid patients requiring intensive care, which has already made it to national and international news.
Bangabandhu Sheikh Mujib Medical University medicine professor Mujibur Rahman said that the most peculiar thing about Covid-19 is that it abnormally lowered oxygen saturation even before the patient could feel anything.
A constant monitoring of oxygen saturation level and oxygen supply is essential in Covid-19 treatment, said Mujib, also an editorial board member of the National Guidelines on Clinical Management of COVID-19.
‘But the problem with making any overall assessment is that we don’t know the actual situation,’ he said.
The country’s health agency, however, continued to assure people of having enough medical oxygen and other necessary equipment in supply.
The agency said that till Wednesday the government had 19,254 oxygen cylinders, 1,476 high-flow nasal cannulas and 1,193 oxygen concentrators.
According to the Covid-19 Oxygen Needs Tracker, a tool developed by the COVID-19 Respiratory Care Response Coordination project, an international initiative, Bangladesh needed 33,958 oxygen cylinders and 2,37,700 cubic metres of oxygen on Tuesday.
Officials of Linde Bangladesh, the biggest oxygen producer in the country, suggested that the government could ban the industrial use of oxygen, such as in the steel industry, for increasing oxygen supply to hospitals.
Industries are sucking up 20 per cent of Linde’s daily production of 95 tonnes.
Besides, the production at Linde’s Bhulta plant in Narshingdi, accounting for three-fourths of its output, was hampered several times after Mid-march due to gas-supply disruption, according to Linde officials.
Linde is importing 20 tonnes once in a while. Besides a sharp rise in the demand in India, inadequate transport facilities, such as shortage of tankers, are obstructing oxygen import, said Linde officials.
Oxygen producers said that the government could have easily set up an oxygen plant, which can be built in a year, after Covid-19 emerged in the country in March last year.
‘It is just not right to leave it to private companies alone to deal with the Covid oxygen demand. The government should take some responsibility,’ said a Linde official.
The oxygen supply shortage is strongly felt at cylinder retailers where individuals go to get their emptied ones refilled as well.
Many retailers have stopped taking refilling orders while others still doing it increased their charge three to four times.
‘Now we need to wait for three to four days to have a refill,’ said Kajal, an employee at a retail shop in Maghbazar.
‘From where would they refill it when there is not enough supply?’ said Kajal.
The price of an oxygen cylinder has also increased by about Tk 5,000.
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