On May 15, Shashidhar Shetty, a resident of Bengaluru was desperately looking for an oxygen cylinder for his relative Indumathi, a COVID-19 patient who was isolated at home. "I tried many leads online but none of them helped. I was told that they were not giving cylinders for home use," says Shashidhar. Indumathi was later shifted to Shankar Hospital in Chamarajpet in the city.
Shashidhar, like many others in Bengaluru searching for oxygen cylinders for patients who are isolated at home, has been unable to find one in the past week. He did not know that this was because the Karnataka government revised its guidelines for medical oxygen on May 9, prohibiting medical oxygen from being supplied for home use. The new guidelines asked re-fillers and manufacturers to not supply medical oxygen to individual persons and ordered medical oxygen supplies to be redirected only to hospitals.
The change in the rules has impacted patients who are isolated at home and need oxygen support; but the Karnataka government says that the guidelines were needed because of the acute shortage of medical oxygen in the state. "There is not enough oxygen for patients admitted in hospitals and there is no way to stop hoarding or black marketing if this (supply to home) is permitted. If the patient's condition is serious enough and they need oxygen, they should seek hospital admission," says Senior IAS officer Munish Moudgil, who has recently been appointed as the nodal officer for oxygen logistics in Karnataka.
However, he did hint at a system in the future for individuals to place orders and receive medical oxygen supply at home. "In the last seven days, the caseload in Bengaluru city has come down by more than 60,000. Hence, at this stage, issuing cylinders to individuals is not planned. In the coming days once an IT based system is created then we will start it," he added.
The guidelines on May 9 were issued after several hospitals in the state reported a shortage of medical oxygen. In a tragic incident in Chamarajanagar district, 24 patients at the Chamarajanagar Institute of Medical Sciences (CIMS) died after an interruption in the oxygen supply on May 3.
The Karnataka government on May 14 stated that the oxygen consumption in the state is 828.45 metric tonnes (MT) per day of which 285 MT is consumed in Bengaluru alone. Many of the hospitals reporting oxygen shortages in Bengaluru are smaller hospitals which do not have their own storage units and need regular, even daily, refilling of medical oxygen. These include Arka Hospital, Medax Hospital, Chaitanya Hospital, Railway Hospital, among others, which have issued emergency appeals for oxygen.
On May 11, the state government also touted the Oxybus – a bus with oxygen support stationed at 20 hospitals. But more than a week after it was announced, the buses are yet to be operational.
The state government's decision to restrict medical oxygen use at home has not cut off all sources to procure medical oxygen. However, this has made it extremely tough for people to procure medical oxygen for home use even in cases of emergencies as manufacturers and re-fillers are no longer supplying to individuals.
Activists and volunteers have questioned the state government's move and have suggested that the government should create a system for oxygen cylinders for home use like the one hinted at by Munish Moudgil.
"Suppliers are reluctant now due to the government mandate and we have shifted our focus to verifying leads for oxygen concentrators. I think the government should definitely set up an emergency bank [of medical oxygen] that can be released on doctors’ advice or oxygenated ambulances that are assured to reach patients at home," says Padmini Ray Murray, a volunteer with OxygenBLR.
OxygenBLR, a volunteer group set up last month to publicise leads for oxygen cylinders, has also stopped verifying and publishing leads for cylinders from last week due to the government mandate against supplying to individuals. "But we still get few appeals from people at home looking for oxygen cylinders," says Padmini. One of the people who contacted Padmini for an oxygen cylinder for home use in the past week was Shashidhar, whose relative was still hospitalised as of May 18. "She is recovering but she is still in the hospital," he says.