At 9 pm on Friday, 44-year-old Anandan’s* relatives were informed that he had to be shifted out of Lifeline Hospitals in Chennai’s Kilpauk.The critical COVID-19 patient was on ICU support for three days and was on high flow nasal oxygen or HFNO. But to save his life, the hospital had to arrange to shift him out as its oxygen reserves were nearly over on Friday night.
“The hospital informed us that by 1 am they were going to run out of oxygen. So we decided to look for other ICU beds. The doctors at Lifeline were trying their best to secure more oxygen for all their patients in the meantime,” Ravi*, a relative of Anandan’s who was searching for ICU beds for the patient at other hospitals told TNM. Anandan was then rushed to another private hospital in Nandanam at 10 pm, where authorities declined to admit him as they had no vacant ICU beds. He was then rushed back to Lifeline Hospital, which had managed to secure oxygen temporarily and re-admit the patient.
Speaking to TNM, Dr Natesh, Vice President of Lifeline Hospitals, says, “There is an acute shortage of oxygen, but we have been pulling through thanks to the state government’s support. We have 8 ICU patients and our daily demand is three tanks of liquid medical oxygen, with 233 cubic litres of LMO per tank. Of late we have been getting 1 tank or rarely two tanks of oxygen supply per day. Friday was critical as we received zero tankers for refilling our oxygen tanks.”
The hospital confirms that they have not transferred out any ICU patients. “But we have asked kin of patients on non-ICU O2 support to use their contacts and check if beds are available elsewhere. This is to reduce our overall dependence on O2 as it is very difficult to maintain the supply,” he explains. Accordingly, some of the patients were transferred to government hospitals and a few others to private hospitals. Lifeline, however, secured 65-70 oxygen cylinders for their ICU patients to ensure continuous supply. “We don’t normally use cylinders, but since there is a shortage of liquid medical oxygen, we have only managed to get this,” Dr Natesh adds.
Several smaller hospitals across Chennai reported an acute shortage of oxygen supply on Friday night. TNM contacted three other hospitals who confirmed that they made distress calls to the Chennai Corporation on Friday to secure oxygen for their patients.
“We had to transfer out two COVID-19 patients from our ICU on Friday as they needed quite a lot of oxygen. Right now, we are unable to establish continuity in oxygen supply and we don’t want to risk patients’ lives,” says Dr AG Karthikeyan, Director of NRG Speciality Hospitals in Chennai. NRG Speciality Hospitals has a 4-bedded ICU ward and six oxygen supported non-ICU beds, all of which are occupied by COVID-19 patients.
“We rely on oxygen cylinders at NRG and ideally, our ICU needs 8-9 full cylinders per day for continuous oxygen supply to sick Covid patients. But for the last two weeks we have been facing a shortage and it has become acute over the last three days,” Dr Karthikeyan explains. With the shortage persisting, NRG Hospitals plans to shift out one more COVID-19 patient to a bigger hospital by Saturday.
Over the last two days, doctors at a private hospital in Chennai’s Pulianthope have been urging relatives of their COVID-19 patients to look out for other ICU beds in the city. The hospital has only been receiving half of their liquid oxygen demand for a week now.
“We require two tankers or 460 litres of liquid medical oxygen per day for the 8 ICU patients and others on oxygen support. For one week now we have only been getting one tanker of 230 litres of medical oxygen. It’s simply not enough and we are trying to shift our patients to other hospitals,” says Dr Richard*, who manages the ICU ward of the hospital. Dr Richard adds that they’ve dialled 104 and other helplines provided by the Greater Chennai Corporation but have been unsuccessful in securing more oxygen. “Our suppliers told us that there is a lot of demand and that is why they are not able to meet our requirements,” he adds.
On contacting the Chennai Corporation, these hospitals are offered an ID number and the contact of a zonal drug inspector. The drug inspector is to coordinate oxygen supply to hospitals in his or her zone.
“The Corporation and the drug inspectors are responsive but the issue is that the city does not have enough oxygen stock. The drug inspector we spoke to gave us a list of contacts of oxygen suppliers near us. These suppliers informed us that they have run out of oxygen or that there is a long waiting list,” Dr Karthikeyan says.
On May 12, Wednesday, the Union government informed the Madras High Court that it had increased liquid medical oxygen allocation to Tamil Nadu from 419 metric tonnes to 519 metric tonnes per day, under the National Oxygen Plan.
The submissions were made to a bench led by Chief Justice Sanjib Bannerjee and Justice Senthilkumar Ramamoorthy. When the Chief Justice observed that the State’s requirement might go up to 800 metric tonnes per day, Additional Solicitor General R Sankaranarayanan said that he had discussed with officials on establishing oxygen generation plans in TN through the Defence Research and Development Organisation or DRDO.
The submissions were made after a letter by Tamil Nadu Chief Minister MK Stalin who wrote to the Union government on May 12, stating that the oxygen allocation to the state was insufficient.
*Names changed to protect patient identity