Covid-19: Heavy use of oxygen brings new danger to world’s hospitals

Deaths in India

A day earlier, 15 patients in India died in a fire in a covid intensive care unit (ICU) at Vijay Vallabh Hospital in Virar, near Mumbai. Oxygen was not the genesis of that fire, the lead investigator, Nilesh Ukunde, told the Mumbai Mirror; but, as tubes were pulled from patients’ noses for evacuation, while other tubes were melted by flames, the room filled with oxygen, making the blaze far worse.

The fire began, Ukunde said, with sparks from a wiring short circuit in the ceiling above the ICU nurses’ station. “Huge quantities of alcohol from sanitisers are released in the atmosphere of the ICU wards. Being lighter, it settles up on the ceiling forming a layer,” he said. “In case of a short circuit, the presence of alcohol in the air results in a flashover, engulfing whatever comes in its way within a fraction of seconds.”

The curtains drawn around each covid patient’s bed stopped normal ventilation from clearing the alcohol in the air, he said. The sprinklers did not work, although the hospital had passed a fire audit. The fire was the second deadly blaze in a covid ICU in India’s Maharashtra state this month. Four patients with covid-19 were killed in a fire at a private hospital in Wadi, Nagpur district, on 9 April.

An oxygen leak at another hospital in Maharashtra state on 21 April left 22 covid-19 patients dead, as the pressure feeding their tubes fell to zero during an attempted refill of the hospital’s main tank. The hospital was treating 150 patients with covid-19, of whom 15 were on ventilators.

Television cameras were present as clouds of white gas—water vapour condensing on the cold oxygen—filled parts of the hospital and the street outside. They also showed staff frantically trying to resuscitate patients as relatives cried. A woman told TV9 that her mother began to gasp as soon as the oxygen supply stopped. “She died, and so did everyone in her ward,” the woman said.

Oxygen supplies

India’s massive demand for oxygen has created both a bustling black market and a large charitable movement providing cylinders to patients with covid-19. Some hospitals tell patients to bring their own oxygen, while patients who cannot find a hospital bed often self-treat with oxygen at home. These patients may struggle as new government regulations instruct industrial oxygen suppliers to give their product directly to hospitals, rather than filling up individual cylinders.

Some hospitals also reported being close to running out of oxygen, particularly in Delhi and in neighbouring Uttar Pradesh state. The chief minister of Uttar Pradesh, Yogi Adityanath, of India’s ruling BJP party, told a meeting of police chiefs to take action against hospitals that reported oxygen shortages to “create fear.”

“Keep a watch on such people. Duly investigate all such incidents,” he said in a statement released later by his office. “If the scarcity was reported just to create fear, then strict action should be taken against [that] hospital.”