Costs Go Up As States Face Oxygen Lack Because Of A Surge In Cases

: Admin : 2020-09-15

NEW DELHI: As Covid cases surge across India, some states already face an oxygen shortage. Many others are dependent for part or most of their oxygen supply on units outside the state. These face the threat of shortage as some states have tried to prevent oxygen being moved outside their borders, forcing the Union health ministry to issue a letter asking states not to restrict the movement.

The ministry letter was issued in response to the Maharashtra government’s order under the disaster management law that sought to prohibit movement of oxygen out of the state. Madhya Pradesh and Karnataka faced a shortage after Maharashtra stopped supplies on September 7, by upping the share of oxygen production to be kept for itself from 50% to 80%.

It was reported that four patients died in Dewas district in MP due to oxygen shortage, which the government denied, but admitted that there was a shortage. Four districts — Dewas, Jabalpur, Chhindwara and Damoh — faced oxygen shortage last week after Nagpur-based units suddenly stopped supply.

Punjab, too, imposed restrictions on state-based manufacturers selling to other states even as it reached out to Himachal, Uttarakhand and Haryana to augment its supplies. Similarly, there was a shortage in Agra as the demand surged in Delhi and the supplier to the city depended on plants located in the Delhi region. Jhansi and the rest of Bundelkhand in UP were hit when there was a surge in demand in Indore and Bhopal in neighbouring MP.
In Kerala, though 60% is supplied by a company located within the state, the rest is by companies with units located in Tamil Nadu. However, there has been no shortage so far in the state.

In Karnataka, in mid-August, 13 of the 19 district hospitals did not have in-house oxygen cylinders and 50 patients had to be shifted out of a hospital in Bengaluru due to oxygen shortage. The state is still struggling. The demand has shot up to 500 metric tons per day from just 100-150 metric tonnes pre-Covid, said Gaurav Gupta, principal secretary, department of commerce and industry, who heads the committee to ensure oxygen supply. He said the demand was being met by augmented supply.

Along with shortages, many states are also seeing an escalation in oxygen prices though the ceiling price per cubic metre of oxygen was fixed by the National Pharmaceutical Pricing Authority last year at Rs 17. In Telangana, after the authorities started importing oxygen from northern states, the prices jumped from Rs 10 per cubic metre to Rs 50 per cubic metre. In Andhra Pradesh, though prices have not increased much, private hospitals are charging way higher than they used to for oxygen beds.

In Karnataka, the price depends on the type of contract with the manufacturer. For old contracts between manufacturing companies and hospitals, it costs Rs 13-18 per cubic metre, whereas for new contracts the cost is Rs 24-25 per cubic metre. For spot contract during emergency supply, it costs Rs 40 per cubic metre. For private hospitals, the price went up from Rs 20-22 to Rs 30-35 and then to Rs 40 per cubic metre. Private hospitals had agreed up to Rs 7,000 per day charge for government-referred Covid patients when they need high-flow nasal oxygen, but treatment now cannot be given at this price, said Dr Prasanna HM, managing director, Pristine Hospital in Bengaluru.

In Uttar Pradesh, officials confided that the cost has gone up about three-fold. The price of a small cylinder of oxygen, for instance, has gone up from Rs 130 to Rs 315-350. Some companies have doubled the security amount taken against each small cylinder from about Rs 5,000 to Rs 10,000.

In Bihar, Gaurav Rai, a Covid-19 patient who started an oxygen bank after recovering, said 10-litre oxygen cylinders being sold for Rs 8,500 during the crisis were earlier available for about Rs 7,000. In Gujarat, too, the price of one litre of oxygen has jumped from Rs 8.5 to Rs 28-35. In Odisha, the price of a cylinder has gone up from Rs 6,500 in July to Rs 10,000 now. For refilling of cylinders (10 litres), the price has more than doubled from Rs 350 in July to Rs 900 these days. Smaller private hospitals are bearing the brunt. Big corporate hospital say there is no implication on supply and pricing for them because they have annual contracts with suppliers.

Many hospitals in Mumbai complained of shortage in supply. "The real problem behind the shortage is the differences between suppliers and private hospitals on prices. Both the parties have to iron out their disputes," said Panvel City Municipal Corporation deputy commissioner Sanjay Shinde. Kharghar-based Polaris Hospital manager Ashok Kumar said, "There’s no regular supply. Our demand is 25 to 30 cylinders of 7,000 litres a piece. But we get less than half of it." Dr Hema Bindu of Satyam Hospital, Kalamboli, said, "The consumption of medical oxygen for critical covid patients has increased manifold in the last few days. This has led to demand-supply mismatch. We are getting the supply with much difficulty."

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