With Covid-19 cases surging and medical oxygen in short supply, the Centre on Sunday announced in-principle approval for 551 dedicated Pressure Swing Adsorption (PSA) medical oxygen generation plants, to be set up in identified government hospitals in district headquarters across the country using PM-CARES funds. Separately, the Home Ministry issued an order directing states to use all available liquid oxygen for medical purposes only. India on Sunday reported 3,49,691 coronavirus infections and 2,767 deaths over the preceding 24 hours, a new record. The country’s active caseload was 26,82,751, and the national daily positivity rate stood at 20.34 per cent. Eight states of concern — Maharashtra, Chhattisgarh, Uttar Pradesh, Karnataka, Rajasthan, Tamil Nadu, Gujarat, and Kerala — cumulatively account for 69.94 per cent of India’s total active caseload. On Sunday, the Health Ministry issued guidelines on intense action and local containment measures for districts that have reported a test positivity of 10 per cent or higher in the last one week, or more than 60 per cent occupancy of oxygen-supported or ICU beds. “The District Collector should undertake a daily status review, including analysing details of case trajectory, day-to-day operational planning, implementation of various activities,” the Centre told states. Consolidated reports must be sent to the Government of India, it said. Surge districts have been told to conduct daily death audits in hospitals, specifically monitor high-risk cases, and shift elderly and co-morbid contacts of positive cases to quarantine centres for monitoring. In a statement, the Prime Minister's Office said: “PM has directed that these [PSA] plants should be made functional as soon as possible. He said that these plants will serve as a major boost to oxygen availability at the district level.” The “basic aim” behind establishing the plants at government hospitals in the district headquarters “is to further strengthen the public health system and ensure that each of these hospitals has a captive oxygen generation facility”, the statement said. “Such an in-house captive oxygen generation facility would address the day-to-day medical oxygen needs of these hospitals and the district.” The Centre said that the procurement of the 551 PSA plants would be done by the Ministry of Health and Family Welfare. Last week, the Centre had said that out of the 162 PSA sanctioned earlier under PM-CARES, 33 had been installed. The 162 plants, for which Rs 201.58 crore have been allocated, are expected to augment medical oxygen capacity by 154.19 metric tonnes (MT). Fifty nine PSA plants are expected to be installed by the end of April, and another 80 by the end of May. The Centre said that of the 33 PSA plants that have been installed, five are in Madhya Pradesh, four in Himachal Pradesh, three each in Chandigarh, Gujarat, and Uttarakhand, two each in Bihar, Karnataka, and Tamil Nadu, and one each in Andhra Pradesh, Chhattisgarh, Delhi, Haryana, Kerala, Maharashtra, Punjab, Uttar Pradesh, and Puducherry. The 551 plants to be established in the district hospitals will serve as a “top-up” to the captive oxygen generation at health centres, the government said on Sunday. “Such a system will go a long way in ensuring that government hospitals in the districts do not face sudden disruption of oxygen supplies and have access to adequate uninterrupted oxygen supply to manage the Covid-19 patients and other patients needing such support,” the statement said. Meanwhile, sources said that Sunday's Home Ministry order to states was applicable only for “liquid oxygen”, and that industries that use gaseous oxygen can continue to do so in accordance with directions issued by the Ministry earlier. While diverting industrial oxygen for medical purposes through an earlier order, the government had exempted nine industries. These nine industries will continue to be exempted after Sunday's order, the sources said. “The Central Government has reviewed the oxygen supply situation and has decided that with immediate effect, use of liquid oxygen, including the existing stock, will be allowed for medical purposes only, and that all manufacturing units may be allowed to maximise their production of liquid oxygen, and make it available to the Government, for use for medical purposes only,” the order issued by Union Home Secretary Ajay Bhalla said. Invoking the Disaster Management Act, the order directed states and Union Territories to ensure that use of liquid oxygen is not allowed for any non-medical purpose. “.All stocks of liquid oxygen should also be made available to the Government for use for medical purposes. No exception is allowed to any industry with regard to use of liquid oxygen,” the order said. Industry sources said the order essentially means that industries which have captive oxygen plants will not be allowed to store the gas, which is done in liquid form, and that any oxygen that is stored will have to be diverted for medical purposes. Large industries typically use oxygen in gaseous form through pipes from their captive plants. They also store about 5-10% of their production in liquid form to meet peak demand. This, sources said, will not be allowed, and will be applicable even to exempted industries. Beginning April 22, the Centre had restricted the use of oxygen in industries, and diverted the resource to meet the high demand in hospitals. This was not applicable to certain critical industries, including pharmaceuticals, petroleum refineries, steel plants, nuclear energy, and oxygen cylinder manufacturers, etc.
