Written by Sunil Kumar
When Covid-19 patients do not respond to treatment at home, their oxygen requirement increases. Such patients are typically admitted to hospitals that have facilities to administer this life-saving gas. The overall oxygen demand did increase in the country during the first wave, but it was managed well by mobilising oxygen from the resources within the country. India, therefore, dealt well with the first wave of the pandemic.
The second wave challenged and overwhelmed our healthcare resources, especially with respect to the availability of oxygen. The government mobilised medical oxygen on a large scale from all possible resources. However, the availability of cryogenic tankers for transportation and great distances to be covered from the big oxygen generating plants to hospitals proved to be limiting factors. It soon became apparent that transporting oxygen in tankers to the hospitals was not a sustainable and best solution. The hospitals had to be made self-reliant in terms of oxygen generation.
In an internal meeting of the Union Health Ministry on April 23, the Minister directed to ensure fast track installation of the medical oxygen generation plants in five central government hospitals: AIIMS JPN trauma centre, Safdarjung Hospital, RML Hospital, LHMC and Associated Hospitals and NCI, AIIMS Jhajjar. This was a game changing decision.
DGHS (MOHFW, GOI) teamed up with scientists/technical officers from DRDO and visited these five hospitals and finalised the site for installation of these oxygen generating plants in consultation with hospital authorities within 24 hours. The order for installation of the five oxygen plants at these five sites was placed the next day.
The entire project was closely monitored on a day-to-day basis by all the top brass of the Union Health Ministry. The Medical Superintendents of Safdarjung and RML Hospitals and the Director of LHMC, Nodal officer from AIIMS-JPN trauma Centre and NCI facility of AIIMS, New Delhi in Jhajjar (Haryana) supervised the preparation of sites in terms of civil, electrical and oxygen pipeline work for installation of the plant.
In the meantime, senior scientists from DRDO ensured that the plants under construction met quality standards. The Indian Airforce provided its services in air-lifting the oxygen generating plants in semi-knocked down condition, as the sites in hospitals got ready. The plants were installed/commissioned one by one — on May 7 at AIIMS, on May 10 at JPN Trauma Centre, and RML hospital on May 16 at Safdarjung Hospital, on May 17 at NCI, Jhajjar and, finally, on May 18 at LHMC.
These plants function 24 hours a day, producing 960L of medical grade oxygen per minute. They are based on the pressure swing adsorption (PSA) technology developed by DRDO and produced by M/s Trident Pneumatics Pvt Ltd. Coimbatore. These are compact and can operate under all weather conditions. The hospitals have reported satisfaction on the performance of these oxygen generation plants. No noise pollution issue has been reported. These plants are easy to operate and maintain — the first maintenance measure is scheduled after 4,000 hours; so they can run for about six months. A few hours of orientation and training to the technical persons (already available with the hospitals) is all that is required. These plants work on electricity and do not require polluting diesel.
They generate oxygen from ambient air by employing PSA technology for separating oxygen and nitrogen by passing air at high pressure through a zeolite bed. Once fully functional, these plants do away with the need for transporting liquid medical oxygen.
The government plans to install more than 1000 such oxygen generating plants in public healthcare facilities across the entire nation in its efforts to strengthen the health infrastructure. This will help us to not only fight the pandemic but also deal with other health crises.
The writer is Director General Health Services, Ministry of Health & Family Welfare, GoI