The COVID-19 third wave in India is inevitable, say health experts. But are our hospitals prepared for a COVID third wave? Especially if it is as horrifying as the second wave that cost thousands of lives due to lack of oxygen and our healthcare infrastructure’s inability to cope?
The Quint visited some key Delhi government hospitals for a reality check on their preparedness in the event of a COVID-19 third wave.
Our focus was on whether the Pressure Swing Adsorption (PSA) Oxygen plants promised by the Centre and State had been installed at these hospitals. As we know, during the deadly second wave, Delhi depended on the Central Government for oxygen supply and saw acute shortages. But with the help of in-house PSA oxygen plants, the intention was for Delhi’s hospitals to be able to generate their own oxygen.
We found that most Delhi government hospitals have installed or are in the process of installing PSA oxygen plants. But we also found that these plants would fall short in capacity in a crisis. Hence, the dependency on Liquid Medical Oxygen (LMO) would continue.
The biggest problem with LMO is transportation from source to the hospitals that need them. Unavailability of oxygen and gaps in transportation often led to loss of lives during the second wave.
Raja Harish Chandra Hospital – 4 PSA Oxygen Plants
Our first stop was Raja Harish Chandra Hospital in Narela, North Delhi. This 200 bed hospital was a COVID-19 hospital during the second wave. It is supposed to have 4 PSA oxygen plants with an overall capacity of 930 LPM (Litres Per Minute). One plant funded by PM CARES Fund is up, another funded by France in May 2021 is also running. But two other PSA oxygen plants to be funded by Delhi government are yet to be installed.
Medical Superintendent Sanjay Kumar Jain also said that the hospital is in the process of adding 200 to 400 beds, but hiring experienced medical staff could be a big challenge.
‘Oxygen Purity of PSA Oxygen Plant Is 93%’
Another challenge that hospitals relying on PSA oxygen plants will face is the purity of oxygen. As per experts, oxygen purity of PSA oxygen plants is merely 93% and not advisable for patients on ventilators.
A senior hospital staff member, on the condition of anonymity, told The Quint that a single 1000 LPM capacity PSA oxygen plant instead of four plants would have been more cost effective, as it would have required fewer technicians to operate it.
Jain accepted that during the second wave they faced problems at multiple levels – from lack of oxygen to massive influx of patients. Even shifting patients with oxygen cylinders from one floor to another had been tough due to shortages of trolleys and staff.
Bhagwan Mahavir Hospital – PSA Oxygen Plant Yet To Be Installed
Our next stop was the 321 bed Bhagwan Mahavir hospital in Pitampura, North-West Delhi. As per hospital sources, the management plans to increase the number of beds to 744. But it is still uncertain by when.
The hospital is likely to be declared a COVID-19 hospital in the third wave. A senior doctor at Bhagwan Mahavir hospital, on the condition of anonymity, told The Quint said that a 1000 capacity PSA oxygen plant and LMO plant are in the process of being installed in the hospital.
The doctor also underlined the lack of manpower in the hospital. ‘Merely oxygen plants are not enough, we need technicians and doctors to operate them,’ said the doctor.
The doctor added that apart from PSA oxygen plants, the hospital also has oxygen concentrators and oxygen cylinders to cater to oxygen needs.
Jag Parvesh Chandra Hospital – Will Be a COVID Hospital in 3rd Wave
From Bhagwan Mahavir hospital we went to Jag Pravesh Chandra Hospital at Shastri Park in North East Delhi. The hospital’s Medical Superintendent Dr. Adarsh Kumar spoke to us on the phone.
Kumar said that an 800 litre PSA oxygen plant is likely to be installed by the end of September 2021.
Jag Pravesh Chandra hospital is a 200 bed hospital. The Delhi government plans to convert 100 beds into oxygen beds and 100 beds into ICU beds during the COVID third wave.
‘We have floated tenders for Liquid Medical Oxygen plant and very soon we will finalise the vendor,’ said Kumar. The Delhi government has allowed recruitment of 25% extra medical staff so that it can function as a COVID hospital. Kumar said the hospital will recruit more medical staff soon.
Some of the other Delhi government hospitals that have installed PSA Oxygen plants are Maharishi Balmiki Hospital, Deep Chand Bandhu Hospital and Rao Tula Ram Memorial Hospital. While Dr. Hedgewar Aarogya Sansthan is still uncertain about the installation plant.
Though the Delhi government has installed PSA oxygen plants, the dependency on LMO or Liquid Medical Oxygen will remain. And that is a big worry. The Quint