The recent second wave of COVID-19 has seen an unprecedented surge in demand for Liquid Medical Oxygen (LMO) across India. The crisis has been aggravated by the scarcity of tankers and complex logistics necessary for its transportation from distant production sites.
Understanding Liquid Medical Oxygen
Liquid Medical Oxygen, or LMO, is a high-purity oxygen variant suited for use in the human body and plays a pivotal role in various medical treatments. LMO facilitates most modern anaesthetic techniques, enhances tissue oxygen tension by augmenting oxygen availability, aids cardiovascular stability, and more. It features on the World Health Organisation’s List of Essential Medicines and is included under the National List of Essential Medicines (NLEM) according to the Drug Prices Control Order of 2013.
LMO Production in India
India houses a daily oxygen production capacity of roughly 7,100 Metric Tonnes (MT), catering to both medical and industrial needs. Amid the overwhelming crisis, production has escalated to 8,922 MT with an approximate daily sale pegged at 7,017 MT. Predictions are that domestic production will surpass 9,250 MT per day by April-end 2021, implying that India possesses sufficient oxygen production capabilities to manage the current demand.
Factors Causing the Crisis
The crisis can be attributed to several factors:
Production Plant Locations
Most LMO plants are situated in the east of India, resulting in long transportation routes and a turnaround time of at least 6-7 days for each tanker. Additionally, some states have been reported to detain tankers en route further exacerbating the problem.
Limited Availability of Tankers
India currently has only 1,224 dedicated LMO tankers with a collective capacity of 16,732 MT. Given the monumental demand for LMO, reaching as high as 3,500-4,000 MT at certain times, this fleet size is inadequate.
Reluctance to Invest in Cryogenic Tankers
Cryogenic tankers, capable of storing medical oxygen at temperatures as low as -180 degrees Celsius and fitted with double-skin vacuum-insulated containers including a stainless-steel inner vessel, cost approximately 50 lakh rupees each. Companies hesitate to purchase these due to fears of them turning into financial burdens post the crisis.
Leakages and Irrational Use
In the past, authorities have advised hospitals to minimize wastage and unnecessary oxygen use. Industrial experts have also voiced concerns regarding potential leakages in hospital pipelines that circulate oxygen. Black marketing of oxygen cylinders is another disturbing issue.
Government Initiatives in Response
To combat the crisis, several initiatives are underway:
Oxygen Express Trains
To expedite LMO and oxygen cylinder distribution across the country, special trains have been commissioned.
Utilizing Disaster Management Act 2005
The Ministry of Home Affairs has enforced the Disaster Management Act, 2005 to ensure unobstructed inter-state movement of oxygen carrying vehicles.
Restarting Closed Plants
Many closed production facilities like the Sterlite plant in Tamil Nadu are being recommissioned to enhance LMO supply.
Employing Air Force Aid
To hasten transportation, the Indian Air Force is airlifting empty oxygen tankers to industrial units that have transitioned to producing medical-grade oxygen.
Oxygen Enrichment Unit (OEU)
Developed by scientists of Council of Scientific and Industrial Research-National Chemical Laboratory (CSIR-NCL), an Oxygen Enrichment Unit reduces the requirement for ventilators and oxygen cylinders in homecare, villages, and remote areas, especially significant during the ongoing COVID-19 pandemic. Supplemental oxygen during early stages can aid faster patient recovery.
