Kashmir's COVID19 crisis worsens with dearth of oxygen ports

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With increasing number of severely sick COVID19 patients flooding designated hospitals in Kashmir, limited number of beds with oxygen ports and limited cylinder supply are creating a crisis in management of the epidemic.

At SKIMS Soura, patients admitted in emergency and subsequently confirmed to have COVID19 infection continue to remain admitted in the emergency for days. The same emergency area has other patients, critically sick but negative for the viral infection. The delay in scooping out the COVID 19 patients and isolating them, a doctor at the hospital said, is not because of the dearth of space in the hospital, but because of the unavailability of oxygen beds. “Most of the COVID19 patients we admit are severely sick and need oxygen, but we have run out of oxygen beds,” the doctor said.

The failure to segregate patients, he said, was a “health catastrophe” given the rush of people in emergency and the high risk of other patients and attendants contracting the respiratory viral infection.

He said that although the administration of the hospital had designated 260 beds for COVID19, the number of oxygen beds was just 180. “In other beds, the hospital is using oxygen cylinders, which too are limited in supply,” he said.

A senior faculty member at SKIMS said that the Institute has three oxygen plants currently which have the generation capacity of 3200 liters per minute. The upgrade was carried out in January this year, prior to which the capacity of the single oxygen plant at SKIMS was just 750 liters per minute, he said, adding that 250 oxygen cylinders were also procured.

Currently, there are 450 oxygen cylinders in the Institute and these are catering to 80 COVID19 beds and hundreds of other patients who require oxygen. “We need cylinders in circulation. Not too many of them can be put in wards,” he said.

Currently, an official in health and medical education (H&ME) department said, approximately 300 patients severely sick with COVID19 are admitted to SKIMS Soura. “It is a struggle to arrange high-flow oxygen for everyone,” he said.

He said it was impossible to increase the number of oxygen ports to supply to more beds as that resulted in decrease in oxygen pressure and defeating the purpose of oxygen therapy to sick COVID19 patients.

At SMHS Hospital, the situation is ‘slightly better’, the H&ME official said. The hospital has designated 232 beds for COVID19, 180 of which have wall mounted oxygen. In addition, there is a stock of 800 oxygen cylinders at the hospital. The hospital has a 10 bedded ICU for COVID19 patients. “There is no scope to increase the number of ventilators or high-flow oxygen devices,” a doctor at the hospital said.

He said COVID19 patients required oxygen flow and the consumption of oxygen was at least five times more than other patients requiring oxygen.

In addition, with the rising number of cases and the rising demand for oxygen, the arrangement needs to be supported further, an official said.

“A month ago, SMHS Hospital had just 30 COVID19 beds. Now, the number has increased by 200,” he said.

He said the hospital was catering to load of COVID19 patients from across districts of Srinagar. “If things continue like this, no supply will be adequate,” he said.

District hospitals and other health centers designated for COVID19 in peripheries have “rickety infrastructure” and hardly any of these have an oxygen bank, the official said. As a result, all patients in need of oxygen or ventilator are referred to Srinagar based hospitals.

Financial Commissioner Health and Medical Education, Atal Dulloo agreed that demand for oxygen beds was putting a strain on supply at tertiary care hospitals. He said efforts were on at multiple levels to prepare more hospitals for severely sick COVID19 patients. Detailing, he said, 5000 oxygen cylinders had been procured by the department for COVID19. “Most of these will go to Kashmir division hospitals due to high requirements in the division,” he said.

In addition, 11 hospitals, 8 of them in Kashmir division, will be augmented with oxygen supply, he added. This augmentation, he said, will take load off the SMHS Hospital, SKIMS Soura and SKIMS Bemina. “We have also sought approval of the finance department for setting up oxygen generation plants in some big hospitals. However, that will take about six months,” he said.

“We are in the process of setting up a sophisticated oxygen cylinder filling plant at SMHS Hospital immediately,” he said.