PARIS: Difficulty breathing is one of the most common severe Covid-19 symptoms, and as photos of people waiting in long lines for oxygen canisters in India and elsewhere attest, supplies of medical oxygen are far from adequate everywhere in the world.

India is only the latest country to confront a lack of medical oxygen supplies. Earlier in the pandemic there were similar scenes of long lines in countries such as Brazil, the Democratic Republic of Congo, Peru and Venezuela.

Unitaid, a global initiative that helps low- and middle-income countries confront public health challenges, puts the lack of supplies of medical oxygen down to its cost, limited infrastructure and logistical difficulties.

Medical oxygen is key to treating people in respiratory distress, whether at home or in hospitals. According to the World Health Organisation (WHO), one person in five suffering from Covid-19 needs medical oxygen to ensure that the level of oxygen in their blood is sufficient.

How much is needed

In February, the WHO estimated that half a million people needed 1.2 million oxygen canisters a day.

Unitaid put the price tag of helping the countries facing the greatest need at $1.6 billion this year.

It has identified some 20 countries facing the greatest difficulties with oxygen supplies, including Malawi, Nigeria and Afghanistan.

How is oxygen made?

Oxygen is made in two ways: Medical oxygen is made by separating the oxygen from other gases and impurities found in air by repeated steps of compression, filtration and purification, according to Air Liquide Sante France.

Such medical oxygen reaches more than 99.5 percent purity and is rigorously tested.

It can be highly compressed into a liquid form, but has to be maintained below -182C, which according to Air Liquide Sante France is the best way to meet variations in demand as one litre of liquid oxygen is the equivalent to around 800 litres when it is in normal gas form.

Canisters that can travel with patients with one litre of compressed litres of oxygen contain about 200 litres of normal oxygen.

What’s being done for India

The Indian military has used its cargo aircraft to transport oxygen tanker trucks where supplies are lacking, and a train called the Oxygen Express was put into service on April 22.

The military has also said it plans to import 23 mobile production units from Germany.

France plans to send eight such units that will be able to produce enough oxygen to serve 10,000 patients a day. It also plans to ship 200 tonnes of liquid oxygen to Indian hospitals.

Published in Dawn, April 29th, 2021