On 12 September, Dr Amit Thadhani, the medical director of Niramaya Hospitals in Panvel, spent 16 hours trying to find oxygen. Thadani runs the 55-bed hospital that is now a COVID-19 facility and needs 70 oxygen cylinders a day for his patients. Thadhani had placed orders with various oxygen dealers to meet this requirement. By that afternoon, he received only 20 cylinders against one order for 50 cylinders. By the evening, he started to look for other hospitals where he could move his patients. “By the end of the day, after making many calls and making my staff run around town, we were able to source our daily requirement of oxygen, but by then we had already shifted two of our most critical patients to another facility,” Thadani said.
Many medical facilities, especially smaller hospitals and nursing homes, repeatedly ran out of oxygen since late August, as the number of oxygen-requiring COVID-19 cases rose in Maharashtra. Oxygen manufacturers told me that demand for medical oxygen more than doubled since the epidemic started spreading. Oxygen dealers said there is a crippling lack of supply-chain infrastructure, which can result in oxygen not reaching hospitals.
Maharashtra had the highest burden of COVID-19 in India by mid-September, with close to three lakh active cases. It also had the second-highest case-fatality ratio—the number of deaths as a proportion of the number of people reported infected. The pattern observed through this pandemic has been that most deaths occur after severe respiratory distress.