‘Near breaking point’: An unending loop of oxygen shortages and tragic deaths in Delhi hospitals

After being infected with Covid-19, sixty-two-year-old Prakash Dutt Dwivedi admitted himself at the Batra Hospital and Medical Research Centre in South Delhi on April 26. On May 1, his relatives got a call at noon from the hospital saying Dwivedi’s condition was deteriorating.

“Within 15 minutes we found out that he passed away,” said Amit Bharadwaj, Dwivedi’s relative.

The cause of death was not simply Covid-19, however. “When we reached the hospital we saw a lot of crowd there and then we found out it happened because of an oxygen shortage,” Bharadwaj said.

On May 1, at least 12 patients died at Batra Hospital after the facility fell short of medical oxygen, crucial in the treatment of Covid-19. The hospital had confirmed that the deaths had taken place because of a shortage in oxygen.

This is not the first such incident to take place in the capital. For at least two weeks now, Delhi’s hospitals have been starved for oxygen. Most of them have resorted to putting SOS requests for oxygen on social media, a cycle that repeats itself almost daily.

And the depleting stocks and delayed supplies have had devastating results. At least 20 patients under critical care died at Jaipur Golden Hospital in North West Delhi on April 23. The hospital cited a dip in oxygen pressure and approached the Delhi High Court to seek help in maintaining continuous oxygen supply.

Around 25 critically ill patients died between April 22 and 23 at Sir Ganga Ram Hospital, a private facility in Central Delhi. The hospital said it had only an hour’s worth of oxygen left. However, it did not ascribe the deaths to lack of oxygen, claiming instead that a number of its patients were already in a serious condition.

While Delhi has been hit hardest by the oxygen crisis, hospitals in other Covid-hit parts of the country seem to be grappling with the same issue.

In Karnataka’s Chamarajnagar, 23 patients died after a district hospital ran out of oxygen on May 2, though authorities insist not all deaths can be ascribed to the shortage. The Allahabad High Court on May 4 said that deaths of patients in hospitals due to a lack of oxygen “is a criminal act and not less than a genocide” by authorities.

Oxygen wars

The crisis has been most acute in Delhi.

Since the start of the second wave, Delhi has recorded over 20,000 cases daily. Patients have scrambled for beds, oxygen cylinders and medicines. And hospitals too have not been spared as several have flagged depleting levels of oxygen in their supplies. Some have even approached the Delhi High Court to ensure supplies.

At the heart of the matter lies the fragmented responsibilities among various authorities in the capital. For over a week, the Delhi government and the Centre have sparred over the allocation and supply of oxygen at multiple hearings in the Delhi High Court. The Centre is in charge of procuring and allocating oxygen to the states.

The Aam Aadmi Party-led Delhi government claims that the Centre does not supply adequate quantities of oxygen as per its demand. While the Centre maintains that the supplies of oxygen are adequate, and that Delhi is not arranging for the oxygen to be picked up by tankers.

The projection for Delhi’s medical oxygen requirement stood at 445 metric tonne as on April 30. This projection was however revised to 700 metric tonne out of which the Centre only allocated 490 metric tonne, according to the Supreme Court’s order while hearing a suo motu case on the handling of the pandemic. Delhi government officials have claimed that even this 490 metric tonne allotment has rarely been provided in full.

Despite courts passing orders on the matter, the situation remains the same.

Every few hours, a hospital takes to Twitter to say that its supplies are about to run out. A children’s hospital, where over 25 babies and children were in the ICU, sounded the alarm bells over its oxygen supply on May 2. On Tuesday evening, the Indian Army’s Base Hospital in the city flagged shortages in its medical oxygen supply. It alleged that the shortage came about after a “substantial cut” in its supply by the Delhi government.

And the ongoing bickering between the two authorities has left several hospitals in the lurch.

“It is a great tragedy that is unfolding,” said Dr Sudhanshu Bankata, the executive director at Batra Hospital. After the deaths of 12 patients, the hospital has scaled down its admissions to match the oxygen availability, he said.

“We need to reach a lower figure to match the oxygen supply,” Bankata said.

The limited resources and workforce had severely impacted the functioning of the hospital.

“Everybody is near breaking point,” Bankata said. “It is too much and everyone has their own personal tragedy also – where a family member or a doctor has fallen prey.”

In addition to that, hospitals were uncertain of oxygen supply. “If that is not rectified then we will be stuck in this loop,” Bankata said. “This crisis is no secret other than the fact that the people who have created the crisis say there is no crisis. Let us not get fooled by the rhetoric. It is a manmade disaster.”

‘A big loss’

Apart from hospitals, families too were left grappling with the situation.

Fifty-seven year old Sanjay Seth worked as a banking executive in South Delhi and was admitted at Batra Hospital as a Covid patient for nearly 20 days, said Sandeep Malhotra, his brother-in-law.

Hospital staff had told Malhotra that Seth was showing signs of recovery. “His oxygen levels were low initially but slowly he recovered,” said Malhotra, 54.

But on May 1, Malhotra received a call from the hospital. The authorities informed him that they had run out of oxygen and that Seth was critical. “By the time we reached [at noon], he had died,” said Malhotra. “At least they should have told us that the oxygen is over,” he said. “It is a big negligence on the part of the hospital.”

Seth’s family including his wife and two children were also infected with the virus. But they recovered at home under isolation. Seth’s 82-year old mother had survived as well. “She is still in shock,” Malhotra said. “It is a big loss. We are very disturbed.”

‘In front of me’

On April 4, Delhi High Court advocate Atul Bansal, 54, developed a fever and was admitted to Jaipur Golden Hospital on April 8. His fever did not subside and he was admitted to the ICU unit four days later after his oxygen levels dropped, said his relative Archit Aggarwal, a dermatologist.

Bansal started to recover and the family expected him to be shifted out of the ICU ward, Aggarwal said. “He was eating and going to the toilet on his own,” he said.

On April 23, the family received a call from the hospital at 7 pm – Bansal had suffered from a cardiac arrest and the staff had tried to resuscitate him. “When I reached there an hour later, his oxygen saturation was at 70% but the nurse said it was 90% when she checked,” Aggarwal said. “In front of me, his oxygen levels dropped.”

Bansal was one of the 20 patients who died at Jaipur Golden Hospital that day.

The hospital was clearly on edge. “There were a lot of paramilitary and some people were fighting over an oxygen tanker,” Aggarwal said. “A lot of people in the hospital started to panic, and attendants started to cry.”

On the next day, Aggarwal found out through news reports that the hospital had run out of oxygen. The hospital had not informed him about it, he claimed. “If they had told us an hour before then we could have got cylinders,” Aggarwal said.

“If a patient is critically ill and if they do not get oxygen then they will suffer a cardiac arrest,” he said. “The oxygen speed in the ventilator was fluctuating between 20 and 90 as well but I did not know who to tell.”

Bansal is survived by his wife and two daughters. But they were still struggling to grasp what had happened. “She [his wife] was not willing to give up the ashes,” he said. “We had gone to the Ganga twice.”