• • As India grapples with an unprecedented new wave of the COVID pandemic we at RIL, a 300 Bn USD company have risen to the occasion by making an all-out effort to save precious lives.
  • Amid a surging second wave of COVID-19 in the country, we have ramped up production of medical oxygen to 1000 metric tons per day, making us India’s largest producer of medical-grade liquid oxygen from a single location.
  • Traditionally we have never been a manufacturer of medical grade liquid oxygen.
  • For us and for all of us at Reliance, nothing is more important than saving every life as India battles against a new wave of the Covid-19 pandemic.
  • There is an immediate need to maximise India’s production and transportation capacities for medical grade oxygen. We are proud to have worked tirelessly, with a great sense of patriotic urgency, to meet this new challenge.
  • We ramped up production from near-zero to 1,000 tonnes per day at our refinery-cum-petrochemical complex in Jamnagar and other facilities and now produce over 11 per cent of the country’s oxygen demand meeting the needs of nearly every one in ten patients.
  • We have rallied our resources to meet the daily need of over 1 lakh people every day.
  • We are personally supervising the scale-up of production and transportation at Jamnagar in Gujarat under personal presence of our Chairman Mr Mukesh Ambani.

  We adopted a two-pronged approach to strengthen the availability of medical oxygen.

  • One: refocusing several industrial processes at Reliance’s Jamnagar and other facilities for rapid scale-up in production of medical grade liquid oxygen. We did this overnight.
  • Two: augmenting loading and transportation capacities to ensure its swift and safe supply to states and union territories across India.
  • At our refinery-cum-petrochemical complex in Jamnagar and other facilities, we now produce over 1,000 tonnes of medical-grade liquid oxygen per day — or over 11 per cent of India’s total production —
  • Our oil refineries and petrochemical plants produce industrial oxygen as part of processes. This was scrubbed to produce high-purity medical grade oxygen. Also, we converted nitrogen tankers into transport trucks to move medical grade oxygen.
  • In April we supplied over 15,000 mt of oxygen free of cost, helping nearly 15 lakh patients.
  • A critical need of the hour is assured availability of medical-grade liquid oxygen for the treatment of severely ill patients across the country.
  • The oxygen manufactured by the us would be provided free-of-cost to several states across the country to bring immediate relief to over 1 lakh patients on a daily basis.
  • Since the beginning of the pandemic in March last year, we have supplied over 55,000 MT of medical-grade liquid oxygen across the country.
  • Our country is going through an unprecedented crisis. Our Reliance Foundation will continue to do everything we can to help. Every life is precious and we have set up a 1000 bed hospital as well in Jamnagar.
  • Our thoughts and prayers are with our fellow countrymen and women. Together, we will overcome these difficult times.

  Logistics

  • In addition to the production of high-quality medical-grade liquid oxygen, the other challenge has been to quickly overcome the transportation bottleneck in the supply of liquid oxygen to various parts of the country. This necessitated increasing the loading capacity for its safe and quick transportation.
  • To achieve this we made logistical modifications to rail and road transport, such as laying parallel lines, using hoses, and loading up liquid tankers through pressure differential since liquid oxygen pumps cannot be installed at short notice.
  • We also airlifted 24 ISO containers for transporting Oxygen from Saudi Arabia, Germany, Belgium, The Netherlands and Thailand — creating an additional 500 tonnes of transportation capacity for Liquid Oxygen.
  • These ISO containers will help in removing the transport constraints for medical-grade liquid oxygen in the country. In addition, Reliance is airfreighting more ISO containers over the next few days.
  • In another innovation, we converted nitrogen tankers into transport trucks for medical grade oxygen through innovative and safe processes that were approved by the Petroleum and Explosives Safety Organization (PESO), the relevant regulatory body of the Government of India.
  • Prior to the pandemic we have never been a manufacturer of medical-grade liquid oxygen. Starting from nil before the pandemic, we have now become India’s largest producer of this life-saving resource from a single location.
  • Medical grade liquid oxygen has to be produced in liquid form at -183°C with almost 99.5% purity, which poses extraordinary challenges and risks in production and maximizing tonnage.
  • The tankers can hold and transport up to 40,000 litres of liquid oxygen to large makeshift Covid facilities and hospitals.
  • We have also bought tanks for storage at Jamnagar as well at the hospitals.
  • Oxygen moves through tankers to big hospitals where it is put in storage created for the purpose. Smaller hospitals or nursing homes get their supply in cylinders, which are also in short supply. The number of cylinders and tankers required should ideally be double that of the oxygen demand because empty ones go for refilling. This situation can be avoided if hospitals themselves host small oxygen plants.

  Country Arrangements

  • The demand for medical oxygen has jumped manifold amid the second wave of Covid.
  • On an average, a patient occupying an oxygen bed requires 10 litre oxygen per minute and those in the ICUs require 24 litre oxygen per minute.
  • Out of 100 COVID-19 patients, only three require admission in the ICU and around 17 with “moderate disease” will need oxygen beds.
  • Flow of oxygen should be adjusted to the lowest permissible level to target an oxygen saturation of 92%-94% for the hospitalised COVID-19 patients.
  • Hospitals must avoid indiscriminate use of non-invasive ventilation methods on patients and said Bilevel Positive Airway Pressure (BIPAP) should be preferred to High Flow Nasal cannula (HFNC) as the latter consumes enormous amount of oxygen.
  • India so far only has 1,224 tankers with a capacity of 16,732 MT to carry medical oxygen. The government is in the process of manufacturing more cryogenic tankers, with some foreign countries also sending such tankers on lease through commercial agreements.
  • Apart from the current generation of liquid medical oxygen, the steel sector has made available the liquid oxygen in its storage tanks for medical use [approximately 16,000 MT LMO is available as on April 21]. Till date the steel industry has supplied 1,43,000 MT of LMO since September, 2020. As such, in April 2021, supplies of LMO by the steel sector have increased from 1000 MT per day in the first week of April 2021 to around 2600 MT on April 21.
  • Steel plants use oxygen in gaseous form but they can also produce a specific quantity of liquid oxygen for medical use. Steel plants are the main suppliers of medical and industrial oxygen in India.
  • Linde — whose two affiliates in the country are Linde India and Praxair India — and other suppliers are ramping up production to a total of more than 9,000 tonnes per day.
  • A logistics crisis impeding the speedy movement of oxygen from surplus regions in eastern India to hard-hit northern and western areas would also be resolved in the coming weeks as more distribution assets are deployed.
  • At least 14 countries have already started sending their material in aircraft and ships, and they are being sent out, mostly to government hospitals.
  • UK, Ireland, Romania, Russia, UAE, USA, Taiwan, Kuwait, France, Thailand, Germany, Uzbekistan, Belgium and Italy, among others are the countries that have been sending oxygen concentrators, some have been building oxygen plants, some are sending ventilators, while others are sending rapid testing kits, and essential medicines.

  Oxygen transportation is not easy

  • The nature of oxygen produces the biggest challenge in its transportation. This is essential for life and it is also highly inflammable. The vacant tankers of oxygen can be transported from one place to another by the Air Force planes in merely a few hours but full tankers cannot be transported like this. The trains carrying liquid medical oxygen (LMO) cannot run with speeds of more than 60–65 km per hour and tankers on the road carrying this liquid cannot be racing at speeds above 50km per hour.

  Cryogenic tankers have been purchased to carry oxygen

  • Due to the inflammable nature, it is not possible to transport liquid oxygen in a plane. This is the reason that despite its availability at the plant, its transportation becomes a challenge and it took many days before it reached the hospitals where it was required. No arrangement was enough to meet this sudden rise in demand. There were not enough tankers available to carry the oxygen nor filling stations were nearby. That is why the private companies had to chip in to help. The cryogenic tankers were purchased for this purpose. This liquid oxygen turns solid at a temperature of -219 degrees Celsius and it turns into vapour at -182 degrees Celsius. So a cryogenic tanker is required to transport liquid oxygen which is made from a special metal.
  • India was importing around 100 cryogenic containers to transport large quantities of liquid medical oxygen, with Linde providing 60 of those. Some are being flown in by Indian Air Force aircraft. Four cryogenic tanks for transportation of oxygen were brought from Singapore. IAF C-17 aircraft are airlifting more empty O2 containersfrom Dubai.
  • Many of these containers will be placed on dedicated trains that would cut across the country, each carrying between 80–160 tonnes of liquid oxygen and delivering to multiple cities.
  • At the Deendayal port of Kandla, a special cylinder iron has been imported by ships to make oxygen cylinders. Oxygen concentrators have been brought from Singapore by flights. Portable oxygen generators are imported from France. At all the steel plants in the country, be it private or public sector, industrial grade oxygen is being converted into medical grade oxygen on a war footing. Oxygen Express is plying on railway tracks. Oxygen tankers are allowed through green corridors. The Centre has announced to provide Rs 200 crore for installation of 162 pressure swing adsorption ( PSA ) oxygen generation plants in every district of the country. The Health and Family Welfare Ministry had to get these plants installed and the concerned state governments had to make the land available and prepare the site for this. Government took the decision of installing PSA plants in 551 districts of the country and the budget for this will be met by the PM CARES Fund. The formalities of installing these plants should have been completed by December 2020 but this could not happen because the health ministry was not given site preparation certificates by the states where these plants were to be installed. Not even 50 percent of the approved capacity was ready and the state governments did not take the plan seriously; not even the Delhi government where there is a mad scramble for oxygen.
  • The big private companies are either buying cryogenic liquid oxygen tankers from foreign countries quickly or sending oxygen tankers from their plants in different parts of the country.
  • India is also looking to double the number of oxygen cylinders in its distribution network to at least 10,000, which would improve supply to rural areas with weak infrastructure.
  • We are trying to create a hub-and-spoke type of system so that we make a lot of liquid oxygen available at the local area, from where the local dealers can pick it up.
  • The supply of medical oxygen is currently being allocated centrally and monitored by the empowered group, EG II, headed by the secretary in the department for promotion of industry and internal trade, mandated by the Union government. This explains the pressure from states on the Union government, since quotas are allotted by the central committee. The Delhi government had on Sunday alleged the Centre was diverting from its quota to other states.
  • The EG II has members nominated from all the states, along with all major oxygen manufactures, All India Industrial Gases Manufacturers’ Association (AIIGMA), Petroleum and Explosives Safety Organisation (PESO), the Ministry of Road Transport, and the Indian Railways. While medical oxygen is not a controlled commodity, the prices are controlled by the National Pharma Pricing Authority. In normal times, India had an excess supply of medical oxygen, so there was no restriction on interstate movement earlier. We believe that once the pandemic subsides, there will be no restriction on the movement of LMO.
  • While the government banned the use of oxygen in industrial facilities, except for identified sectors on Sunday, several firms, especially government ones, have diverted oxygen supply for medical purposes. Indian Oil Corporation (IndianOil), announced it had started supply of 150 tonne of oxygen at no cost to various hospitals in Delhi, Haryana, and Punjab.
  • In the face of a massive surge in demand for medical oxygen during the second wave of the Covid-19 pandemic, IndianOil has diverted the high-purity oxygen used in its Mono Ethylene Glycol (MEG) Unit to produce medical-grade liquid oxygen at its Panipat Refinery & Petrochemical Complex. The throughput of the Unit has also been scaled down for a more critical cause.
  • INOX has been running all units 24x7 to ensure continuous production of medical oxygen to more than 800 hospitals. It has a production capacity of 2,000 TPD, with 25 of its 44 units making it. Their dedicated fleet of VTS-enabled 550 transport tanks and more than 600 drivers were critical to facilitating the supply of medical oxygen. INOX AP manufactures 3,300 TPD of liquified gases.
  • Bharat Petroleum also announced the supply of 100 tonnes of oxygen at no cost to various hospitals.
  • IFFCO announced that its oxygen plant at Kalol would produce 33,000 litre of medical-grade oxygen every day. The company plans to set up three more oxygen plants at Aonla, Phulpur, and Paradeep.
  • Home Ministry issued an order stating that there would be no restrictions on the supply of medical oxygen between states. The Supreme Court has also taken suo motu cognisance of the present situation and asked the central government to present a national plan on COVID-19 management covering aspects like oxygen and essential drugs supply, vaccination and lockdown. The apex court is scheduled to take up the matter for hearing again on Friday.

  Navy transporting large oxygen cylinders from abroad, while also helping civil administrations

  • The Navy is transporting large oxygen-filled cryogenic containers from abroad.
  • The Navy has deployed seven frontline warships to transport large oxygen containers as well as other supplies from countries like Bahrain, Qatar, Kuwait and Singapore to India.
  • Stealth frigate INS Talwar, for instance, is headed to Mumbai with 40 metric ton of liquid medical oxygen from Manama in Bahrain under the ongoing “Operation Samudra Setu-II”.
  • Similarly, destroyer INS Kolkata is transporting medical supplies and oxygen tankers from Qatar and Kuwait. The second batch of ships, INS Kochi, INS Trikand and INS Tabar, which were mission deployed in Arabian sea, have also been diverted to join the national effort.
  • Large amphibious warfare ships INS Airavat and INS Jalashwa, in turn, have been deployed on the eastern shipboard to embark oxygen cylinders and medical stores from Singapore. The Navy has the surge capability to deploy more warships as and when needed.

  Other medical equipment that we are helping procure

  • 23 mobile oxygen generation plants are being air lifted from Germany. These will be deployed in static hospitals and provide adequate oxygen to the needy.
  • We are also procuring a large number of oxygen containers.
  • We are procuring 100,000 oxygen concentrators.
  • We are also procuring a large amount of ventilators.
  • We are already manufacturing gloves, masks, gowns, testing kits and COVIDvaccines.

  Planning to Buy An Oxygen Concentrator For Home? Here’s How To Pick The Right One

  

  

  • The demand for oxygen concentrator has seen a spike as India is currently struggling to cope with an acute oxygen crisis. The surge in demand, observed in many states including Delhi, Haryana, Gujarat, Madhya Pradesh and Maharashtra, led to an acute shortage of oxygen in the country, with many hospitals sending SOS messages. Lack of oxygen support has also led to several deaths. At this juncture, oxygen concentrators have become a necessity.

  What are Oxygen Concentrators?

  • Concentrators are small device supplying supplementary oxygen-enriched air to people requiring oxygen therapy. They are generally used for patients with lung and other respiratory diseases.

  When should one use Oxygen Concentrator?

  • In the case of Covid-19 patients, who feel breathless when their oxygen saturation drops below 94 per cent, then he or she must be put on Oxygen Therapy immediately to avoid damage to other body parts. Oxygen concentrators play an important role as they supply supplemental oxygen to patients via nasal cannula.
  • Oxygen concentrators work like the air conditioning machine. It takes the oxygen from the air, modifies it and releases it in a different form. Oxygen concentrators concentrate the ambient oxygen.

  How do these machines work?

  • An oxygen concentrator is an electronically operated device that separates oxygen from room air. It provides high concentration of oxygen directly to you through a nasal cannula.
  • Clinical studies have documented that oxygen concentrators are therapeutically equivalent to other types of oxygen delivery systems.
  • Oxygen concentrators are widely used for oxygen provision in healthcare applications, especially where liquid or pressurised oxygen is too dangerous or inconvenient, such as in homes or in portable clinics.
  • They work on the principle of ‘rapid pressure swing absorption’ which is where the nitrogen is removed from the air using zeolite minerals which absorb the nitrogen, leaving the other gases to pass through and leaving oxygen as the primary gas. Once the oxygen is collected, the pressure then drops which allows nitrogen to desorb and be expelled back into the air through silencers.
  • Oxygen concentrators are portable and easy to use and are thus better than oxygen cylinders. Although at Rs 40,000-Rs 90,000, they are more expensive than cylinders (Rs 8,000–20,000), they require very minimal maintenance.
  • The only maintenance cost is power consumption and the disposable filters and sieve beds that need to be replaced over years of usage.
  • While oxygen concentrator devices can be used at the convenience of patients under the supervision of doctors or healthcare workers, the stand-alone cylinder needs to be refilled and needs utmost care and monitoring as there are chances of leakage and can cause fire accidents.
  • Oxygen concentrators do not have limitations of refilling. It takes oxygen from the air itself, which enables unlimited supply of oxygen till electricity is available. Oxygen concentrator is a more safe option compared to the Oxygen cylinders, because cylinders can sometimes leak and oxygen saturation increases the risk of fire.
  • Oxygen concentrators produce up to 95 per cent pure oxygen. It also has in-built oxygen sensors which can indicate if purity levels go down.
  • While the total market size in India is 40,000 units, the sudden peak in demand is likely going to affect the quality as there are not enough manufacturers in the country. Most of the devices are manufactured in China and part of raw material is manufactured in the US. India Inc was never prepared to cater to this huge surge in demand.

  Types of Oxygen Concentrators?

  • You should know that there are two types of concentrators available in the market- continuous flow and pulse dose. Continuous flow oxygen provides the same flow of oxygen every minute unless it is turned off irrespective of whether the patient is breathing it in or not, while pulse dose oxygen concentrator detects breathing pattern and dispenses oxygen when it detects inhalation.

  Guidelines

  • Caution to people that use of oxygen concentrator without medical guidance can be harmful, experts said that it can only be used in moderate Covid-19 cases where the oxygen requirement for a patient is a maximum of 5 litres per minute.
  • Oxygen concentrators are also very useful for patients experiencing post-Covid-19 complications which necessitate oxygen therapy.
  • There are also additional requirements and rules for medical oxygen, including requiring a person to have a prescription to order medical oxygen.

  Importers and Manufacturers in India

  • Common importers and manufacturers in India are Phillips, BPL Medical Technologies Ltd, Invacare, AirSep corporation, SS Technologies, Oshocorp Global Pvt Ltd, Medtronic, Inogen, Nidek Medical, Chart Industries.

  Things to keep in mind before buying or renting an oxygen concentrator

  • Normal air will have 21 per cent oxygen. Concentrator sucks atmospheric air, filter nitrogen and other gases and compresses remaining oxygen dispense it through the cannula. If f 1 litre oxygen is provided to patient through concentrator, the oxygen percentage (or fraction of inspired air) in lungs rises to 24 per cent, with 2 litres it rises to 28 per cent and with 10 litres it rises to 60 per cent. Depending on need, the litres of oxygen per minute have to be regulated.
  • You should take a physician’s advice before giving oxygen to a patience. You should always keep a pulse oximeter with you. Oxygen concentrators can supply between 0.1 litres per minute (LPM) to 5 to 10 LPM. A concentrator has 92–95 per cent pure oxygen.

  ONGC to procure 100,000 concentrators

  • Given the acute shortage of medical oxygen in the country, state run Oil and Natural Gas Corporation (ONGC) has floated an international tender to procure 100,000 oxygen concentrators.
  • Oil and Natural Gas Corporation Limited (ONGC), intends to purchase of 1 Lakh Oxygen Concentrators (Non return valve) in order to meet out the urgent requirement of Oxygen to support Covid-19 patients.
  • An oxygen concentrator is a medical device that draws in ambient air, passes it through a molecular sieve to concentrate room oxygen to therapeutic levels and deliver it to a patient. It provides the patient supplemental or extra oxygen. These devices can supply a continuous stream of oxygen at flow rates of up to 10 litres per minute.

  Storing Oxygen Cylinder at Home During COVID-19 Pandemic will not help.

  • Liquid oxygen is used in the making of seamless cylinders which are used to store medical oxygen.
  • In industrial applications, liquid oxygen is used to create high temperatures to make the bottom and neck of cylinders.
  • These cylinders later carry medical oxygen to hospitals.

  

  

  • Yes! we are talking about people buying Oxygen Cylinders and storing them at home or nearby places.
  • Read this article to know: who requires Oxygen therapy; why storing Oxygen cylinder at home could be dangerous, and many other related facts.

  What is Oxygen Therapy?

  • Oxygen is a kind of gas, which is necessary for the survival of human beings. Even a healthy human can die within three minutes without oxygen. People with breathing disorders may require extra oxygen, if they cannot receive enough oxygen from the air in a natural way.
  • Oxygen therapy is a treatment that provides patients with extra oxygen to breathe in. It is also termed as supplemental oxygen. This kind of therapy is only available through the prescription of authorised doctors or health care providers.

  Who Needs Oxygen Therapy?

  • Oxygen therapy or supplemental oxygen treatment is usually prescribed for patients whose lungs are failing to absorb enough oxygen from the air in a natural way. This complicacy usually happens due to some critical diseases, including chronic obstructive pulmonary disease (COPD), lung disease, pneumonia, broncho-pulmonary dysplasia, cystic fibrosis, asthma, heart failure, sleep apnea, trauma in respiratory system, etc.

  Why Is Oxygen Therapy Given in COVID-19 Treatment?

  • Not every COVID-19 patient experiences breathing problem. In some cases, COVID-19 disease caused by novel Coronavirus (Sars-COV-2) tends to infect and damage lungs, making the organ less effective in passing oxygen from the air to bloodstream.
  • COVID-19 patients who are experiencing severe breathing problems are admitted to hospital for receiving supplemental oxygen. The oxygen therapy is provided through nose via plastic tubing, or using a loose-fitting face mask.
  • If the patient needs more oxygen to improve oxygen level in blood, then ‘Continuous Positive Airway Pressure (CPAP)’ treatment is prescribed to facilitate the circulation of gases in and out of the lungs. In this treatment, Oxygen is given via a tightly-fitting mask connected to a machine via plastic tubing. Doctors control how much oxygen at what pressure to deliver. Usually, this treatment requires large amount of oxygen, which is usually available at the hospitals.

  Ventilator-Oxygen-COVID19-patient

  • A small proportion of the most severely ill COVID-19 patients are provided invasive mechanical ventilation (IMV) treatment. In this case, a breathing tube is inserted into the windpipe (intubation) of the patient. Doctors control the amount and pressure of delivered oxygen by the ventilator which does the breathing function for the patient. IMV treatment is provided for 10 days on average. And only 33 percent patients treated with IMV has survived so far.

  Does Every COVID-19 Patients Need Oxygen Supply?

  • There is no evidence of getting benefited by Oxygen Therapy if a COVID-19 patient is not suffering from abnormally low level of oxygen in the blood (Hypoxemia). In some cases, weak patients suffering from COVID-19 can get benefit from medically prescribed ventilator support.
  • According to health experts, only 82 percent of patients suffering from COVID-19 disease do not require any Oxygen Therapy treatment at all. These patients may recover through proper care while staying in isolation. Only 15 percent of the remaining 18 percent COVID-19 patients may suffer from severe breathing problem and require high quantities of oxygen flow to stay alive.

  Why Shouldn’t You Store Oxygen Cylinder at Home?

  • Only Doctors can Provide Oxygen Therapy Safely
    Both the high and low amount of oxygen saturation in blood can be dangerous. Only doctors can decide whether a patient with COVID-19 requires Oxygen Therapy. Even if you manage an Oxygen Cylinder at home for treating a COVID-19 patient, you cannot use it unless you are a doctor. The pressure and amount of Oxygen Supply must be controlled by a doctor or an authorised health care provider. So, there is no point in storing Oxygen cylinders at home in advance without medical prescription.

  Oxygen Cylinder Can Explode Like a Bomb

  • Though oxygen gas does not burn, it works like an oxidizer, which supports the process of combustion. For instance, you have stored an oxygen cylinder at or a nearby place of your home. Now, if somehow a fire starts within three metres of that oxygen cylinder, it can create a blast and feed the flames. It can even blow up your home like a bomb.
  • Activities like smoking, applying electrical equipment or keeping flammable objects like petrol, aerosol, cleaning fuel, alcoholic solutions, oil, grease, etc at the vicinity of Oxygen cylinder can be dangerous. Even an open flame or a heating source like candle, or gas stove brought within three metre of the oxygen cylinder can initiate the spark.
  • The oxygen-sustained fire can burn until the last drop of remaining oxygen in the cylinder. Therefore, it is never a good idea to store oxygen cylinder at home.

  Oxygen Cylinder Shortage at Hospitals

  • In recent days, some people are storing oxygen cylinders at home in advance even before getting infected by COVID-19 while some unscrupulous businessmen are storing Oxygen cylinders to sell them higher prices later.
  • As a result, crisis of oxygen cylinders has been created at hospitals. It can be dangerous for the severely ill COVID-19 patients who are in dire need of prescribed Oxygen Therapy.

  Price Hike Of Oxygen Cylinders

  • Unwanted storage of Oxygen Cylinders has led to an almost three-fold price hike. For instance, nowadays, a 1400-liter oxygen cylinder costs about INR35,000, which was available at INR 11,000 only a few months back. This situation may continue if unauthorised purchase and storage of oxygen cylinder are not monitored and controlled.

  How to Monitor Oxygen Saturation at Home?

  • To determine whether a COVID-19 patient requires oxygen therapy, doctors test the amount of oxygen in his/her arterial blood. You can also measure oxygen saturation at home by clipping a finger using a pulse oximeter.
  • This portable device can indirectly measure the level of oxygen in a human body without taking a blood sample. According to the measurements of a ‘Pulse Oximeter’, normal levels of blood oxygen stay between 95 to 100 percent. If the oxygen saturation drops below 90 percent, the patient may suffer from Hypoxemia.
  • The common symptoms of Hypoxemia include rapid breathing, fast heart rate, shortness of breath, coughing, wheezing, sweating, changes skin-colour, confusion, etc. If you are currently experiencing any of these symptoms, seek medical assistance immediately.
  • Therefore, you can easily check the oxygen level of your body and stay healthy without being crazy for storing oxygen cylinders at home.

  What Can You Do With Your Stored Oxygen Cylinders?

  • You can donate the oxygen cylinder to nearby hospital and contribute in the fight of humanity against the life-threatening COVID-19 pandemic.

  ‘Oxygen Level of 92–93 Shouldn’t Be Considered Critical, But…’: AIIMS Chief on Use of O2 Cylinders

  • As per the World Health Organisation (WHO), if the oxygen saturation level is 94 per cent or less, then the patient needs to be given a treatment quickly. A saturation level of lower than 90 per cent is considered as a clinical emergency.
  • Oxygen saturation levels of 92 or 93 in Covid-19 patients should not be considered critical, but this is a buffer level which indicates that the patient needs medical help on time.
  • If your oxygen saturation level is 94 per cent or above, it still means there is sufficient oxygen in the body. There is no need to panic. Misusing the same by a person with normal levels of oxygen can deprive someone whose saturation level is well below 90 or 80.
  • Previously when we used to do prolonged oxygen therapy for people with lung diseases, we have seen people doing fine in oxygen saturation of even 88 per cent. Oxygen saturation of 92 or 93 should not be considered critical. But this is a buffer level when you can seek medical help without panicking.
  • Oxygen is crucial for the treatment of patients with severe Covid-19, since the disease affects lung functioning. Shortness of breath or difficulty of breathing is one of the most common symptoms in patients with severe Covid-19. It also hampers the supply of oxygen to various parts of the body. They hence need oxygen therapy, to be supplied through medical oxygen.
  • As per the World Health Organisation (WHO), if the oxygen saturation level is 94 per cent or less, then the patient needs to be given a treatment quickly. A saturation level of lower than 90 per cent is considered as a clinical emergency.
  • Latest clinical guidance for management of adult Covid-19 patients stated that an oxygen concentration less than or equal to 93 per cent on room air requires hospital admission, while that below 90 per cent is classified as a severe disease, requiring admission in the ICU.

  Innovations

  In first, NASA’s Mars rover makes oxygen on another planet

  • The unprecedented extraction of oxygen, literally out of thin air on Mars, was achieved by an experimental device aboard Perseverance
  • NASA has logged another extraterrestrial first on its latest mission to Mars: converting carbon dioxide from the Martian atmosphere into pure, breathable oxygen.
  • The unprecedented extraction of oxygen, literally out of thin air on Mars, was achieved by an experimental device aboard Perseverance, a six-wheeled science rover that landed on the Red Planet on February 18 2021 after a seven-month journey from Earth.
  • In its first activation, the toaster-sized instrument dubbed MOXIE, short for Mars Oxygen In-Situ Resource Utilisation Experiment, produced about 5 grams of oxygen, equivalent to roughly 10 minutes’ worth of breathing for an astronaut, NASA said. Although the initial output was modest, the feat marked the first experimental extraction of a natural resources from the environment of another planet for direct use by humans.
  • MOXIE isn’t just the first instrument to produce oxygen on another world, but the first technology of its kind to help future missions “live off the land” of another planet.

  How does it work?

  • The instrument works through electrolysis, which uses extreme heat to separate oxygen atoms from molecules of carbondioxide, which accounts for about 95% of the atmosphere on Mars.
  • The remaining 5% of Mars’ atmosphere, which is only about 1% as dense Earth’s, consists primarily of molecular nitrogen and argon. Oxygen exists on Mars in negligible trace amounts.
  • But an abundant supply is considered critical to eventual human exploration of the Red Planet, both as a sustainable source of breathable air for astronauts and as a necessary ingredient for rocket fuel to fly them home.
  • The volumes required for launching rockets into space from Mars are particularly daunting.
  • According to NASA, getting four astronauts off the Martian surface would take about 7 metric tons of rocket fuel, combined with 25 metric tons of oxygen.
  • Transporting a one-ton oxygen-conversion machine to Mars is more practical than trying to haul 25 tons of oxygen in tanks from Earth.
  • Astronauts living and working on Mars would require perhaps one metric ton of oxygen between them to last an entire year.
  • MOXIE is designed to generate up to 10 grams per hour as a proof of concept, and scientists plan to run the machine at least another nine times over the next two years under different conditions and speeds.
  • The first oxygen conversion run came a day after NASA achieved the historic first controlled powered flight of an aircraft on another planet with a successful take-off and landing of a miniature robot helicopter on Mars.
  • Like MOXIE, the twin-rotor chopper dubbed Ingenuity hitched a ride to Mars with Perseverance, whose primary mission is to search for fossilised traces of ancient microbes that may have flourished on Mars billions of years ago.

  IIT Bombay pilots technology to convert nitrogen plant into oxygen generator

  • This is being done by fine-tuning the existing Nitrogen Plant setup and changing the molecular sieves from Carbon to Zeolite.
  • Indian Institute of Technology (IIT) Bombay is piloting a new technology to convert a nitrogen plant into an oxygen generator amid the oxygen crisis in the country.
  • The institute took up a pilot project with Tata Consulting Engineers (TCE) to evaluate the conversion of PSA (Pressure Swing Adsorption) Nitrogen Unit to PSA oxygen unit.
  • This is being done by fine-tuning the existing nitrogen plant setup and changing the molecular sieves from Carbon to Zeolite. Such nitrogen plants, which take air from the atmosphere as raw material, are available across India in various industrial plants. Therefore, each of them has the potential of being converted to an oxygen generator to tide over the current emergency.
  • At IIT Bombay, a PSA nitrogen plant in the Refrigeration and Cryogenics Laboratory was identified for conversion to validate the proof of concept. To undertake this study on an urgent basis, an MoU was signed between IIT Bombay, Tata Consulting Engineers and Spantech Engineers to finalise an SOP that may be leveraged across the country.
  • The country is reeling under an unprecedented crisis with several hospitals struggling to get a continuous supply of oxygen.
  • The manufacturing and supply of this life-saving gas, which was always in surplus in India, has suddenly become scarce, and a top priority for the government.

  How does it work?

  • Spantech Engineers, Mumbai, who deal with PSA Nitrogen & Oxygen plant production, agreed to partner with IIT Bombay and TCE on this pilot project and installed the required plant components as a skid at IIT Bombay for evaluation using IIT Bombay’s infrastructure at the IITB Nitrogen facility at the Refrigeration and Cryogenics lab.
  • This gaseous oxygen can be utilised for COVID related needs across existing hospitals and upcoming COVID specific facilities by providing a continuous supply of oxygen.
  • IIT Bombay said the setup for the experiment was developed within three days, and the initial tests have shown good results. Oxygen production could be achieved at 3.5 atm pressure with a purity level of 93–96 percent.

  ISRO develops 3 cost-effective ventilators, oxygen concentrator

  • The VSSC started working on these ventilators at the beginning of the first wave of Covid-19 in March 2020 but the work slowed down with the threat diminishing late last year.
  • The Indian Space Research Organisation’s Vikram Sarabhai Space Centre (VSSC) in Thiruvananthapuram, has developed three different types of ventilators and an oxygen concentrator at a time when a shortage of these critical medical equipment resulted in deaths of many Covid-19 patients across the country.
  • Technology transfer will be done for the commercial production of these three ventilators and the one oxygen concentrator by this month itself. Likely to be priced around ₹1 lakh, the ventilators developed by the ISRO were cost effective and easy to handle compared to the mini conventional ventilators that are currently priced around ₹5 lakh.
  • Based on designs, features and specifications, these have been named Prana, VaU and Svasta. All three are user-friendly, fully automated and with touch-screen specifications, meeting all safety standards. The doctors and other experts have checked its efficacy and confirmed it meets international standards.
  • In fact the VSSC started working on these ventilators during the first wave in March 2020 but the work slowed down with the threat diminishing late last year. However, the institute was asked to expedite work after the second wave of the disease stunned the country’s healthcare system, causing several deaths due to lack of ventilators, oxygen and Covid-19 medicines such as Remdesivir.
  • While Prana is meant to deliver respiratory gas to the patient by automated compression of an Ambu bag, Svasta is designed to work without electric power, and the VaU is a low-cost ventilator equivalent to commercially available high-end ventilators.
  • The system is envisaged as a dual-mode ventilator that can work with either medical air/oxygen from the hospital or with ambient air.
  • The VSSC has also developed a portable medical oxygen concentrator called Shwaas. It is capable of supplying 10 litre enriched oxygen per minute, adequate for two patients at a time. It enhances the oxygen gas content by selectively separating the nitrogen gas from ambient air through Pressure Swing Adsorption (PSA) which is commonly used for production of oxygen from air.

  Centre approves procurement of 1.5 lakh units of DRDO’s ‘Oxycare’ system

  • The DRDO has transferred the technology to multiple industries in India which will be producing the ‘Oxycare’ systems. Apart from this, the DRDO has also decided to set up seven medical oxygen plants in Odisha.
  • The DRDO recently installed high capacity medical oxygen plants at AIIMS Trauma Centre for Covid-19 patients.
  • The Centre approved the procurement of 1,50,000 units of ‘Oxycare’ system developed by Defence Research and Development Organisation (DRDO). The procurement will be done at a cost of ₹322.5 crore under the PM-Cares fund to help the Covid-19 patients.
  • After the approval, the government will procure 1,00,000 manual and 50,000 automatic ‘Oxycare’ systems along with non-rebreather masks.
  • ‘Oxycare’ is a SpO2-based oxygen supply system which regulates the oxygen being administered to patients based on the sensed SpO2 levels. It prevents the person from sinking into a state of hypoxia which can be fatal.
  • The ‘Oxycare’ system was originally developed for soldiers posted at extreme high-altitude areas. The indigenously developed system is robust and can be effectively used to treat Covid-19 patients.
  • There are two variants of the DRDO system. The basic version consists of a 10-litre oxygen cylinder, a pressure regulator-cum-flow controller, a humidifier and a nasal cannula. In this model, the oxygen flow is regulated manually based on the SpO2 readings. The second one is equipped with electronic controls which automatically regulates the oxygen flow through a low-pressure regulator and a SpO2 probe.
  • The DRDO has transferred the technology to multiple industries in India which will be producing the ‘Oxycare systems.
  • Apart from this, the DRDO has also decided to set up seven medical oxygen plants in Odisha.
  • The plants will come up at Boudh, Cuttack, Bhadrak, Gajapati, Jharsuguda, Nayagarh and Koraput districts, CGM of National Highways Authority of India (NHAI), Odisha, Ram Prasad Panda, said. The civil and electrical works of the plants will be done by the NHAI while the DRDO will look after the technical aspect, he added.
  • The DRDO’s move is a part of its massive drive under which it has decided to set up 500 medical oxygen plants in the country within three months with the help of its indigenous developed technology.
  • Once completed, each plant will generate 1,000 litres per minute (LPM) of oxygen and the life-saving gas will be supplied to hospitals through pipelines.

  PM Cares funds 500 PSA plants, 1 lakh concentrators

  • The effort to provide oxygen to Covid-19 patients received a further boost with the government deciding to procure 1 lakh oxygen concentrators for supply to high-burden States and giving approval for an additional 500 pressure swing adsorption (PSA) oxygen plants.
  • The decision to purchase 1 lakh oxygen concentrators was taken at a meeting chaired by Prime Minister Narendra Modi. These contraptions will be procured at the earliest using PM-CARES fund and given to high-burden States, an official statement said. The PM-CARES fund would also support the procurement of 500 PSA oxygen plants, using a technology developed by the Defence Research and Development Organisation for on-board oxygen generation for the Light Combat Aircraft.
  • The medical oxygen plant (MOP) technology was developed to supply oxygen on board the light combat aircraft (LCA) by the Defence Bioengineering and Electromedical Laboratory (DEBEL).
  • The PSA technology, developed by the Bengaluru-based Defence Bio-Engineering Electro Medical Laboratory, has already been transferred to Tata Advanced Systems, Bengaluru, and Trident Pneumatics, Coimbatore, which will supply 332 and 48 PSA plants, respectively. The other 120 plants will be built by units working with the Dehradun-based Indian Institute of Petroleum. These 500 plants will be in addition to the 713 PSA plants already approved by the government. The DRDO has already commenced site selection for setting up five plants in the Delhi-NCR region. These plants will installed in three months.
  • The PSA plants will augment supply of LMO at hospitals in district headquarters and tier-2 cities.
  • A PSA oxygen plant employs a technology that absorbs nitrogen from ambient air to concentrate oxygen for supply to hospitals. They operate at near-ambient temperatures and use specific adsorbent materials (that trap a substance on their surface) like zeolites, activated carbon, molecular sieves etc to trap oxygen at high pressure.
  • While the oxygen produced by these plants is believed to be less pure than liquid oxygen derived from cryogenic technology, the plants could have helped ease the ongoing medical oxygen crisis that has emerged as one of the biggest challenges in India’s battle against the second Covid wave. The plants are also described as being more economical.
  • The Central Medical Services Society (CMSS), an autonomous body under the Ministry of Health and Family Welfare, is the nodal agency issuing tenders in this regard and is responsible for installation and commissioning. It invited tenders last October to set up PSA oxygen plants in government hospitals.
  • A 240-bed hospital with 40 ICU beds uses oxygen worth about Rs 5 lakh per month during normal times. Such a hospital, would need to spend approx. Rs 50 lakh to set up a PSA with the requisite oxygen capacity, and break even — recover cost of setting up the plant from the revenues generated — within 18 months.
  • However, liquid oxygen produced using cryogenic technology has more purity compared to oxygen generated through the PSA process. The purity of the former is 99 per cent, compared to only around 93 per cent for the latter, they added.
  • PSA plants can be installed in around one month if equipment is readily available.

  New Anti-Covid Drug That Reduces Dependence on Oxygen Will Be Out in a Month: DRDO Scientist

  

  

  • The new anti-Covid oral drug developed by the DRDO will help hospitalised patients and reduce their supplemental oxygen dependence. The drug 2-deoxy-D-glucose (2-DG) has been developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a leading laboratory of Defence Research and Development Organisation (DRDO), in collaboration with Dr Reddy’s Laboratories (DRL) in Hyderabad. The drug, which comes in powder form in a sachet and is taken orally by dissolving it in water, was approved by the Drugs Controller General of India (DCGI) for emergency use as an adjunct therapy.

  Following FAQ explains how anti-Covid-19 therapeutic application of the drug will work on patients.

  How did DRDO develop the 2-DG drug?

  • DRDO started working on 2 DG when the first wave of Covid-19 hit India in April 2020. They found that the drug stops the spread of coronavirus inside the body cells. After the findings, they asked the DCGI for permission to conduct clinical trials. In May 2020, they got permission for the clinical trials. By the end of October 2020 they had completed the second phase of trials, and the results were very good. Using standard care, the 2 DG will be more beneficial for the Covid-19 patients.

  What do you mean by standard care?

  • Standard care is the primary medicine used in hospitals for treating Covid patients.

  Will the 2-DG drug be effective for patients with mild symptoms or moderate and serious symptoms?

  • The trials were conducted on moderate and serious covid patients who were admitted to hospitals. All the patients benefitted, and no side effects were found. So it’s a safe medicine. In the phase two trials, they found that the recovery rate of the patients was higher and in the third phase, we observed reduced dependence on supplemental oxygen.

  How 2-DG drugs control the coronavirus and reduce the dependence on oxygen?

  • The 2 DG drug, like glucose, spreads through the body, reaches the virus-infected cells and prevents virus growth by stopping viral synthesis and destroys the protein’s energy production. The drug also works on virus infection spread into lungs which help us to decrease patients dependability on oxygen.

  When will this drug be available to patients?

  • DRDO’s Industry partner is Dr Reddy’s Laboratories. They are working and trying together to expedite manufacturing. In a few weeks or within a month time, the medicine will be available for the patients.

  Are the raw materials needed for 2-DG drug available in India, or will they be imported?

  • There is no problem with the availability of raw materials for the drugs.

  Will the 2 DG dug affect the surge in Covid cases and prevent deaths?

  • All patients who participated in the trials have recovered from covid-19. Therefore, they hope that Covid patients will be benefitted from this drug.

  Supreme Court sets up National Task Force to streamline oxygen allocation, ensure availability of essential drugs, medicines

  • The Supreme Court has set up a twelve-member National Task Force (NTF) to facilitate a public health response to COVID-19 based on scientific and specialised domain knowledge.
  • The court suggested that the Centre adopt a pan-India approach so that they can prepare for the third wave of coronavirus.
  • It has asked the Centre to look at the oxygen audit and reassess the basis for allocation as the third stage of the pandemic might be different from the first two.

  Procedure for import of oxygen cylinders, cryogenic tankers eased

  • The government on Wednesday further eased the process of registration and approval for importing oxygen cylinders and cryogenic tankers amid shortage of the life-saving gas due to a spike in COVID-19 cases in the country.
  • The government has done away with the norm of physical inspection of global manufacturers and production facilities by the Petroleum and Explosive Safety Organization (PESO) before the grant of such registration and approval.
  • According to an official release, PESO will not carry out physical inspection of production facilities of global manufacturers before granting registration and approvals for importing oxygen cylinders and cryogenic tankers/containers.
  • The commerce and industry ministry said that the government has reviewed the existing procedure of registration and approval of global manufacturers for importing oxygen cylinders and cryogenic tankers/containers.
  • Such approvals would be granted online without any delay on submission of certain manufacturer’s particulars like ISO certificate of manufacturer; list of cylinders/ tankers/containers, and their specifications.

  Corporate spending on oxygen, ventilators counted as CSR

  • Funds earmarked for CSR could be spent on setting up medical facilities towards Covid care, medical oxygen generation and storage plants as well as production and supply of oxygen concentrators, cylinders and other medical equipment needed to fight back the pandemic
  • Spending by corporates towards setting up oxygen plants and other medical infrastructure towards combating Covid-19 will be counted as eligible corporate social responsibility (CSR) activity, in order to expedite efforts to bolster the healthcare infrastructure amid a deadly second wave of the pandemic.
  • Funds earmarked for CSR could be spent on setting up medical facilities towards Covid care, medical oxygen generation and storage plants as well as production and supply of oxygen concentrators, cylinders and other medical equipment needed to fight back the pandemic, the ministry of corporate affairs said in a statement.
  • Earlier companies had been allowed to spend CSR funds for Covid to set up “makeshift hospitals and temporary”.
  • The Companies Act mandates businesses with net worth of ₹500 crore or more, or annual revenues of at least ₹1,000 crore, or net profit of at least ₹5 crore, to spend 2% of their average net profits of the preceding three years on CSR activities.
  • Given corporate profits may be depressed during the economic downturn, which could also tell on the amount businesses spend on CSR, the companies have been given more flexibility to spend on charity. Accordingly, they are free to spend more than their obligation — 2% of their net profits — on CSR in any given year and the excess amount spent can be set off against the CSR spending obligation in future years.
  • CSR rules that were implemented recently have been tweaked which could lead many companies to take their obligations more seriously.

  The difference between household CPAP machine and oxygen generator?

  • Nowadays, home ventilators and oxygen concentrators are relatively popular home medical equipment. Many people don’t know the difference between ventilators and oxygen concentrators. They regard the ventilator as an oxygen concentrator and mistakenly believe that the ventilator can also produce oxygen. In fact, the ventilator and the oxygen generator are two essentially different medical devices. So, what is the difference between a home ventilator and an oxygen generator?
  • The difference between home ventilator and oxygen concentrator is that they use different principles.
  • The principle of the home ventilator: Inhalation action produces negative pressure in the chest cavity during autonomous ventilation, and negative pressure in the alveoli and airway occurs through passive expansion of the lung, which constitutes the pressure difference between the airway orifice and the alveoli to complete the inhalation; the chest and lungs after inhalation Retract elastically and produce an opposite pressure difference to complete exhalation. Therefore, normal breathing is due to the “active negative pressure difference” between the alveoli and the airway orifice generated by the body through the breathing action to complete the inhalation. After the inhalation, the thoracic and lung elastic contraction produces a passive positive pressure difference between the alveoli and the airway orifice and exhales. To meet the needs of physiological ventilation.
  • The principle of the oxygen generator: the use of molecular sieve physical adsorption and desorption technology. The oxygen generator is filled with molecular sieves, which can absorb nitrogen in the air when pressurized, and the remaining unabsorbed oxygen is collected, and after purification treatment, it becomes high-purity oxygen, which is generally not suitable for critically ill patients!
  • By understanding the principles of home ventilator and oxygen concentrator, it is easy to distinguish between ventilator and oxygen concentrator. Simply put, the concept of a ventilator is different from an oxygen concentrator. The ventilator is like an air compressor, providing air flow like an electric fan, and is used to help and replace human breathing. The oxygen generator is like a sieve, filtering out the oxygen in the air. In hospitals, there are also two kinds of machines that are used together to treat more serious diseases such as pulmonary disease and heart failure.
  • The main users of household ventilators are: obese, abnormal nose development, hypertrophy and thick pharynx, uvula blocked passage, tonsil hypertrophy, abnormal thyroid function, giant tongue, congenital micrognathia, etc. Use it for symptoms such as snoring, sleep apnea and sleep apnea!

  Should COPD use an oxygen concentrator or a ventilator?

  • Patients with chronic obstructive pulmonary disease will have varying degrees of lung function decline according to the severity of the disease. The symptoms of lung function decline include chest tightness and shortness of breath. When reading articles, many patients saw that some people recommended the use of ventilators for home treatment, and some people recommended the use of oxygen concentrators. So how effective are these two medical devices for patients with COPD?
  1. You can choose an oxygen generator for simple hypoxia without carbon dioxide retention
  • Many lung diseases have only hypoxia symptoms in the early stage, but no carbon dioxide retention. This is because the diffusion rate of carbon dioxide is 20 times that of oxygen, so carbon dioxide exchanges more than oxygen in the same time. As long as there is no serious ventilation problem, it is normal There will be no carbon dioxide retention problem. This stage is generally called type 1 respiratory failure. So if the lung function is reduced but there is no carbon dioxide retention problem, then at this stage you can buy an oxygen generator and go back for oxygen therapy.

  2. Both hypoxia and carbon dioxide retention need to use a ventilator

  • If the lung function is further reduced and the lung ventilation capacity is further reduced, then not only will there be a problem of hypoxia, but also carbon dioxide retention. This stage is called type II respiratory failure. At this stage, the patient’s small airways are severely obstructed and gas exchange is difficult. At this stage, oxygen inhalation alone cannot solve everything. Because insufficient ventilation is easy to retain carbon dioxide in the body, it is necessary to use a ventilator to increase it at this stage. Ventilation, it is best to use a ventilator and an oxygen generator together for the best effect.

  3. How do I know if there is carbon dioxide retention?

  • If you want to know whether there is carbon dioxide retention, you can do an arterial blood gas analysis. Through blood gas analysis, you can know the carbon dioxide partial pressure, oxygen partial pressure and other indicators.

  4. Are there any side effects and dependence on the ventilator?

  • Under reasonable parameters and modes, the ventilator has no side effects. You can understand that the home ventilator is an auxiliary device. After wearing it, the fan provides the patient with breathing pressure and assists the patient to breathe normally. Normally, breathing is done by humans. To control, the ventilator will not replace the patient’s breathing. The ventilator just makes the patient breathe more easily, improves the patient’s ventilation, and reduces the chance of carbon dioxide retention.

  5. How much is the flow rate of the oxygen generator?

  • For home oxygen therapy, the flow rate of the oxygen generator is generally below 2L/min. Patients with good ventilation can be higher, but not too high. If combined with a ventilator to inhale oxygen, it is also possible to adjust the oxygen flow to 5L/min in this case.

RIL becomes India’s largest producer of medical-grade liquid oxygen from a single location was originally published in Wellness As HealthCare 2.0 on Medium, where people are continuing the conversation by highlighting and responding to this story.