ADUDANS: Govt. should change tack on medical oxygen as supplies become choke point in Covid-19 fight

By Dr Steve Adudans On Sun, 26 Apr, 2020 18:39 | 3 mins read
medical oxygen
A medical oxygen production plant in Nakuru County. PHOTO | COURTESY

The Ministry of Health recently appealed to members of the public in possession of oxygen cylinders that they’re not using to hand them over to the government to aid in the fight against Covid-19.

The move is laudable as the cylinders will be required in boosting the country’s capacity as patients who need critical care may also need oxygen supplementation.

Covid-19 is predominantly a respiratory disease, and as patient numbers continue to rise, we are going to see an increase in demand for medical oxygen.

Covid-19 patients who are hospitalized can develop pneumonia and end up in respiratory distress. When breathing becomes difficult patients often require supplemental oxygen.

‘Choke point’

But the spike in demand for oxygen by coronavirus cases directly impacts other non-coronavirus patients and could strain oxygen resources for everyone who relies on it inside and outside the hospital.

Oxygen supplies have emerged as the latest choke point in the battle against the coronavirus. The number of patients in the country continues rising.

Hence, oxygen might become a limited commodity just like ventilators or medications if supply chains cannot keep up with our increased demand.

If so, it will be just like a precious metal that we don’t have an infinite
amount of, such as gold.

‘Fatal outcomes’

In Kenya, it is unfortunate that we have not prioritized medical oxygen and therefore no accurate data of what is available.

It is estimated that at least 50 percent of patients who need oxygen in Kenya don’t get it as it is often reserved for critically ill patients.

With the potential demand for oxygen owing to coronavirus spread spiking, need is likely to increase with fatal outcomes if we are unprepared.

It will be vital for hospital systems nationwide to keep a close eye on their current supply of oxygen as if it were a necessity like personal protective equipment, ventilators, regularly used medications and other resources related to Covid-19 — as well as their supply chains.

‘Smart management’

Hospitals need to be smart and wise with oxygen use. We might take some aspects of medical therapy for granted, like the supply of medical oxygen.

The specific issues that cause the prevalent lack of access are many: first, the distances between hospitals and the source of oxygen can be vast.

Oxygen cylinders must be picked up at an oxygen generation plant in a major city and transported hundreds of kilometres. This adds delays and significant cost.

‘Partnerships’

Siaya County Referral Hospital together with a social enterprise, Hewatele, have partnered in an initiative that the government can replicate by embracing partnerships with oxygen manufacturers to bridge the projected deficit at this difficult time.

Under the arrangement, Siaya County gave Hewatele land to construct an oxygen plant.

One of the arrangement was that the social enterprise offers the facility oxygen at a subsidized rate and also offer training to health care workers on the proper use of oxygen.

Initially, the hospital purchased 299 litres of oxygen per month, but it can now get 2,309 litres of oxygen per month, giving it an increment of 672 percent.

Health facilities in the neighborhood have also benefited as oxygen tanks are now just shipped a few kilometres to rural facilities with charges that are 30 percent less than the current monopolist suppliers.

This enables these clinics access to an essential medicine that they could never afford or would never reach them. These hub-and-spoke programs also assure proper use by deploying experts to train health professionals on the optimal use of oxygen for the best possible patient care.

Dr Steve Adudans is the Executive Director, Center for Public Health and Development. He holds an MSC in Infectious Diseases from the London School of Hygiene and Tropical Medicine, University of London.

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