SPECIAL Preventing a Repeat of the COVID-19 Second-Wave Oxygen Crisis in India - Observer Research Foundation
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SPECIAL
151
no.
Preventing a Repeat of the COVID-19
Second-Wave Oxygen Crisis in India
Amit Thadhani
JUNE 2021
© 2021 Observer Research Foundation. All rights reserved. No part of this publication may be reproduced, copied, archived, retained or transmitted through
print, speech or electronic media without prior written approval from ORF.Introduction
M
edical oxygen is the single most
important intervention for
moderate and severe cases of
COVID-19. Without it, patients
can suffocate and die. In India, Indeed, the distribution of medical oxygen
in the past one and a half years of the pandemic, is a complex endeavour. Large hospitals are
both hospitals that treat COVID-19, and those that usually supplied directly by manufacturers that
do not, suffered a shortage of medical oxygen. The use tankers to transport the oxygen. Meanwhile,
problem was noted during the peak of the first wave medium and small hospitals, as well as nursing
in September 2020, and recurred on a much larger homes, rely primarily on intermediaries: the
scale during the peak of the second wave, in April manufacturers supply liquid oxygen to filling
and May 2021. Some trackers have estimated that stations, again via tankers; gas agencies, who own
as many as 512 lives were lost across the country due cylinders, then get them filled in filling stations
to oxygen shortage or denial.1 The reason is not a and thereafter supply them to the nursing homes
lack of medical oxygen, per se, but the inadequacy either via “jumbo cylinders” (gaseous oxygen) or
of the distribution network of tankers to transport “dura cylinders” (containing liquid oxygen that
liquid oxygen from the point of manufacture, to the expands 860 times to gaseous form).
hospitals.
Attribution: Amit Thadhani, “Preventing a Repeat of the COVID-19 Second-Wave Oxygen Crisis in India,” ORF Special Report
No. 151, June 2021, Observer Research Foundation.
2This entire supply chain was severely disrupted
at multiple levels due to the steep and sudden rise
in demand across the country—from 3,842 MT per
day on 12 April 2021 to 8,400 MT per day by 25 beginning of May—before gradually reducing as
April, and further up to 11,000 MT per day by the the number of fresh cases declined.2 At the time
of writing this report, the demand has gone down
to normal levels and supplies are adequate once
again.
India’s oxygen crisis during the peak of
the second wave, was not because of lack
of supply per se, but the inadequacy of the
distribution network.
3Responding to the Surge
I
n April 2021, when the demand for medical
oxygen suddenly increased, more tankers
needed to be pressed into service. However,
India only had around 1,200 cryogenic government announced in the last week of April
oxygen tankers across the country—the that they would import cryogenic tankers from
number is insufficient for servicing the requirements. Bangkok, as well as oxygen plants from France.8
To solve the problem, some state governments such The Central government also flew in ready-to-
as that of Uttar Pradesh repurposed tankers used use plants for installation at several government
for other liquid gases to service the transportation hospitals. As per the central government, the
of medical oxygen; they utilised technology, too, number of oxygen tankers stands currently in
and tagged tankers to get real-time data on their excess of 2,000 amounting to about 30,000 MT
location.3 Several large corporations including of liquid oxygen. This, too, would probably be
Reliance, Adani Group, and Tata Companies, inadequate in the event of a large third wave if
stepped in to divert industrial oxygen from their daily consumption again rises to 11,000 MT per
plants to hospitals across the country.a The Central day or more, as the average turnaround time for
government airlifted tankers from other countries4,5 a tanker is five to seven days.
and has been running Oxygen Express trains to
affected areas for the rapid transport of liquid
oxygen from large industrial plants.6,7 The Delhi state
a Industrial and medical oxygen are the same. The difference between the two is that for medical oxygen, the chambers, cylinders, and
transport tanks need to be cleaned regularly.
4In what has been widely described as reciprocity
for India’s own vaccine outreach during the first
wave in 2020, different countries sent donations of
oxygen concentrators, oxygen plants, and tankers
to India beginning in the last week of April when
the country’s massive battle with the steep surges Odisha, which was recording relatively lower
in cases was being highlighted in the international infection rates in the beginning of the second
media.9 The question remains: Why was India wave, stepped in to supply 345 tankers of oxygen
caught unprepared for the sudden rise in demand to severely affected states as it has several large
for medical oxygen? industrial plants producing massive quantities
of oxygen.16 The state was able to comfortably
How the Best Laid Plans Came to Naught manage its own requirements.
In the beginning of 2020, the Ministry of During the first wave, some parts of the country
Commerce’s Department of Promotion of such as Mumbai and other cities of Maharashtra,
Industry and Industrial Trade formed an ‘oxygen faced shortages in oxygen but quickly overcame
monitoring committee’ and held several rounds of the gaps by diverting oxygen tankers from states
discussions with oxygen manufacturers’ associations that had more. The second wave brought a
on the augmentation of capacity based on potential severe challenge, however, as several large states
requirements.10 State governments were apprised across the country suffered massive increases
of the need to set up oxygen plants at the bigger in cases in a very short time. This exposed the
hospitals in their jurisdictions, and funds were sheer inadequacy of the distribution network
allocated for 162 oxygen plants from PM CARES for medical oxygen. Manufacturers were unable
Fund for this purpose in January 2021.11 By that to deliver even to the large hospitals. Smaller
time, however, it appeared that the first wave of the hospitals ran out of supply, sometimes leading
pandemic was ebbing, and the sense of urgency was to catastrophic consequences.17 To manage the
lost. Most states did not proceed to setting up the situation, these smaller hospitals lent each other
oxygen plants—and they would land into extreme a few cylinders that helped for a few hours, until
difficulties during the second wave. their own supplies arrived. Suppliers’ vehicles
would often spend several hours waiting in queue
Only a few states, such as Assam and Uttar for refilling of oxygen cylinders, only to be turned
Pradesh, set up oxygen plants at key hospitals.12,13 back as stocks were quickly exhausted.
Kerala, too, augmented its capacity and claimed to
be oxygen-surplus; soon, however, they requested
for additional oxygen allocation as the situation
in the state started to deteriorate.14,15 The state of
5Compounding Issues
The Black Market
The cost of medical oxygen rose rapidly to as much
as ten times that before the pandemic. Cylinders
quickly disappeared from circulation, as individuals Small portable cylinders such as those used by
and black-marketeers alike began to hoard mountaineers, were selling at over INR 25,000/-
supplies.18 Black-marketing, though rampant across each in Delhi; the actual cost would not be more than
most of North, West and Central India, occurred on INR 1,000. In some states such as Maharashtra, the
a much lesser scale in states such as Kerala, Tamil government stepped in to put a cap on the price
Nadu, and Karnataka, as far fewer patients may have of oxygen per cylinder. This proved completely
been on home oxygen due to better public health ineffective, though, as dealers billed separately for
infrastructure. Moreover, the peak of the second transportation and logistics, leaving the net cost to
wave in some Southern states such as Karnataka hospitals virtually unchanged. The black market
and Tamil Nadu (in the second week of May 2021) for oxygen cylinders continued to flourish across
came about two weeks later than that in states such several states as hospital beds became scarce and
as Maharashtra and Delhi (in the third week of April home care was the only option for thousands of
2021)—by which time a significant part of the supply patients.19 Oxygen concentrators quickly flew off
problem had been sorted out. the shelves and their selling price shot up from
INR 35,000 to 40,0000 pre-COVID-19, to over
INR 100,000 in April and May 2021.
6Oxygen Rationing
As the situation turned dire, the central and state
governments turned to oxygen rationing. The by over 50 percent. Several other measures have
concept is not unique to India. Hospitals in the also been introduced. Hospitals have been directed
United States (US) and the United Kingdom (UK) to appoint a nurse whose sole responsibility will
resorted to implicit or explicit rationing of medical be to monitor and control oxygen wastage, from
services including oxygen during the peak of the leaking oxygen lines to patients not turning off
pandemic in their respective countries.20 However, their oxygen on visits to the washroom.23,24 Another
the manner in which rationing is done is different person must be appointed to brief the collector’s
in each country. In India, the Central government office on daily requirements and supplies.
collected data on oxygen beds and ICU beds from
all COVID-19 hospitals in each state and allocated In Maharashtra, the state government has set
a certain quantity of oxygen to the state, according up ‘control rooms’ that ensure that the supply
to the amount that was deemed necessary for the chain is maintained, even though the cost of
treatment of every patient. For example, 5 lit/min oxygen for the hospitals is extremely high.
was allocated for an oxygen bed, and 20-24 lit/min Municipal officials, and occasionally top officials
for an ICU bed. such as the collector of the district, take rounds in
COVID-19 hospitals and point out ways in which
In turn, each state allocated a quota to each oxygen wastage can be curbed. At some places,
district, and each district to the hospitals under this has gone to extremes, with doctors making
their jurisdiction. Moreover, the use of High-Flow allegations about officials turning off some
Nasal Cannula (HFNC) was strongly discouraged by patients’ oxygen supply, fiddling with ventilator
several state governments such as Maharashtra and settings, and reprimanding treating teams for
Karnataka as unnecessary wastage of oxygen.21,22 wasting oxygen if the patient’s oxygen saturation
HFNC is a commonly used treatment modality for does not fall without it.25
COVID-19 patients that pushes in a high flow of
oxygen at up to 100 lit/min to severely ill patients. It
is known to reduce the need for ventilatory support
7Though on the face of it, these measures might
be able to ensure equitable distribution of a highly
valuable resource, it will only be counter-productive
because of the following essential facts: 3. Vendors can under-fill the oxygen cylinders,
sometimes intentionally, or others due to
1. Patients’ requirements are not static. They may lapses in the filling process. Therefore, there is
change from minute to minute, and from 2 lit/ no guarantee that the allotted quota contains
min to 15 lit/min within a matter of hours. It the claimed amount of oxygen.
takes much longer for requirements to fall than
it takes for them to rise, and therefore, even 4. If supply of oxygen is going to be fixed
attempting to average the requirements may not at a certain level with no possibility for
work well. compensation if a patient with higher
requirements were to need treatment, it is
2. ICU requirements of oxygen are much higher almost inevitable that hospitals would try
than 20 lit/min. As the fundamental treatment to accommodate only those patients it can
modality in COVID-19 is non-invasive ventilation manage within that allotted quota, and avoid
(NIV) or BiPap,b the average consumption is 30- those who have higher requirements. This
40 lit/min. translates to patients with less severe cases
getting adequate treatment in hospital, while
the more severe ones are unable to find a
hospital bed.
b NIV – non-invasive ventilation, in which the patient is on a conventional ventilator but without a breathing tube placed in the throat.
Ventilatory support is provided through a specialised face mask. 30 - 40Lit/min can be delivered through NIV. Consumption of oxygen
is higher due to leaks around the mask.
Invasive ventilation: in which ventilator is connected to the patient with a breathing (‘endotracheal’) tube placed in the throat.
Generally requires around 10-12 Lit/min to maintain oxygen levels but mortality is much higher in COVID patients who are on invasive
ventilation.
BIPAP – a positive pressure machine that delivers oxygen under pressure through a face mask. It is less effective than ventilation and
consumes upto 30 Lit/min of oxygen.
High Flow Nasal Cannula – a specialised device that delivers very high flows of oxygen upto 100 Lit/min. It is known to reduce the need
for invasive ventilation by as much as 50%.
8While “oxygen rationing”, therefore, ensured
that hospitals get at least some regular supply of
oxygen, it indirectly discouraged these facilities from
admitting more critically ill patients with the highest the oxygen supplies to Delhi were adequate, but
requirements for an ICU bed, for fear of being still maintained that additional allocations could
unable to treat other patients properly due to limited not be done without compromising on supplies
supplies of oxygen. This can translate to higher to other states. Some states seized oxygen tankers
mortality. Oxygen rationing, though unavoidable meant for other states27 and diverted them to their
in many respects under the present situation, is far own hospitals, leading to conflicts between states.
from an ideal solution. If the requirements are to be Oxygen tankers have now been given security and
calculated, they should be on the basis of maximum escorts to ensure that they reach their destinations
and not minimum consumption. For example, without disruption.28
instead of telling hospitals not to use HFNC,
the requirement needs to be considered during At the time of writing this report, the second
calculations for procurement. wave has abated with daily numbers of fresh cases
across India dropping to around 50,000, from the
At the state level, the oxygen crisis led to peak of over 400,000 per day recorded on 4 May
allegations of political favouritism. The issue 2021.29 The conflicts regarding oxygen supply,
reached the chambers of the Supreme Court, too, appear to have been resolved, at least for now.
where the state of Delhi and the Centre made
allegations and counter-allegations on each other
regarding oxygen supplies to Delhi.26 While the
Delhi government claimed that supplies were
deliberately held up by the Centre, it refused an Oxygen‘rationing’
oxygen audit to ascertain its actual requirements.
The central government, for its part, insisted that indirectly discouraged
hospitals from admitting
more critically ill patients,
for fear of being unable to
treat others due to limited
oxygen.
9Towards Long-term Solutions
T
he Central government in June 2021
launched “Project O2 For India”30
under the direct command of the
office of Principal Scientific Advisor.
A National Consortium of Oxygen Swing Adsorption (PSA) plants can be set up
consisting of corporations, Indian Institutes within a matter of a few days in small areas of
of Technology (IITs), and various non-profit up to 200 sq ft, as compared to the traditional
organisations is helping the government in building cryogenic plants that take six months or more
up the supply chain of critical materials and parts and need a large area of a few acres, at least.
of oxygen plants. Funding for plants is being Most oxygen plants that are being installed in
arranged through PM CARES,c as well as corporate hospitals are PSA plants. The problem for the
sponsorships via CSR funding. vast majority of nursing homes and small and
medium-sized hospitals, is the capital investment
Execution of permanent solutions such as needed to install PSA plants. Some states such as
oxygen plants and procuring adequate numbers Madhya Pradesh and Maharashtra are offering
of cryogenic tankers also need to be completed incentives to private companies for the setting up
in an urgent manner. There are today reasonably of cryogenic oxygen plants and manufacturing
good solutions available: for example, Pressure cryogenic containers.31,32
c The Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund (or PM CARES) was created on 27 March 2020, as the
first wave of the COVID-19 pandemic swept through India.
10The execution of
permanent solutions such
as setting up oxygen
plants and procuring
adequate numbers of
cryogenic tankers need to
be done urgently.
be reasonably assumed that most of them would
have a functional oxygen plant in place within the
next few months, provided the local authorities
expedite the installations. According to the
government’s data presented before the Supreme
Other states are prioritising building oxygen Court, 33 plants funded through PM CARES are
plants within government hospitals and over 1,200 already functional and 80 are in various stages of
oxygen plants have been sanctioned at government construction.36
hospitals with PM CARES funds.33 Of these, 551
plants were approved for district hospitals.34 Tenders Corporate-sponsored PSA plants are being
were called for 162 plants in October 2020. The commissioned almost on a daily basis across the
process ran into problems as the companies that country. Table 1 gives a representative but not
won the tender were unable to deliver the plants.35 exhaustive list of some of the plants being executed
However, several corporations such as Coal India, across the country:37,38,39,40,41,42,43,44,45,46
Maruti Suzuki, and Tata Group have stepped in,
offering to build plants at various hospitals. Several
plants have been commissioned in UP, Haryana,
Kerala, Assam, Nagaland, Gujarat, Maharashtra
and other states either through state and central
government funding, or by corporate support. As
there are 734 district hospitals in the country, it can
11Company State Number of plants
Maruti Suzuki J&K, Haryana & others 22
HCL Delhi 17
IGL Delhi 1
Tata Sons and DRDO Multiple 500
Oil PSUs Multiple 100
DCM Shriram Gujarat 2
Tech Mahindra Multiple 50
Northern Coalfields Madhya Pradesh 5
Western Coalfields Maharashtra 2
Powergrid Corporation Rajasthan 3
Maharashtra Health Minister Rajesh Tope has
declared that it would be made mandatory for all
private hospitals to have in-house oxygen plants.47 plants that were lying in disuse have been
The Haryana Government has also asked all recommissioned and restarted. Police raids have
hospitals with over-50 bed capacity to make their been conducted on black-marketeers and huge
own arrangements for oxygen.48 Some oxygen numbers of cylinders and oxygen concentrators
have been recovered.49,50
12Recommendations and
Conclusion
P
rivate hospitals are also being mandated
to install oxygen plants. However, most
small nursing homes and medium-
sized hospitals do not have the required
resources. Hospitals without intensive Some additional obstacles are expected
care setups can manage with oxygen concentrators thereafter. Many government hospitals indeed
and cylinders, and plants should not be insisted had their own oxygen plants but they had fallen
upon. For medium and larger hospitals, some into disuse. Repairs were not done and instead,
financial support is needed to soften the cost large liquid oxygen tanks were installed that made
implications of oxygen plants in the short term. The the hospital dependent on transport network and
Central government has made provisions for soft suppliers. A similar situation must be pre-empted
loans to hospitals51 and nursing homes for setting and strategies formulated to prevent the newly
up oxygen plants, for a maximum of INR 2 crores built plants from falling into disuse. This becomes
and interest rate for the loan has been capped at 7.5 especially important as many of these plants are
percent per annum. being donated by well-meaning organisations
and their maintenance will eventually have to be
Several NGOs and religious organisations have managed by the recipients. Hospitals will save
also offered to set up oxygen plants at government significant financial resources on oxygen due to
facilities.52,53 However, the drive to install oxygen these plants and some part of these resources
plants is facing resistance from administrators of would need to be diverted towards maintenance.
many government hospitals, as they claim lack of Regular functioning audits of the plants would also
space and permissions as obstacles in setting up the need to be conducted and capacity augmentation
plants.54 An “iron fist in velvet glove” approach will done as needed.
be needed to overcome such bureaucratic hurdles.
13Endnotes
1 “India reported 512 oxygen-related deaths during second wave of COVID: Open Data Tracker,” The New Indian Express,
May 19, 2021.
2 Biman Mukherjee, “India has always had enough oxygen,” Fortune, May 18, 2021.
3 “Uttar Pradesh tags 38 oxygen tankers for real-time supply tracking,” Times of India, April 26, 2021.
4 “India oxygen crisis: Tata Group donates cryogenic containers.” Gasworld, April 21, 2021.
5 “Union Government imports 20 cryogenic tankers of 10 MT and 20 MT capacity, allocates them to States.” The Statesman,
April 27, 2021.
6 A.K. Das, “More Oxygen Expresses On The Way To Haryana, MP, Telangana And UP,” Swarajya, May 2, 2021.
7 B. Kagrana, “COVID-19 Aid From Ukraine Carrying 184 Oxygen Concentrators Arrives In India,” Republic World, May 31,
2021.
8 Joshi, Mallica, “Delhi to import 18 oxygen tankers from Bangkok, 21 oxygen plants from France: Kejriwal,” Indian Express,
April 27, 2021.
9 PTI, “India received 2060 oxygen concentrators, three oxygen generation plants as foreign aid,” The Hindu, May 8, 2021.
10 S. Choudhury, “How India ensured steady supply of medical oxygen,” March 2, 2021, https://www.pressreader.com/india/
hindustan-times-ranchi/20210302/281616718099049.
11 PM CARES Fund Trust allocates Rs.201.58 crores for installation of 162 dedicated PSA Medical Oxygen Generation Plants in public
health facilities. News release on pmindia.gov.in, January 5, 2021.
12 “Assam Has 8 Oxygen Plants Producing 5.25 MT /Day, 5 Plants in Process: Himanta Biswa,” The Sentinel, April 24, 2021.
13 “O2 Plants being installed over 13 medical colleges, institutes in UP, Say Officals,” Medical Dialogues Bureau, May 1, 2021.
14 V.S. Kumar, “How Kerala became an oxygen-surplus State in one year,” The Hindu, May 1, 2021.
15 “CM Pinarayi Vijayan Requests PM Modi to Provide 1,000 Tonnes of LMO, Vaccine Doses to Kerala,” News 18 India, May 5,
2021.
16 “Odisha Police escorts 345 tankers carrying 6354.742 MT medical oxygen to states,” News Kerala, May 6, 2021.
17 S. Nair, “Palghar: 11 Covid patients die due to shortage of oxygen cylinders in Nalasopara, The Times of India, April 13, 2021.
1418 Marianne Guenot, “India’s COVID19 surge is highlighting a ruthless global black market for oxygen where sellers jack
prices up to 1000%,” Business Insider, April 23, 2021.
19 “Bihar: Cops bust a black marketing racket of oxygen cylinders & concentrators; 225 cylinders seized,” Times Now, May 10,
2021.
20 J. Cohen, “The Grimmest Days Of The Covid-19 Pandemic Coincide With The Most Severe Forms Of Rationing,” Forbes,
January 8, 2021.
21 TS Johnson, “To breathe easy, use NIV instead of HFNO to conserve Oxygen stock, Karnataka Govt urges hospitals,” Indian
Express, May 17, 2021.
22 “Maharashtra: High-flow tube is guzzler of oxygen, avoid it, says task force,” Times of India, April 16, 2021.
23 Piyush Bhusari, “Audit helps Pune hospitals save 30 tonnes of oxygen a day,” Times of India, May 8, 2021.
24 “Oxygen audit panels set up in all hospitals,” The Hindu, Thiruvananthapuram, May 15, 2021.
25 “Save The Doctors” Campaign, Facebook post, June 2, 2021, https://m.facebook.com/savethedocs/posts/1654636058079767
26 Gonika Arora, “Delhi oxygen crisis: Slight relief and a deadline for Centre from Supreme Court,” India TV News, May 6,
2021.
27 “Our trucks are being diverted midway’: INOX informs Delhi HC that Rajasthan govt had held up 4 oxygen tankers meant
for Delhi,” OpIndia, April 27, 2021.
28 R. Dikshit, “Uttar Pradesh: Chandauli gives oxygen tankers ‘VIP’ status to save transportation time,” April 28, 2021.
29 Amitabh Sinha, “Explained: The peak of India’s second wave of Covid-19 is in sight, but end may still be far away,” Indian
Express, May 14, 2021.
30 “Govt launches ‘Project O2 for India’ to increase supply of medical oxygen,” Business Today, June 13, 2021.
31 “Madhya Pradesh: Invest in oxygen plants and get up to Rs.75 crore aid,” Free Press Journal, May 4, 2021.
32 PTI, “Maharashtra to give financial incentives for new oxygen-making units,” India TV News, May 21, 2021.
33 PTI, “Govt to procure 1 lakh portable oxygen concentrators, 500 more PSA oxygen plants from PM Cares Fund,”
Moneycontrol, April 28, 2021.
34 “Surge hits a new peak, Centre approves 551 oxygen plants for govt hospitals in districts,” Indian Express, April 26, 2021,
https://indianexpress.com/article/india/pm-cares-fund-oxygen-generation-plants-coronavirus-pandemic-7288290/
1535 “India is Running Out of Oxygen, COVID 19 patients are dying because the government wasted time,” Scroll, April 18,
2021, https://scroll.in/article/992537/india-is-running-out-of-oxygen-covid-19-patients-are-dying-because-the-government-
wasted-time
36 “Medical oxygen supply crisis: 33 PSA plants installed, 4 in HP,” Tribune, April 18, 2021, https://www.tribuneindia.com/
news/nation/medical-oxygen-supply-crisis-33-psa-plants-installed-4-in-hp-240801
37 “Dharmendra Pradhan inaugurates PSA based oxygen generating plant and booster set up by IGL,” psuconnect.in, June
14, 2021, https://www.psuconnect.in/news/dharmendra-pradhan-inaugurates-psa-based-oxygen-generating-plant-and-
booster-unit-set-up-by-igl/28240
38 “Delhi: CM launches 22 oxygen plants at nine hospitals,” The Hindu, June 13, 2021, https://www.thehindu.com/news/cities/
Delhi/cm-launches-22-oxygen-plants-at-nine-hospitals/article34802768.ece
39 “Maruti Suzuki in process of installing 24 oxygen plants in govt hospitals,” Business Standard, May 28, 2021, https://
www.business-standard.com/article/companies/maruti-suzuki-in-process-of-installing-24-oxygen-plants-in-govt-
hospitals-121052801529_1.html
40 “DRDO to set up 500 medical oxygen plants within 3 months: Rajnath Singh,” Times of India, April 28, 2021, https://timesofindia.
indiatimes.com/india/drdo-to-set-up-500-medical-oxygen-plants-within-3-months-rajnath-singh/articleshow/82289850.cms
41 “Oil PSUs to set up medical oxygen plants at 100 locations,” Live Mint, May 6, 2021, https://www.livemint.com/companies/
news/oil-psus-to-set-up-medical-oxygen-plants-at-100-locations-11620317470650.html
42 “DCM Shriram Ltd sets up oxygen generation plant at ESIC Ankleshwar,” The CSR Journal, May 29, 2021, https://
thecsrjournal.in/csr-dcm-shriram-ltd-sets-up-oxygen-generation-plant-at-esic-ankleshwar/
43 “Tech Mahindra Foundation and Mission Oxygen to set up 50 oxygen plants for charitable and government hospitals across
India,” Mahindra.com, May 12, 2021, https://www.mahindra.com/news-room/press-release/tech-mahindra-foundation-and-
mission-oxygen-to-set-up-50-oxygen-plants-for-charitable-and-government-hospitals-across-india
44 “Gehlot inaugurates PowerGrid installed oxygen plant at Jaisalmer District Hospital,” UNI India, June 4, 2021, http://www.
uniindia.com/news/india/health-powergrid-oxygen-plant/2413017.html
45 “Singrauli: Coal India Arm Northern Coalfields to Install Oxygen Plants in Madhya Pradesh and Uttar Pradesh,” Free
Press Journal, May 10, 2021, https://www.freepressjournal.in/bhopal/singrauli-coal-india-arm-northern-coalfields-to-install-
2-oxygen-plants
46 “WCL gives Rs. 15.38 crores for Oxygen plant at Nagpur & Chandrapur,” Nagpur Today, https://www.nagpurtoday.in/wcl-
gives-rs-15-38-crores-for-oxygen-plant-at-nagpur-chandrapur/05041816
1647 S. Jog, “Mandatory for pvt hospitals to set up oxygen plant: Public Health Minister Rajesh Tope,” The Free Press Journal,
April 16, 2021.
48 S. Dayal, “Gurgaon hospitals with 50 plus bed capacity directed to make own oxygen arrangements,” The Indian Express, May
7, 2021.
49 Bagish Jha, “Gurugram: 260 oxygen cylinders found in raid, racket was selling each for Rs 35,000, Times of India, May 6,
2021.
50 “Black Marketing of Oxygen Concentrators: Absconding Businessman Navneet Kalra Arrested, News18, May 16, 2021.
51 PTI, “Finance Ministry widens scope of ECLGS, banks to offer concessional loans for setting up oxygen plant,” Deccan
Herald, May 30, 2021.
52 C. Vrindavan, Chinmaya Mission Tristate Center, May 26, 2021,
https://nenp.facebook.com/ChinmayaVrindavan/videos/503409387679514/?__xts__%5B0%5D=68.ARDQ0yt_
PoVwZh3MNPeyx0Um0EaULGCtSOdmYiK9ITyyHGTrYez1Z50LTk6hJAiCczTWotCZbYMV3XRxAfpCrnifa
0645izaPpqCP6yuBCkb7ObabTh4CZo_ewrCVNSvORdYz5L0VCUWqqkKYdC-deF8bTIy14S6lkyGPoEZs.
53 “PPCR arranges 250 ventilators, 4,000 oxygen concentrators from Singapore,” Hindustan Times, April 24, 2021.
54 Abantika Ghosh and Remya Nair, “Modi govt invited bids for 150 oxygen plants in October, Today, just 33 are up,” The Print,
April 24, 2021.
About the Author
Dr Amit Thadhani is a practising general surgeon and Director, Niramaya Hospital, Kharghar Navi, Mumbai, a 75-bed hospital that
has been a Dedicated COVID-19 Hospital in the past year.
Cover image: Getty Images / Hidustan Times
Back cover image: Getty Images/Andriy Onufriyenko
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