The deaths of 26 Covid-19 patients at the Goa Medical College & Hospital (GMCH) during the night of May 10-11 has laid bare the gaps in the state’s medical infrastructure, and brought to the fore problems with the supply chain of oxygen.
With 2,491 new Covid-19 cases and 63 deaths on Thursday, Goa is the throes of a medical emergency and the new dreaded time is between 2 am and 6 am.
While Chief Minister Dr Pramod Sawant and Health Minister Vishwajit Rane squabbled over the real cause of deaths in the state’s largest Covid facility on May 10-11, the Bombay High Court at Goa (HC) chided the government for violation of Article 21 (Right to Life) of the Indian Constitution, sought updates about the state’s oxygen supply, and directed the Central government to supply allotted (26 MT) oxygen quota to Goa.
“Enough is enough,” the HC reprimanded the state government. “Statistics show an alarming rate of deaths taking place in Goa due to want of oxygen. We need to find a solution. We can’t be in denial. Article 21 (Right to Life of the Indian Constitution) is completely violated if people die due to lack of oxygen,” the HC noted on Wednesday.
Logistics problems
Though Dr Sawant quickly announced some redemptive measures, Goa continues to gasp for breath due to oxygen supply shortfall. The transportation from oxygen companies to hospitals has been badly affected due to lack of trained tractor drivers and Dura cylinders are still awaiting expert operators. Police is now escorting oxygen trollies and the state government is looking for tractor drivers from Karnataka and Maharashtra.
Oxygen requirement
To realistically tide over the oxygen shortfall crisis, each day, GMCH would need at least 500 jumbo cylinders of oxygen by 2 pm, followed by another 250 jumbo cylinders by 10 pm, and another 250 jumbo cylinders by 6 am the next day. In addition, it would require at least 72 trolleys of oxygen (but only around 55 were being supplied due to lack of production, trollies and drivers). Currently, GMCH’s oxygen shortfall stands at 400.
2-6 am deaths
Is 2-6am the Death hour? Between May 1 and 12, 2021, 419 patients died in GMCH between 2 am and 6 am. On May 11, the count was 26 patients during this timeframe; on May 12, the Death hour continued to wreak havoc - of the 40 Covid-related deaths in GMCH, 15 died between 2 am and 6 am.
When questioned by the HC about the 2-6 am deaths, GMCH Dean Dr Shivanand Bandekar said those on pipe oxygen are critical patients who require continuous oxygen, and while GMCH has high-flow nasal oxygen (HFNO) it is not using it because it consumes a lot of oxygen. “Not using HFNOs as it consumes more oxygen is not the answer; this is not the approach,” the HC chided the GMCH official.
Covid preparedness
- GMCH Dean admits shortage of beds and oxygen supply: After the HC sought the appearance of GMCH Dean Dr Shivanand Bandekar in the court via video conferencing, the dean admitted to shortage of beds and oxygen supply in GMCH - there are only 700 beds for 1,000 Covid patients, 320 patients are on oxygen cylinder while 160 patients are on piped oxygen.
- State government to arrange 600 oxygen cylinders every day: In an announcement that came too late for some families, Chief Minister Dr Pramod Sawant said that the state government will arrange 600 cylinders every day and a 20,000-litre oxygen tank will be set up at GMCH in 8-10 days for continuous uninterrupted supply of oxygen. “Plans are afoot to install Dura cylinders as a backup to GMCH’s oxygen manifold. Each of these Dura cylinders will have a capacity of at least 28 jumbo cylinders as they are filled with Liquid Medical Oxygen (LMO) instead of pressurised gas,” Dr Sawant said in an official statement.
- 300-beds and 150 HFNOs to be commissioned soon: Vishwajit Rane, the state health minister, announced that a 250-300 bed hospital and more than 150 HFNOs will be commissioned soon in GMCH’s Super Specialty Block. “In our continuous efforts to reduce mortalities due to Covid-19 in the state of Goa, we will also be working on adding more stringent measures to be put in place. Our team is working persistently to contain the surge in cases and to bring the virus under control,” Rane tweeted.
- Porvorim MLA sets up Covid-assist helpline: Porvorim MLA Rohan Khaunte has launched a Covid-assist helpline (8308607788) for those in need of ambulance service and oximeters.
On Wednesday, Goa received 32,870 doses of Covishield from the Centre to be used to vaccinate people in the 18-44 age category. Manipal Hospital opened its online slot for Covaxin vaccination (18-44 years) at 5 pm on Thursday; the slots will be available during May 17-22, 2021.
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