Shortage Of Oxygen In Low- & Middle-Income Countries Leaves COVID-19 Patients Gasping For Breath Pandemics & Emergencies 24/06/2020 • Grace Ren One of the major medical supply limitations the Yekatit Hospital Medical College in Ethiopia faces is the shortage of oxygen tanks As new coronavirus cases surge around the world, shortages of supplemental oxygen, a crucial treatment for people suffering drastically low blood oxygen levels due to COVID-19, have left patients in many low- and middle- income countries gasping for breath. “WHO estimates that at the current rate of about 1 million new cases a week, the world needs about 620,000 cubic metres of oxygen a day, which is about 88,000, large cylinders,” World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus told reporters on Wednesday. In wealthier countries in Europe and North America, oxygen flows free through hospitals, piped directly to a patients’ bed. But as the pandemic appears to wind down in Western Europe and gather steam in Latin America, South Asia, Eastern Europe, and Africa, a shortage of the lifesaving gas has already led to COVID-19 deaths in countries with weaker health systems, according to AP News. Hospitals in many low-resourced countries do not have the capacity to produce oxygen – and heavy tanks of gas are often transported from factories miles away, or imported from other countries. Many low-income countries’ own oxygen factories’ tanks may also contain rust or chemicals that could damage coronavirus patients’ lungs, as these factories mainly produce the gas for use in construction or mining, WHO Chief of Operational Support and Logistics Paul Molinaro told the New York Times. WHO has been concerned about distribution of oxygen since the early days of the pandemic. “We need also to focus on getting better distribution of medical oxygen,” WHO Emergencies Executive Director Mike Ryan said at a press briefing in late March, when much of the global attention at been focused on a shortage of ventilators. Oxygen Concentrators Also in Low Supply portable oxygen concentrator by Innogen Hospitals can make their own oxygen using oxygen concentrators, which purify oxygen from the surrounding air and can be hooked up non-invasive continuous positive airway pressure machines (CPAP) to provide support. But even concentrators are in short supply. “Many countries are now experiencing difficulties in obtaining oxygen concentrators. Some 80% of the market is owned by just a few companies; demand is currently outstripping supply,” said Dr Tedros. WHO has procured 14,000 oxygen concentrators for use in 120 countries in recent weeks. Talks to buy some 170,000 more machines are in the works. The agency has also bought 9800 pulse oximeters, small monitors used to measure a patients’ blood oxygen level. Without access to such monitors, patients’ blood oxygen levels can drop precipitously low before telltale symptoms such as blue lips appear. However, COVID-19 patients in critical condition and put on ventilators require higher flow rates of oxygen than commercially available oxygen concentrators are able to supply, said Dr Tedros. “WHO is supporting several countries to buy equipment that will enable them to generate their own concentrated oxygen in larger amounts,” he added. “This is a sustainable solution for COVID-19 and beyond, but requires technical expertise for maintenance. WHO has also published technical specifications for the design of this equipment, as well as guidance for countries on oxygen sources, and distribution.” Image Credits: UNICEF Ethiopia/2015/Mersha, Wikimedia Commons: Oxystore.