Concern over medical oxygen as govt starts plan to increase supply

South Africa’s medical oxygen levels have raised some concern, with Health Minister Zweli Mkhize saying the country “does not, right now, have the same level of oxygen for medical usage”.

Mkhize said government had held urgent weekend meetings with liquid oxygen suppliers to increase oxygen provision, as well as capacity at hospitals in the country, including field and district hospitals, in Gauteng, the Western Cape and Eastern Cape.

“We have also, in the modelling, noticed that the country doesn’t right now have the same level of oxygen for medical usage, and therefore we have now been involved in these discussions to divert some of the oxygen for industrial use into the healthcare [system] and also looking at how the production must be increased,” Mkhize said.

He added there had been some concern around infection levels, particularly in Gauteng, because the province had recorded many cases in a short period of time.

“The sudden increase within a short space of time is what really jacked the system in Gauteng. At the beginning, we identified certain hospitals that needed to be given focus as being the ones where the patients with Covid-19 would be treated but it became over time that we needed to open up all the hospitals to be able to manage [Covid-19 patients],” the minister said.

As a result, the National Emergency Intervention team has been set up to assist Gauteng to increase the number of beds in hospitals.

While field hospitals were originally provided to isolate patients, Mkhize said government realised it would be more useful if the beds were provided with oxygen.

“Now that’s a new issue that got built in long after we established the number of beds that we needed to prepare,” he said.

He explained that as Covid-19 patients commonly experience a lack of oxygen in the blood, they will then need to be put on oxygen to assist them.

Modifications in hospitals

Department of health spokesperson Popo Maja said the increase in demand for medical oxygen during the pandemic has led to government needing to make some “modifications” in a number of hospitals to ensure a stable supply of air.

Maja said there had been no issues regarding oxygen reported to the department, but he added government had embarked on a plan to address “engineering challenges” experienced by some medical facilities in the country.

“National government has approved a systematic plan to address these engineering challenges in all provinces. Oxygen suppliers have been engaged as early as the beginning of March to ramp up production of oxygen. Both national and provinces are working together to monitor the situation, just to avoid anything going wrong,” Maja said.

He added that while there had not been any obstacles regarding supplies in hospitals, adjustments had to be made to the infrastructure in some facilities to allow for more access to oxygen for patients.

“There has not been a problem with oxygen supply to any of the hospitals. In view of the increased oxygen demand for Covid-19, we have had to make some modifications to the mechanical and engineering infrastructure at some hospitals to ensure that the level of the pressure of oxygen in the system is stable.

“Some emergency engineering work has been necessary and will continue to be done wherever necessary in order to ensure that oxygen gets to the patients,” Maja said, including in Gauteng and the Eastern Cape.

“By engineering services, we mean that we are making available oxygen in wards where oxygen was not necessary before. We are also making oxygen available in field hospitals,” he explained.

Concern over supplies

However, one expert, who wished to remain anonymous for fear of vilification, recently raised concern over supplies earlier this month, and said the three months of lockdown to prepare for the spike of coronavirus infections might not have been enough.

“We’ve stopped the lockdown right in the midst of this infection explosion, and in winter when people are getting flu anyway, but it’s very worrying because even with the three months of preparation it’s almost like it isn’t enough. You can only do so much or have so many hospital beds or have so much oxygen in preparation.”

While South Africa have ventilators for critical Covid-19 patients, “what we do not have enough [of] is the oxygen that goes through the ventilator mask to keep the person alive.”

Oxygen issues experienced in some hospitals have been engineering or infrastructure related, including blockages in the pipes or tubes that takes the oxygen to the patient, the source said.

Afrox, a major supplier of medical oxygen in South Africa, said they had met all their supply demands.

“Afrox has met all the medical oxygen demands from our customers, including state hospitals and clinics during the pandemic to date and has the ability to substantially ramp up supplies as needed going forward,” the company said.

“Afrox has a contract to supply oxygen and other medical gases to all government hospitals and clinics in South Africa. There are no barriers or shortages to supply all the needs of state hospitals and clinics at this time. The same applies to all Afrox’s private healthcare customers.”

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