Write a letter to the editor of a newspaper describing the acute shortage of oxygen cylinders in the hospitals of your Covid-affected locality.

The latest horror of the pandemic is that large numbers of people around the world are dying for lack of access to medical oxygen, especially in India. Each day, tens of thousands of people are admitted to hospitals with Covid-19, driving the demand for the oxygen far beyond the supply.

Oxygen makes up 21 percent of the atmosphere. A handful of companies capture and purify it in bulk, but they sell most of it to industry. Many poorer parts of the world lack the infrastructure needed to deliver or make use of the medical grade supplies those companies sell, which are designed to be delivered via pipes to hospital rooms.

Some hospitals and clinics have machines that produce purified oxygen at a much smaller scale, but they are in short supply. So many hospitals and patients in poor countries and in remote areas rely on the most expensive option: oxygen tanks that have became scarce in the countries hit hardest by the virus.


The shortages affect patients with every kind of respiratory ailment requiring oxygen, not just those with Covid.

The World Health Organization said in February that $1.6 billion would be needed to remedy the oxygen shortage for a year; now that estimate is up to $6.5 billion. Efforts to raise that money have faltered, though it is a small fraction of what has been spent on vaccines and financial support for businesses and workers.

Here are answers to some of the questions being asked about the oxygen crisis. An employee refilling oxygen tanks as a free service provided by the government in Iztapalapa, Mexico City. In the last two months, the unmet, global need for medical oxygen has more than tripled.Credit…Luis Antonio Rojas for The New York Times


How did it get so bad, so quickly?

Given the enormous, and obvious, need for oxygen during a pandemic affecting the respiratory system, the crisis should not have come as a surprise. But in a year when policymakers lurched from one pandemic challenge to another — P.P.E. shortages, lockdowns, the threat of economic collapse, remote schooling, therapeutics, vaccines — oxygen supply never rose to the top of the list.


“Oxygen hasn’t been sufficiently prioritized,” said Robert Matiru, program director at Unitaid, one of the global public health groups working to address the shortage with the World Health Organization.

Even before the pandemic, some poorer regions were unable to ensure adequate supplies. But it was not until early this year, when lethal oxygen shortages hit northern Brazil, Mexico and elsewhere, that it became clear that what had been seen as a potential problem was becoming a dire emergency. The World Health Organization created an emergency task force on the oxygen shortage and called for money to address it.

What is needed to solve this crisis?

Money and time.

Public health advocates say hospitals should have P.S.A. plants and the piping to go with them, but in poor countries that solution can be cost prohibitive, achievable only with international aid. India’s government plans to install the equipment in hundreds of hospitals, but that could take months.

Companies that make P.S.A. plants and oxygen concentrators are ramping up production around the world, but that, too, takes time.


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