No Covid deaths due to oxygen shortage? Doctors who saw the horror disagree

There have been submissions in the high courts of various states about the deaths linked to oxygen supply, which required documentation, here are the reasons.

No Covid deaths due to oxygen shortage? Doctors who saw the horror disagree
The Central Government on July 20, 2021, stated no deaths due to lack of oxygen reported by states/UTs during COVID-19 second wave. (Photo credit: PTI)

New Delhi: The Opposition parties have bitterly criticised the Central Government after it told the Rajya Sabha on July 20 that no deaths due to lack of oxygen were specifically reported by states and Union Territories (UTs) during the second COVID-19 wave.

During the Monsoon Session of Parliament on July 20, Dr Bharati Pravin Pawar, Union Minister of State for Health in a written reply in the Rajya Sabha noted that health is a state subject and states and UTs regularly report the number of cases and deaths to the Centre.

“Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states and UTs.

“Accordingly, all states and UTs report cases and deaths to the Union Health Ministry on a regular basis. However, no deaths due to lack of oxygen have been specifically reported by states and UTs,” Pawar said in the statement.

The minister had responded to a question on whether a large number of COVID-19 patients died on roads and hospitals due to an acute shortage of oxygen in the second wave.

Centre shifts blame on states

After the statement caused an uproar by the Opposition leaders, the ruling Bharatiya Janata Party (BJP) spokesperson Sambit Patra at a press conference on July 21 slammed the Opposition-ruled state governments who had cornered the Centre over deaths of Covid patients due to oxygen shortage earlier.

The BJP spokesperson asserted that the Centre only collects data from the states it does not generate any data of its own. He accused Opposition-ruled states of changing their stance in the High Court.

“…the deaths of 21 Covid patients at Delhi’s Jaipur Golden Hospital went to the Delhi High Court which passed an order for a committee to be formed to probe the matter. The committee’s report was submitted in the High Court by the Aam Aadmi Party (AAP) government which said that there is a lack of any evidence to suggest that these deaths were because of oxygen shortage. The AAP government has informed the Delhi High Court that oxygen shortage as the cause of death of 21 Covid patients could not be ascertained by an expert committee which probed the matter.” Patra said.

The BJP spokesperson also said the Maharashtra government in its affidavit to the Aurangabad Bench of Bombay High Court said that no patient had died due to oxygen shortage in the state.

“These governments were accusing the Centre of shortage of oxygen but when they have to submit a report to the High Court why does that report change, is the question. The key question is whether states sent the numbers which we did not reveal.”

Oxygen Delhi

In this file image dated April 27, 2021, family members of COVID-19 patients wait outside an oxygen-filling centre to refill their empty cylinders at Naraina in New Delhi. (Photo credit: PTI)

State that reported deaths

However, the Andhra Pradesh government on June 29 told the Andhra Pradesh High Court that 23 Covid patients died at Sri Venkata Ramnarayan Ruia (SVRR) Hospital due to lack of oxygen.

Speaking with News9, Dr M Raghavendra Rao, Director of Medical Education, Andhra Pradesh asserted that it is public knowledge that these deaths were due to oxygen shortage and naturally this information will go to the Central Government also.

“We are going to file a case against the oxygen supplier also. The information about these deaths is sent to the Government of India through formal channels.”

Furthermore, in May, a Karnataka High Court-appointed committee in its report said that 36 deaths at a Covid-19 hospital in Chamarajanagara could have been caused due to lack of oxygen supply.

“The death of these 36 in-patients could be attributed to the non-availability of oxygen during the night of 02-05-2021 and early hours of 03-05-2021,” the report said.

The High Court of Bombay at Goa made the following observation after Goa health minister Vishwajit Rane claimed that patients at the Goa Medical College could have died due to interrupted supply of oxygen.

“The material placed before us establishes that patients are indeed suffering and, in some cases, succumbing for want of oxygen in the state of Goa.”

Both Karnataka and Goa governments have denied that these deaths took place due to oxygen shortage.

Deaths due to oxygen shortage or not

Nevertheless, the country witnessed citizens queuing up and scampering to obtain oxygen cylinders and there were panic calls on the streets to arrange for oxygen supply.

According to user-generated data gathering effort DataMeet, media reports from 20 states indicate there were at least 619 deaths due to oxygen shortage.

However, subsequent inquiries suggested the fatalities were caused due to other reasons.

For serious COVID patients with hypoxemia, when oxygen levels in the blood are too low, oxygen therapy is critical.

Dr Ravindra Mehta, Chief of Critical Care, Consultant Pulmonologist, Apollo Hospitals in Bengaluru says depending on the person’s oxygen need and reserves, for example, for a patient on an HFNC ventilator if oxygen is not supplied anywhere from five to 10 minutes it can be lethal.

“For other machines, it could vary between 10 and 20 minutes.”

The pulmonologist explained that if patients have no reserve oxygen and they are on machines for oxygen supply then even a short amount of time without oxygen can be life-threatening or cause permanent organ damage.

“If oxygen supply is cut off, all organs fail, the death certificate will not mention the patient died of oxygen shortage because it cannot be written that way. But imminent death is related to that particular deficiency,” he said.

Kanpur Oxygen Cylinders

Family members of COVID-19 patients wait to get oxygen cylinders filled in Kanpur, Uttar Pradesh. (Photo credit: PTI)

Pandemic response under question

Dealing with a pandemic requires efficient data collection to form strategies to control infection and reduce mortality.

The national COVID task force should have taken note of these deaths even if the states did not report them.

Dr Chandrakant Lahariya, Delhi-based physician-epidemiologist and public health expert, told News9 that public health experts have already been highlighting that there is a need for more data on pandemic-related aspects.

“Secondly, as a responsive government, which intends to deliver health services to the people, and the reality that many people searched for oxygen, it will be prudent that the government takes up proactive efforts rather than focussing upon the traditional approach of collecting data from state governments on this aspect.”

The public health expert highlighted that governments and policymakers need to develop a better understanding of the impact of oxygen on health outcomes.

“It is only logical that understanding and working on the impact of oxygen is the right thing for the government to have done on its own.”

When asked whether such lack of data may affect the Centre’s response to the pandemic, the epidemiologist replied in the affirmative.

“There are three dimensions to it: one, we need better data to understand the impact in the past, two, we need better data to prepare for the future and three, it is an opportunity to create better recording and reporting systems than we have in the past,” Dr Lahariya emphasised.

Hospitals like Shree Ram Singh Hospital and Sir Gangaram Hospital in Delhi, Sun Hospital in Lucknow reported a shortage of oxygen at their facilities.