Fourth wave will leave hospitals gasping for air

The predicted and more lethal fourth wave of the Covid-19 virus next month will push hospitals grappling with the shortage of medical oxygen into the brink.

Most counties depend on private oxygen suppliers, whose supply is not sustainable, and hoarding of oxygen cylinders only worsens the situation.

Even Kenyatta National Hospital has not been spared by the shortage of oxygen.

Elective surgeries were suspended there in April and are yet to resume.

The management noted that supply of oxygen by BOC has remained low.

Nyanza region sources its oxygen from Hewa Tele oxygen processing plant in Siaya.

David Mutua, the plant manager, said they produce between 50 and 55 cylinders of 50 kilogrammes each every day, which is not enough and they have to outsource oxygen from Nakuru and Nairobi plants to meet the demand in Siaya, Bungoma, Kakamega, Kisumu and Homabay.

Consumption has doubled

Siaya spends about Sh4 million on medical oxygen, out of which, at least Sh2.8 million is for managing Covid-19 patients, according to Health CEC Dismas Wakla.

“The oxygen is piped to isolation centres at Siaya County Hospital, Bondo sub-County Hospital and Ambira and consumption of oxygen is increasing by day.” said Wakla.

He attributed the rise to failure by locals to observe Covid-19 prevention measures.  But the county has increased isolation beds at Ambira, Bondo and Siaya hospitals with 150, 60 and 200 respectively.

The Jaramogi Oginga Odinga Referral and Teaching Hospital (JOORTH) is another facility which outsources medical oxygen despite it being the leading referral facility serving Nyanza and Western Kenya.

Dr George Rai, its chief executive, said consumption of medical oxygen has doubled in recent months from 3,000 litres weekly to about 6,000 litres.

It costs Sh1.8 million to buy the essential commodity from BOC Gases and besides its use in theatres and wards, Dr Rai attributes increased consumption “to the Covid-19 pandemic, because majority of patients admitted have shortness of breath.”

The oxygen is also piped to the Covid-19 isolation unit and by May 27, the hospital had 31 Covid-19 cases, of which 19 were on high flow oxygen. Dr Rai said major hitch incurred is replenishing the commodity, due to high demand.

As mitigation, JOORTH is constructing a Sh51 million oxygen processing plant with a capacity of 500 litres per minute of which 300 will be for its own use while 200 litres will be supplied to other health facilities in Kisumu.

Packaging process

To contain the virus, Dr Rai recommends promotion of the “bubble theory whereby anybody who tests positive should form a group and keep it for about three months. With such, we shall be able to break chain of transmission.”

Dr Neto Obala, a clinical pharmacist coordinating Covid-19 activities, says while previously patients suffered loss of smell and taste, and had fever and headache, “now majority have low oxygen levels and it mandatory to save their lives” since Covid-19 comes with attendant problems of upper respiratory system, breathing difficulties and low oxygen levels.

The shortage of medical oxygen has also been reported at the Covid epicentres including the Lake Basin region, North Rift and Upper Eastern, according to a report by the Lake Basin Economic Block (LREB) Eminent Persons Advisory Committee on Covid-19.

LREB mentions Siaya, Trans Nzoia and Migori as the only counties out of 14 in the region which have capacity to produce medical oxygen.

An oxygen analyser is used to check purity of the oxygen during packaging process.

A cylinder of 50 kilogrammes is sold at Sh4,000, 22 kilogrammes goes for Sh1,600 while the 5.5 kilogrammes sells at Sh880.

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