‘Third COVID-19 wave imminent’: How prepared is India?

Medical oxygen capacity ramped up, oxygen beds increased, says Union government 

By Kiran Pandey
Published: Tuesday 28 December 2021

There is a renewed call for caution and action as countries across the globe pull themselves to fight another surge in novel coronavirus disease (COVID-19) cases driven by the new variant of concern omicron

United Nations Secretary-General António Guterres December 27, 2021 warned that infectious diseases pose “a clear and present danger to every country”.

The devastation caused by the novel coronavirus disease (COVID-19) pandemic showed the world has failed to learn from health emergencies, he said on the International Day of Epidemic Preparedness.

The same has been affirmed by the 2021 Global Health Security (GHS) Index released December 8, which said countries across all income levels, including India, are unprepared to meet future epidemic and pandemic threats.

Global Health Security Index assesses countries across six categories — prevention, detection and reporting, rapid response, health system, compliance with international norms and risk environment.

As the third wave of the pandemic becomes imminent in the wake of omicron, how prepared is the Indian government?

India’s performance has declined owing to a slow response to such situations. It performed poorly under “rapid response”, a key indicator under the GHS Index 2021.

The country’s score has slipped 11.8 points since 2019. Its current score is 30.3, much lower than the poor global average of 37.6.

The score has been arrived at based on data collected from August 2020-June 2021. Between April and June 2021, India experienced the devastating second wave that overwhelmed the healthcare system. While the hospitals struggled to cope, critical drugs and oxygen were in short supply.

India prepared for 3rd wave, claims government

The “third wave of the pandemic”— driven by the new variant of concern omicron — is projected to peak February 3, 2022, according to a study by the Indian Institute of Technology, Kanpur.

The yet-to-be peer-reviewed study was posted on preprint repository MedRxiv December 21.

Experts, too, had alerted the country about the inevitable third wave. They have cautioned against the dismantling of health infrastructure in fear of the inevitable third wave. Special hospitals created for COVID-19 should not be shut down, advised the health experts.

The Union government on December 10 acknowledged that omicron may lead to a fresh surge in COVID-19 cases. The matter was raised on several occasions in the Rajya Sabha and the Lok Sabha during the winter session.

Rs 1827.78 crore was released to states / Union territories in 2021-22 under Emergency Response and Health System Preparedness Package: Phase-II, according to the Union health ministry.

In the meantime, India’s medical oxygen capacity, essential for serious COVID-19 patients has increased nearly 28 per cent between October 2020 and November 2021.

There has been an increase in oxygen capacity to 8,778 tonnes / day from 6,876 tonnes / day in November 2021, Bharati Pravin Pawar, minister of state in the Union health ministry told Lok Sabha December 3.

The Union government has sanctioned 1,563 Pressure Swing Adsorption (PSA) oxygen generation plants. PSA oxygen plants generate medical-grade oxygen.

These include 1,225 PSA plants that have been installed and commissioned under PM CARES Fund in every district of the country, said Pawar.

Nearly 34 per cent of these have been commissioned in four states — Uttar Pradesh (128), Madhya Pradesh (88), Tamil Nadu (70), Maharashtra (68) and Bihar (62). At least 25 PSA oxygen plants have been commissioned in the national capital Delhi.

She informed that the states have been asked to install PSA plants in public health facilities and facilitate the installation of PSA plants in private health facilities. The required rates of oxygen flow in a non-intensive care unit (ICU) and ICU setting is 10 and 24 litres per minute per day per case.

This means that these plants can support more than 100,000 beds a day.

Online digital solutions such as the Oxygen Demand Aggregation system (ODAS) and Oxygen Digital Tracking System (ODTS) have been developed to ascertain the demand for medical oxygen from all medical facilities and to track their transportation.

ODTS helps track the daily allocations of oxygen, their dispatch and deliveries, including the movement of oxygen tankers.

The spread of omicron

At least 578 cases of COVID-19 caused by omicron have been reported from 19 states / UTs, as of December 27, 2021. Delhi with 142 cases tops the chart, followed by Maharashtra (141) and Kerala (57).

Measures, including night curfews, have been imposed by governments in Assam, Delhi, Gujarat, Haryana, Karnataka, Madhya Pradesh and Uttar Pradesh amid the surge.

Rajesh Tope, Maharashtra health minister, said in a media report in November end the third wave expected to arrive may be mild and medical oxygen and ICU beds will not be required.

Now, Maharashtra, among the worst-hit states, has prohibited a gathering of more than five people between 9 pm and 6 am.

Restaurants and gyms in the state are allowed to operate at 50 per cent capacity only. There is a possibility of a ‘yellow alert’ in Delhi, according to the recent health bulletin: The positivity rate increased from 0.55 per cent on December 26 to 0.68 per cent on December 27 in one day.

This is under the ‘Corona Graded Response Action Plan’ passed in July 2021. The Delhi government is likely to take a call in a review meet December 28.

Are hospitals prepared?

Delhi, the most infected state by omicron, has allotted 13,418 beds for COVID-19 patients, according to the Coronavirus dashboard of the state health department.

The state now has 10,374 COVID-19 oxygen beds. Of these, 292 are occupied and 10,082 are vacant, as of December 27, 2021.

Andhra Pradesh claimed to have spent about Rs 8,000 crore on multiple interventions for prevention, mitigation and management of COVID-19.

Close to 23,457 oxygen concentrators and 27,311 D-type oxygen cylinders are available. The state government has set up oxygen generation plants in 140 hospitals, which would be made available by December 15, said Chief Minister YS Jagan Mohan Reddy.

Andhra Pradesh has so far reported six COVID-19 cases of omicron.

National regulator, the Central Drugs and Standard Control Organization, granted permissions to six COVID-19 vaccines for manufacture in the country while three vaccines are presently used in the national COVID-19 vaccination programme: Covishield, Covaxin and Sputnik V.

On December 25, 2021, Prime Minister Narendra Modi announced the next step: India will start vaccinating children between 15 and 18 years from January 3, 2022.

Uttar Pradesh too has announced vaccinating children aged 15-18 years from January 3, 2022.

In India, people above 60 years of age who have co-morbidities will also be allowed to take the ‘booster dose’. Healthcare and frontline workers will be provided with “precautionary doses” from January 10, 2022.

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