26 hospitals getting centralised oxygen supply to combat Covid-19

The Bangladesh government will install central oxygen tanks or Vacuum Insulated Evaporators (VIEs) in 26 hospitals treating Covid-19 patients across the country.

After installation, the VIEs will ensure uninterrupted oxygen supply to around 12,000 coronavirus patients without the need for cylinders.

Officials concerned told The Business Standard that within the next ten days,the VIEs will be installed in Dhaka's Kurmitola General Hospital, Shaheed Suhrawardy Medical College and Hospital, and Kuwait Bangladesh Friendship Government Hospital. 

Besides, the other 23 hospitals will get central oxygen tanks within this month.

Under the supervision of the National Electro-Medical Equipment Maintenance Workshop (NEMEMW), LINDE Bangladesh and Spectra International Ltd will install the VIEs in 13 hospitals each, with a cost of Tk45,590,000.

On Saturday, NEMEMW's Chief Technical Manager Md Aminur Rahman said, "We sought the health ministry's approval on June 10 to install the VIEs in 26 hospitals treating Covid-19 patients.

"If we get the approval by Sunday, it will be possible to install central tanks for supplying oxygen to patients through pipelines within this month."

He continued, "LINDE Bangladesh and Spectra International Ltd have started working on the project after getting our verbal confirmation. Two 20-kilolitre VIEs will be installed in Dhaka's Kurmitola General Hospital and Sylhet's MAG Osmani Medical College. 

"The remaining 24 hospitals will get 5-kilolitre VIEs. We have finished installing pipelines in all 26 hospitals."

One kilolitre of liquid oxygen produces 960,000 litres of gas. A Covid-19 patient needs ten litres of oxygen per minute, and 10,000-14,000 litres of oxygen per day. So, one 5-kilolitre tank can supply oxygen to 350 patients for 24 hours on one refill.

As patients will still require ventilators for receiving oxygen, the government has decided to import ventilators as well. A hospital with a 5-kilolitre VIE will be able to provide oxygen to 50 Covid-19 patients for 3-4 days with each refill. 

Many facilities are using oxygen cylinders, which need to be replaced relatively quickly as they deplete faster. The availability issue of oxygen cylinders is also a major concern for patients. There are many complaints that patients have died without getting oxygen in hospitals.

Habibur Rahman Khan, additional secretary and focal point of the health ministry media cell, said, "We have no information as to when the number of coronavirus infections in Bangladesh will reach its peak and then start to go down.

"An emergency initiative will be taken to install VIEs in hospitals for ensuring an uninterrupted oxygen supply to patients. Steps will be taken so that the ministry gives its immediate approval for this project."

A central oxygen supply means having a dedicated place in the hospital where the oxygen is stored and supplied to all patients at their beds, using pipelines in the wall. There are staffers who monitor how much oxygen the storage chamber has and make sure that the patients are not deprived of it.

Doctors said the problem with cylinders is that they need to be constantly monitored by doctors or nurses to see if there is enough left, or if it has been properly refilled.

This has been proving to be an issue in hospitals treating Covid-19 patients because of acute mismanagement and manpower shortage, while also increasing the chances of a patient dying.

Frontline medical personnel said they have lost many people – including university teachers, physicians and bankers – just because of supply shortages of high-pressure oxygen.

Commenting on the issue, Chattogram Medical College Hospital's medicine department Professor Dr Aniruddha Ghosh said, "Fifteen to eighteen percent of patients need oxygen support. For them, oxygen cylinders cannot provide the adequate pressure they require. 

"Therefore, a Covid-19 treatment facility should have a central oxygen supply system."

Currently, Dhaka Medical College Hospital and Sylhet MAG Osmani Medical College have 10-kilolitre VIEs, while 20 other hospitals have 5-kilolitre VIEs. 

The VIE in MAG Osmani Medical College needs to refilled every 2-3 days due to high demand from patients. Therefore, a new VIE with 20-kilolitre capacity will be installed there. 

Dr Rowshan Ara, member of the National Technical Advisory Committee (NTAC) on Covid-19, said, "It will take time to install VIEs. We have advised the ministry to import Hi Flow Nasal Cannula (HFNC) and oxygen cylinders to ensure oxygen supply to Covid-19 patients in the meantime.

"The equipment can be imported from China within the next seven days. The HFNC can be used to directly supply a patient with oxygen without a ventilator."

Dhaka's Sarkari Karmachari Hospital, Chattogram's 250-bed Hospital, Khulna's Shaheed Sheikh Abu Naser Specialised Hospital and Gazipur's Shaheed Tajuddin Ahmad Medical College are among the 26 hospitals that are getting the VIEs.