There must be millions in our country who are adhering to all precautions, emotionally and financially supporting others, obeying dynamic laws proposed by various lawful institutions, and yet feel anguished at the end of every day. It's extremely disheartening. And now, we have a new reason - The oxygen crisis of India.
As reports started to highlight the shortage of oxygen in hospitals, some with mere hours of stock left, many were disturbed by lack of preparedness on multiple levels leading to such a dire situation. Since then, I spend more than 40 hours researching and assessing to understand the reasons leading to our country's newest crisis. This article is not about what could have been done, rather outlining a comprehensive timeline of dynamic decisions taken, and in some cases - not taken.
After a successful trial lockdown (Junta curfew) on 22 March 2020, Prime Minister of India, Shree. Narendra Modi ordered a nationwide lockdown for 21 days (25 March 2020 – 14 April 2020) aimed to beef up medical infrastructure as well as break the transmission chain of the deadly novel coronavirus that crossed the borders of Wuhan city, China.
PM Cares fund is set up on March 27, 2020. Prime Minister of India, Shree. Narendra Modi appealed on social media at 8:00 pm on March 28, 2020. Within the first half-hour after the PM's tweet, the entire nation wholeheartedly donated. The amount collected was not disclosed but experts estimate that donations could add up to USD 30 billion.
On 29 March 2020, the fifth day of the lockdown, under the leadership of the Prime Minister, Home Ministry set up 11 Empowered Groups of officers by invoking powers under the Disaster Management Act of 2005. The core purpose of these EG 11 groups was to deal with issues and formulate a comprehensive and integrated response to mitigate coronavirus-related issues. Also, identify problems, and provide solutions for time-bound implementation, delineate policy, formulate plans as well as strategies operations in future.
The nationwide lockdown was extended further until 3 May 2020 followed by various state-mandated lockdowns aimed to further hinder community transmission.
In the second week of national lockdown, governments on different levels approve thousands of makeshift hospitals across the country and increase the quota in every hospital to dedicatedly treat coronavirus cases.
The results of lockdowns across the nation had a drastic negative impact on the economy and most affected the lower-income group of citizens. It also resulted in drastic positive outcomes in pollution control, climate, and wildlife welfare along with avoiding community transmission of the contagious coronavirus, thus preventing loss of lives.
During lockdowns, law enforcing officers in different cities collected up to 3 crores each, in just a couple of weeks, the highest was in Mumbai and Delhi. For context, there are 40 cities in India with a population of over a million, and 396 cities with a population between 100,000 - 1 million. This also led to widespread use of the term ‘Covidiots’. Prime Minister during his live televised address to the nation specially mentioned and warned who were in denial and putting the lives of others in jeopardy by flouting rules and not take precautions. [Obstinacy]
After 38 days, on May 4, 2020 liquor shops across the nation reopened leading to a beeline of kilometers, throwing social distancing measures in the wind. Police had to use force to disperse gatherings outside liquor shops in numerous cities across the country. [Obstinacy]
The Government of India, On May 7, 2020, initiated phase 1 of the Vande Bharat Mission to evacuate nearly 15,000 Indians stranded abroad began.
Between May 12 to May 16, 2020 - Finance Minister announced an economic package of Rs 20 lakh crore (equivalent to 10% of India’s GDP) under the name - Aatma Nirbhar Bharat Abhiyaan.
India begins to witness phasing out of rigorous lockdowns between June to July of 2020, despite the transmission numbers high, fatality numbers remained the lowest in the world.
On July 15, 2020, Phase-1 clinical trials of India’s first indigenous Covid-19 vaccine, Covaxin, developed by Hyderabad-based pharmaceutical company Bharat Biotech in collaboration with the National Institute of Virology and Indian Council of Medical Research, starts across the country.
By August 2020, India's testing capability surpassed Russia and other developed countries of the west, standing at third (34.5 million tests) after China (90.4 million) and the United States (74.7 million). Additionally, on 26 August 2020, the Serum Institute of India started India trials of Covishield, the Astrazeneca-Oxford vaccine.
In September 2020, the 11 empowered groups were restructured reducing to the new 6 empowered groups (EG 6)
Summary: Apart from the aforementioned measures, numerous other proactive, dynamic approaches were adopted which lead to the flattening of the curve by September 2020 (until we witnessed the second wave)
According to reports now made public, back in April 2020, Empowered Group 6 (EG 6) had already red-flagged possible oxygen shortage. According to the Confederation of Indian Industry (CII) reports, India produced over 2 million metric tons of industrial oxygen in 2020. As a usual business, more or less 50% of this production was converted for medical use (depending on demand)
During the peak of the first wave, India did not utilize even 3,000 metric tons of medical-grade oxygen, leading to a surplus. Subsequently, India exported 9,200 metric tons of industrial-grade oxygen (0.004% of total production)
The two predominant difference between Medical grade and Industrial grade oxygen is purity acheived by appropriate packaging, and ability to backtrack which is not necessary for Industrial use.
Regardless, based on April 2020 feedback from EG 6, in October 2020, the central government invited bids to set up 150 oxygen plants to be built in major hospitals which in turn would have cut down on procurement and transportation time. It also allocated Rs 201.58 crore among identified states and union territories from the PM Cares fund. Unfortunately, not all state governments reciprocated immediately.
In November 2020, EG 6 (headed by NITI Aayog CEO Amitabh Kant) in a meeting again red-flagged possible shortage of medical-grade oxygen in the future. In the meeting, it was decided for efficiency reasons, the responsibility be transferred to the Department for Promotion of Industry and Internal Trade (DPIIT) which comes under the Ministry of Commerce and Industry
Records show that four days after this meeting, a nine-member committee was set up under the chairmanship of DPIIT Secretary Guruprasad Mohapatra to “ensure adequate availability of medical oxygen in the wake of Covid-19 pandemic.” The Committee had also advocated to National Pharmaceutical Pricing Authority for capping prices of oxygen Cylinders to ensure that availability, as well as affordability of the Oxygen Cylinders, was ensured in all hospitals for medical use.
The Central Medical Services Society (CMSS), an autonomous body under the Ministry of Health and Family Welfare, is the nodal agency issuing tenders in this regard and was responsible for installation and commissioning. The orders, industry sources say, were placed in December but when vendors reached the hospitals for installation, many “faced resistance”.
“The usual response was there is no space. The real reason though was probably vested interests in continued procurement of oxygen rather than generating the entire requirement onsite,” said many industry sources.
Summary: Responsible people in dynamically established ministries and groups had the foresight, and as per press releases and government documentation, it proves adequate actions were being considered, awaiting implementation.
In the third week of April 2021, reports started to emerge from Indian mainstream media highlighting the acute shortage of medical oxygen in different Indian cities. More than 100 people in different cities lost lives due to a lack of oxygen, marking a shameful chapter in India's fight with Coronavirus. Soon after, conflicting information started to flood news and social media predominantly for blaming others, causing immense distress to Indians in a time when we should unite and stay positive.
On 20 April 2021, Moneycontrol.com, an Indian online business news website, a subsidiary of the media house TV18 was the first who published non-verified news claiming India exported 9,300 MT of oxygen between January to March 2021, which was further propagated by NDTV and numerous politicians from the opposition. After 24 hours, a corrigendum was issued by the news portal on every platform, however other news channels, as well as prominent personalities on social media, continued to quote the report for attacking the central government. Link to corrigendum posted on Twitter from their official verified handle. [Irresponsible journalism]
In October 2020, the government had invited tenders for 150 pressure swing adsorption (PSA) oxygen plants, which were to be built into hospital premises, thus reducing dependency on cylinders (Inefficient and time-consuming process of procurement during Pandemic) with a cumulative capacity of 80,500 liters/minute. As confirmed by the Union Ministry of Health and Family Welfare, only 33 were set up. This report came after a strategic portion of a closed-door meet on 23 April 2021, between the Prime Minister and Chief Minister of the 10 most affected (out of 36) states was televised live by Chief Minister of Delhi, Shree. Arvind Kejriwal where he was seen pleading to Prime Minster to arrange more oxygen for residents of Delhi. Later, many ministries and fellow chief ministers pointed out that of many nationwide tenders, 8 PSA Oxygen plants were to be built in Delhi alone as per quota allotted however, only 1 was operational in the 5 months' time. Unfortunately, the noise created due to the charade left negligible chances of accountability. Residents of Delhi suffered for 2 weeks amid the shortage of oxygen. Except for a few fortunate state, rest bickered for weeks [Shameful politics]
Numerous Public interest litigation (PIL) filed across India, challenging slander from vested interests. The information available on mainstream media contradicts when submitted in an affidavit to the court.
Although the highly transmissible double and triple mutations of novel coronavirus were already flagged in the last months of 2020, the infections leading to the second wave were not felt until the start of March 2021. Despite strong evidence and growing numbers, highly charged political rallies and religious gatherings in alarmingly high numbers were allowed and attended, predominantly in the states of West Bengal and Uttar Pradesh. Maharashtra, the third-largest state, continues to be the most affected in the entire country despite no political rallies or comparatively large religious gatherings. Regardless, the Bhartiya Janta Party (BJP) that forms the current government of India did not show any restraint while being the cause of huge gatherings in more than 3 states during the month of April 2021. [Lack of restrain for larger good]
Apart from the aforementioned key events, large-scale coordinated ongoing propaganda/chest-thumping is being countered every hour on TV, Print, Radio, and Social Media. For a commoner, none of the information or action matters when they or their close one would learn that oxygen is about to run out. It's extremely terrifying to even imagine.
In such cases, a gullible commoner would unsurprisingly use a catchall phrase to blame one person even if it was them who failed to adhere to basic issued guidelines for public health.
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