Medical oxygen: how is it made and why is it rare in some countries?

PARIS.- Faced with respiratory failure caused by the coronavirus, the ranks of patients in distress are increasing in India and other developing countries to try to get medical oxygen, which is far from being sufficiently available on an industrial scale all over the world.

Affordable and sustainable access to oxygen during the pandemic has become a growing challenge and its scarcity has led many people to scramble to achieve it, queuing up to almost ten hours for the chance to recharge the tube and to help their loved ones. Many infected died during their relatives waited a turn to stock up.

Lines that multiply

Lack of oxygen in the India Yes Democratic Republic of Congo, queues in front of the hospitals of Venezuela, price speculation Peru, the input black markets in Brazil. For weeks, it has been reported around the world that oxygen, vital in saving people with respiratory problems, is rare in many so-called low- and middle-income countries, especially Latin America Yes Africa, but also in the India, is now one of the countries hardest hit by the pandemic.

Although vital for the effective treatment of patients with Covid-19, access to oxygen, relatively easy in Europe and North America, is limited in these countries due to cost, poor infrastructure and logistical barriers, explains Unitaid, the sponsored international organization. World Health Organization (WHO) which is in charge of centralizing the acquisition of treatments.

WHO says one in five patients with Covid-19 will need oxygen.

What are the needs of these countries in the face of the pandemic?

In February, the WHO estimated that more than half a million people in those countries needed 1.2 million cylinders of oxygen a day.

Unitaid estimates its needs at 1.6 billion dollars for the purchase of bottles for the poorest countries this year: “A global emergency that requires a global response”. According to the organization, some 20 countries, including Malawi, Nigeria and Afghanistan, will face major challenges.

How is medical oxygen made?

There are two main types of oxygen production: medical and that produced by means of a concentrator.

the Medical oxygen can be obtained by separating gases from air. This is composed of 78% nitrogen, 21% oxygen and 1% of various gases such as argon, carbon dioxide and helium among others, he told the AFP Régis d’Hérouville, Director General of Air Liquide Santé France.

02 (oxygen) is isolated from the air after the stages of compression, filtration and purification. Concentrated at more than 99.5%, it is a drug. It is transported liquefied in large containers or tanks with insulating walls, which allows it to maintain its temperature below -182 ° C or in gaseous form in bottles of smaller volume.

“The supply of liquid oxygen is what makes it possible to meet the most important needs and variations in demand.. One liter of liquid oxygen is equivalent to approximately 800 liters of gaseous oxygen. Oxygen can also be supplied in pressurized cylinders to allow patient mobility. In this case, one liter of gaseous oxygen at 200 bar corresponds to 200 liters of gaseous oxygen that a patient can use directly, ”explains Hérouville.

On the other hand, the oxygen produced by the concentrator It is an oxygen concentrated at 93% in general. It is portable electrical equipment that extracts and purifies oxygen from the ambient air in real time, or larger production units that can supply large entities such as hospitals.

“In the absence of liquid oxygen production infrastructure, concentrators are useful, but they are sized for a specific need, which makes it difficult to respond to a sudden and rapid increase in oxygen consumption multiplied by five or even six, as we saw in some French hospitals during the Covid crisis -19. In addition, consume a lot of energy and have a high maintenance cost», Declares Hérouville.

Who are the main producers?

Outside of China, the world’s top three suppliers of medical oxygen are: Germany Linde, allied to the American group Praxair, French Liquid air and the American Airline products.

But medicinal oxygen is mainly produced by many local and regional players, because one of its main problems is that it is difficult to transport over long distances. For this reason, it is no longer available in industrialized countries.

Production units have been built to supply sectors other than health, such as the steel and chemical industries.

What oxygen for India?

In India, Air Force cargo planes began delivering large oxygen tankers last week in places where it was needed. On April 22, a first “Oxygen Express” train was put into service.

The Indian Ministry of Defense also announced the import of 23 mobile oxygen production units from Germany. France sent eight oxygen production units and liquefied oxygen containers to supply up to 10,000 patients in one day.

AFP