Queues in front of hospitals in India and Venezuela, soaring prices in Peru, shortages in the Democratic Republic of Congo, black market in Brazil… Oxygen, vital to save covid patients in respiratory distress, is lacking in several countries. Globally, the threat of a shortage has been hovering since the start of the covid-19 pandemic.

Liquid or gaseous oxygen

But when we talk about oxygen, what are we talking about? Oxygen used as a treatment can take two forms.

First of all, so-called medical oxygen is a key component of resuscitation services. Concentrated at more than 99.5%, it is a drug identified by a unique batch number and distributed in hospitals. It can be packaged in canisters, in liquid form or in gas form.

Liquid oxygen is the most efficient form of meeting increased demand, because one liter of liquid oxygen is approximately equivalent to 800 liters of gaseous oxygen.

Plan B: concentrators

Then, oxygen can also be produced by concentrator, an electrical equipment that extracts and purifies oxygen from the ambient air in real time. It is 93% concentrated and can supply large entities, such as hospitals.

This equipment is particularly useful in areas which do not locally produce liquid oxygen. But they are sized for a given need, and therefore have difficulty responding to an increase in demand, as in the case of an epidemic outbreak. Another problem: they consume a lot of energy.

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Easy access to Europe …

While access to oxygen is relatively easy in Europe and North America, it is limited in many developing countries. In question: its cost, limited infrastructure and logistical obstacles, explains Unitaid, the international organization hosted by the World Health Organization (WHO), responsible for centralizing the purchase of treatments.

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And one of its main problems is that it is difficult to transport over long distances. This is also the reason why it is more available in industrialized countries, where production units are located.

… But limited in 20 countries

According to Unitaid, access to oxygen is complex for some twenty countries located in Latin America in Africa, but also India and Afghanistan. In these countries, less than half of hospitals have oxygen at all times.

However, in February 2021, the WHO estimated that more than half a million people needed 1.2 million bottles per day in these countries because of the covid epidemic.

One in five covid patients need oxygen

Why such a request? Covid patients in respiratory distress, hospitalized or at home, and whose blood oxygen levels drop dangerously, should receive oxygen. According to the WHO, one in five patients with covid will need oxygen.

This represents colossal needs in countries like India or Brazil, which have tens or even hundreds of thousands of new cases of covid per day, and which initially have restricted access to oxygen.

Without oxygen, no survival

And what if patients who need oxygen can’t access it? If a patient in respiratory distress does not receive external oxygen, the proportion of oxygen in his blood decreases: it is a desaturation of the blood and the patient is then in hypoxia.

The organs are no longer properly oxygenated, which causes them damage that is all the more serious as the hypoxia is prolonged. In the most severe cases, hypoxia leads to coma or even death from cardio-respiratory arrest if it is not taken care of.

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This is precisely what happened in January 2021, in Brazil. Dozens of covid patients have died in saturated Manaus hospitals for lack of oxygen.