Lok Sabha Question No. 85 (STARRED), answered on 2021-12-03
Subject: Deaths due to Oxygen Shortage
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Balubhau (Alias Suresh Narayan) Dhanorkar, Adoor Prakash

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO.85 TO BE ANSWERED ON THE 3 RD  DECEMBER, 2021 DEATHS DUE TO OXYGEN SHORTAGE

## *85. SHRI BALUBHAU ALIAS SURESH ADV. ADOOR PRAKASH:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government had sought report/data from States/UTs regarding deaths of Covid patients due to oxygen shortage in various hospitals across the country during the second wave of the pandemic, if so, the details thereof;
- (b) whether the Government has received the above data from States/UTs except for Punjab,  if  so,  the  details  thereof  along  with  the  number  of  deaths  reported  in  each State/UT;
- (c)  whether  the  Government  has  issued  any  guidelines  for  States/UTs  to  record  the deaths due to oxygen shortage, if so, the details thereof and if not, the reasons therefor;
- (d)  whether  any  inquiry  has  been  conducted  or  action  has  been  taken  by  the Government regarding death of Covid patients due to oxygen shortage and if so, the details thereof; and
- (e)  the  measures  taken  to  ensure  that  States/UTs  have  sufficient  supply  of  medical oxygen in anticipation of potential future waves of COVID-19?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (DR MANSUKH MANDAVIYA)

- (a) to (e) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 85* FOR 3 RD  DECEMBER, 2021

(a) to (e) Government has sought data from States/UTs regarding deaths of COVID-19 patients  due  to  oxygen  shortage  across  the  country  during  the  second  surge  of  the pandemic. Request for data on the subject was emailed to all States/UTs including the last  email  sent  on  29 th November  2021.  In  response,  only  two  states  (Punjab  and Arunachal Pradesh) have responded. Punjab has emailed that in Punjab, 4 suspected deaths  have  occurred  due  to  lack  of  oxygen  in  one  hospital  (private)  in  Amritsar district.

Detailed guidelines  for  reporting of deaths have been issued by  Union  Health Ministry  to  all  States/UTs.  Accordingly,  all  States/UTs  report  cases  and  deaths  to Union Health Ministry on a regular basis.

ICMR on 10 th May 2020 issued 'Guidance for appropriate recording of COVID19 related deaths in India'

(Available at: https://www.icmr.gov.in/pdf/covid/techdoc/Guidance\_appropriate\_recording\_of\_relate d\_deaths\_India.pdf).

MoHFW vide letter dated 9 th October 2020 has conveyed to States/UTs, WHO and ICMR guidelines on correct recording of COVID-19 related deaths in accordance with  globally  accepted  ICD-10  classification  and  also  urged  states  to  undertake periodic death audits with the aim to improve quality of healthcare services by suitable corrective measures. States/UTs were also provided with a proforma for undertaking death audits in this regard.

The COVID-19 management toolkit for District Collectors shared by Ministry of Health & Family Welfare on 2 nd April 2021 with states, also highlighted the need for deaths audits and follow up action as one of the key monitoring parameters.

170  Central  teams  deployed  to  33  states/UTs  have  also  reiterated  need  for correct recording of deaths and undertake periodic death audits.

Health  is  a  State  subject.  Government  of  India  is  supporting  States  in  their endeavor to enhance preparedness and response capacities against COVID-19. Various initiatives have been undertaken by the Government to provide technical guidance and further  strengthen  health  infrastructure,  availability  of  essential  logistics  including drugs and medical oxygen supply to manage COVID-19.

Ministry of Health & Family Welfare continues to provide technical guidance for managing various aspects of COVID-19. So far more than 150 guidelines/advisories/SoPs/plans  have  been  provided  to  States/UTs.  This  includes technical guidance on myriad of issues ranging from surveillance and containment of COVID-19, travel advisories, clinical management protocols for adults and children, management of mucormycosis, rational use of oxygen, SOPs for safe resumption of activities in workplaces, markets, religious places etc.

Besides  this  all  States/UTs  are  also  being  provided  financial  support  through various avenues including National Health Mission, Emergency COVID-19 Response Packages and State Disaster Response Funds to assist in management of COVID-19 pandemic.

As with regards to provisioning of medical oxygen, the following initiatives have been undertaken by Government of India:

- i. States  have  been  supported  with  supply  of  oxygen  cylinders  and  oxygen concentrators.  1,02,400  oxygen  cylinders  were  procured  in  April  and  May  of 2020 and distributed to States. Further orders for additional 1,27,000 cylinders have been placed on 21.04.2021 (54,000 jumbo cylinders (D type) and 73,000 regular cylinders (B type) and same has been delivered to all States and UTs. One  lakh  Oxygen  Concentrators  are  being  procured  and  distributed  to  States under  PM  CARES  Fund.  Guidance  note  has  been  prepared  and  circulated  to States  by  MoHFW  on  08.06.2021  regarding  oxygen  concentrators  in  primary health facilities.
- ii. States are also being supported in terms of installation of Oxygen concentrator plants/ PSA (Pressure Swing Adsorption plants) plants.
- iii. As many as 1563 PSA plants are being established by the Government of India. These includes 1225 PSA plants being installed under PMCARES Fund in every district  of  the  country.  The  remaining  338  Plants  (110  by  M/o  Petroleum  & Natural Gas, 21 by M/o power, 56 by M/o Coal, 95 by M/o Railways and 57 by foreign grants) are from other sources. As on 25 th November 2021, all the PSA plants sanctioned under PM-CARES have been commissioned.
- iv. Further,  States  have  also  been  requested  to  set  up  similar  oxygen  generation plants in the remaining public health facilities.
- v. Oxygen  Demand  Aggregation  system  (ODAS)  which  is  an  online  digital solution has now been developed to ascertain the demand for medical oxygen from  all  medical  facilities  based  on  bed  availability  and  occupancy  and aggregating them at the State level.
- vi. An Oxygen Digital Tracking System (ODTS) to track the daily allocations of oxygen,  their  dispatch  and  deliveries,  including  movement  of  oxygen  tankers has also been developed and put in place.
- vii. All  the  States  have  been  advised  rational  use  of  oxygen  and  to  prohibit  the wasteful usage by strict monitoring.  The guidelines on rational use of oxygen were issued on  25 th September 2020. These were further revised and disseminated to States on 25 th April 2021.
- viii. States  have  also  been  advised  to  undertake  oxygen  consumption  audit  in hospitals including private hospitals and to undertake facility-wise/hospital-wise oxygen inventory  mapping  and  advance  planning  for  timely  replenishment  so that there is no stock out.