"We should have strategic reserves of oxygen for the country to cover 2-3 weeks’ consumption, similar to the arrangement made for petroleum products. Similarly, all hospitals should have a buffer capacity for Emergencies," said the 12-member panel.
Amid the Covid-19 pandemic, the NFT has recommended that about 20% buffer capacity of the states' requirement should be created for allocation over and above baseline demand for allocation to areas where cases rise.
“Efforts are to be made to further scale up LMO production in preparation for the next pandemic. There is an urgent need to increase the production of LMO from about 5% - 8% of gaseous industrial oxygen. Government should support and subsidize concerned industries," it said.
In case of an emergency, the states may also look at making make-shift hospitals near industrial oxygen production units that will be able to supply piped oxygen with strict quality control, the panel suggested.
Technology should also be augmented to convert nitrogen plants to oxygen-producing plants in case of an emergency situation, it said.
According to the NFT, the focus should also be placed on cylinders, gaseous oxygen and the arrangement of cylinder fillers. CO2 cylinders from beverage industries may also be converted to oxygen cylinders.
The panel said that besides cylinders & LMO, the setting up of PSA plants must be encouraged, based on the actual assessment, as they have the capability to manage a 100 bedded hospital and fill cylinders for ambulances and PHC/CHC as well.
“Make Oxygen generation units (PSA) compulsory for all hospitals, including for medical colleges and district hospitals. All district hospitals should have PSA plants with compressors so that they can manage their own load as well as fill cylinders for CHC/ PHC/ Ambulances," it said.
Each hospital with 100 or more beds should be encouraged to have an LMO installation and a cryogenic storage tank for LMO should be insisted upon for every hospital in metropolitan areas, it said.
For rural areas, the panel said that oxygen supply should be supported with new strategies including the need to shift PSA plants towards vulnerable areas with cylinder turnaround time also needs to be efficient.
“An adequate number of cylinders must be kept as a buffer. The rural and semi-urban areas preparation should be prioritized henceforth", it said.
It added that concentrators should be used in Covid Care Centres in rural areas, and district hospitals, where patients need 5L/min oxygen, thereby saving about 5% - 7% of oxygen usage.
The panel pointed out that oxygen cylinder filling and storage in rural areas is important and hence, central filling stations should be considered in districts/rural areas and for smaller villages, liquid oxygen cylinders of 250 litres may be considered to be parked for 10-12 bed facilities.
“There should be a strategy to manufacture oxygen locally or in the neighbourhood for the big cities to fulfil at least 50% of their LMO demand, as road transportation is vulnerable. This may be taken up in respect of Delhi and Mumbai on priority, due to their population density. All 18 metro cities will be made oxygen independent, with at least 100 MT storage in the city itself," the panel said.
It recommended hospitals suggest awake-prone position to patients if oxygen saturation remains below 92% on 5L flow to reduce oxygen requirement.
The top court had set up the NTF on 6 May to formulate a methodology for allocation of oxygen for saving lives of Covid-19 patients and to facilitate a public health response to the pandemic.
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