While not all of these would need oxygen beds at the same time, experts TOI spoke with say it would be prudent to plan the supply of oxygen accounting for the upper limit. While the Centre and states have been carrying out a mapping exercise to determine oxygen requirement, cases of states reporting insufficient allocation have become commonplace in the last fortnight or so.
According to the Centre, for an estimation of the required oxygen supply, the empowered group-1 (EG-1) has categorised patients into three categories: 80% of the cases which are mild and do not require oxygen; 17% cases which are moderate and can be managed on non-ICU beds and 3% of cases which are severe ICU cases.
For some, the oxygen needed could be as low as under 10 litres per minute (LPM), while for others it could go up to 20LPM or more, but all of the 20% of the active cases would need oxygen. The calculation of the number of people ( see graphic) needing oxygen is based on the Eg-1 formula as of the end of May 3 when India had more than 34.4 lakh active cases.
The actual number of people needing oxygen could be slightly less or more, as the situation is dynamic based on multiple variables, including how poor the home monitoring of cases is in many cities or the lack of healthcare infrastructure that delays medical intervention leading to mild and moderate cases deteriorating to severe cases. There are other unaccounted factors too.
The Centre has said: “On the basis of this categorisation, oxygen requirement of states on the basis of active cases is being calculated which is around 8,462 MT. Based on the trend of active cases, the “doubling rate of cases” is calculated for each state, which implies, the number of days in which Covid cases are likely to double. The number of active cases are projected on the basis of the doubling rate and oxygen requirement is calculated. These projections get changed daily on the basis of real time change.”
Given the dynamic situation, this number could go up. Sample this: As of May 3, there were already 12 states with more than 1 lakh active cases — Maharashtra (6.5 lakh) and Karnataka (4.4 lakh) had the highest active case burden — and another seven states had active cases upwards of 50,000 with three of them reporting more than 80,000.
While cases in Maharashtra and a few more states have begun to dip marginally, a low recovery rate — as is the case during a massive surge — means that it would take at least 14 to 21 days for the active cases burden to reduce. Comparatively, states like Karnataka and others continue to report a high number of cases adding significantly to their active caseload, which may offset the decline in Maharashtra.