An Interim Report on the audit of medical oxygen demand and consumption in Delhi prepared by a Supreme Court-appointed committee has confirmed what was being suspected, that the Delhi govt was grossly overestimating its oxygen demand during the months of March and April. The sub-group constituted by the apex court to study the oxygen situation in Delhi has said that the state was demanding 4 times more oxygen than required, and had hampered the oxygen supply chain in the entire region.
Amid the high drama over oxygen supply in Delhi, the Supreme Court had formed a National Task Force on 8th May to streamline medical oxygen allocation across the country on a “scientific, rational and equitable basis”. A bench headed by Justice DY Chandrachud had constituted a 12 member National Task Force (NTF) on Friday to assess, recommend the need and distribution of oxygen for the entire country. Under this NTF, a 5-member sub-group was formed to assess the situation in the National Capital Territory (NCT) of Delhi, which included AIIMS Delhi director, Max Healthcare director, one official each from Delhi and Union govt, and a PESO official.
After conducting a series of meetings from 11th May to 21st May, and obtaining various documents from Delhi govt, Union govt, Hospitals, PESO and Oxygen suppliers, the sub-group has submitted its interim report.
Wrong calculations, errors, and baseless claims
The report states that while the Delhi govt had demanded 700 MT medical oxygen in its submission to the Supreme Court, there was no basis for such a demand. It says that the Delhi govt had wrongly calculated its oxygen demand, there were lots of error in its numbers and calculations, and it had highly overestimated its oxygen demand.
The Delhi govt was collecting data on ICU and non-ICU beds from hospitals and compiling them in a spreadsheet, but the committee found that there were discrepancies in the data sent by the hospitals. While the Delhi govt records show that 5500 ICU beds and 18000 non-ICU beds were functional in NCT, it didn’t match with the data sent by the hospitals. This had resulted in higher calculation of oxygen demand as the data sent by hospitals showed much higher number of beds, which was found to be wrong.
The committee found that there was gross discrepancy between the claimed actual oxygen consumption and the consumption calculated by formula for bed capacity. The report finds that while the Delhi govt had claimed an oxygen consumption of 1140 MT, it was about 4 times higher than the calculated quantity of 289 MT.
The committee found that four hospitals in NCT, Singhal Hospital, Aruna Asaf Ali Hospital, ESIC Model Hospital, and Liferay Hospital, had claimed extremely high oxygen consumption even though they had very few beds. The claims made by these 4 hospitals were clearly erroneous, and when the Committee revised the numbers for those hospitals by correcting the numbers, they found that the actual demand was much less.
The committee also found that while the Delhi govt had been claiming that their demand of high oxygen is based on a formula provided by the union govt, that was not the case, and Delhi’s oxygen demand would be much less based on that formula. This shows, the Arvind Kejriwal govt was lying about how it had arrived at its demand.
According to the committee report, the actual consumption for 183 hospitals according to the Delhi govt data was 1140 MT, but after correcting the wrong data of the four hospitals, it comes down to 209 MT only. Which means, the claimed consumption was four times of the actual consumption.
The oxygen consumption according to union govt formula should be 289 MT, and the same as per Delhi govt formula should be 391 MT. If one considers the GOI formula for total bed strength, it would be 415 MT on 3rd May, when the Delhi had the highest number of non-ICU and 5866 ICU beds. On the same day, the consumption according to the Delhi govt formula would be 568 MT.
This shows, even when the Delhi govt was demanding 700 MT and 976 MT of medical oxygen, the same would be 415 MT as per GOI formula and 568 MT on its own formula on the day it had highest number of beds reserved for Covid-19.
The SC appointed audit committee found various errors made by Delhi govt in estimating its oxygen demand. The Delhi govt assumed that all ‘Oxygen non-ICU beds’ require oxygen, but the real-life experience shows that, even if a patient occupies an oxygen bed, that patient may not need oxygen. Even after the oxygen requirement of a patient is over, the patient may continue on the same bed for various other treatments, and therefore assuming that all patients admitted on ‘oxygenated non-ICU COVID’ beds will need oxygen for calculating Liquid Oxygen Demand is wrong and leads to overestimation, the committee found. According to GOI formula, only around 50% of patients in non-ICU oxygenated beds use oxygen, but the Delhi govt had used 100% beds.
The Delhi Government had claimed that its formula for calculating oxygen requirement was based on ICMR Guidelines, but no such guidelines were presented before the audit committee.
The committee also found that one reason of error in data provided by the hospitals is that many of them didn’t understood it properly. Some hospitals had even could not differentiate between KL and MT, resulting in wrong estimates.
Even after the union govt had pointed out the errors in the data collected from hospitals, the same was not rectified. The report says it is still not clear on what basis had an allocation of 700MT been sought by Govt of Delhi in the Supreme Court of India when collated data had so many gross errors and it took an oxygen audit to point out the same.
PESO Report
The SC appointed committee also referred to a PESO report, which was earlier reported by OpIndia, where it was found that Delhi was unable to consume and store all the oxygen it was receiving. PESO had found that Liquid medical oxygen tanks in Delhi were filled to the capacity of 71% in the morning of 10th May 2021, and even if 700 MT of oxygen is supplied as per Delhi govt demand, they won’t be able to store it.
The PESO had found that the average daily consumption of liquid media oxygen in Delhi was 284 to 372 MTs, and there was no infrastructure for storing 700 MTs of LMO. Due to lack of storage facilities, tankers had to wait a long time to transfer the gas to storage tanks, which had impacted the media supply chain.
PESO had also found that Delhi was having surplus oxygen, which was affecting the LMO supplies to other states. As there were not enough capacity to store the received oxygen, the Delhi govt had asked the suppliers to stock the oxygen in their tanks, and had even returned some of the tankers to the suppliers.
The Petroleum and Explosives Safety Organization (PESO) had warned that this was a disaster in waiting, if the situation continues like this.
The PESO report said Actual requirement of Delhi is much less than what is demanded, and with Delhi receiving excess oxygen, other states like Rajasthan, UP, Haryana, HP, Uttarakhand, Punjab, and even J&K were suffering badly, as oxygen from those states were being diverted to Delhi on the orders of Delhi High Court. The report had said that Delhi was neither auditing its usage, nor assessing its realistic demand to enable central Government to reallocate supplies to other northern states in a fair manner.
The audit committee also said that while the Delhi govt had rebutted the PESO report, and had claimed to have enough storage capacity, the data provided by the Delhi govt was not consistent with the records the committee was having.
Comparison with Mumbai
The Supreme Court appointed committee also observed that with almost equal numbers of active Covid-19 cases in April, Mumbai was using much less oxygen compared to Delhi. An OpIndia report earlier had pointed out how Delhi’s Oxygen demand was almost four times the use of Mumbai, with almost similar number of cases. While Mumbai was using around 250 MT oxygen for around 90,000 active cases, Delhi was demanding 976 MT for the similar number of cases.
It is notable that while Delhi was demanding high amount of oxygen for several weeks from March to May, the demand had abruptly disappeared the day the Supreme Court had ordered audit of oxygen demand. During the hearing on oxygen supply at the Apex Court, the Delhi govt had been opposing oxygen audit, even while other places had benefited from such audits.
Based on the findings, the audit committee made interim recommendations for Delhi, and determined that the average daily requirement of oxygen in Delhi was around 400 MT in the third week of May.
