Amidst the threat of the delta plus variant of COVID-19 and the emergence of a third wave, the Maharashtra government has asked all 36 district collectors to implement the District Oxygen Management Plan (DOMP). The plan envisages a judicious mix of liquid medical oxygen (LMO), pressure swing adsorption (PSA) plants and oxygen cylinders to meet the medical oxygen requirement during the third wave.
According to the DOMP model prepared by the Public Health Department, 70% medical oxygen demand should be met through LMO, followed by 20% through PSA plants and 10% through cylinders. This is necessary as it is a difficult task to mobilise additional LMO from outside Maharashtra in the wake of a spurt in demand for oxygen as witnessed in April-May. The state produces about 1,300 metric tonnes of LMO per day. During the peak of the second wave during April-May the state was consuming 1,800 MT. The government had to strive to meet the increase in demand as it had to procure oxygen from various states. Chief Secretary Sitaram Kunte, who was accompanied by Public Health Department Additional Chief Secretary Dr Pradeep Vyas, on Monday, reviewed the district-wise preparations on the implementation of DOMP.
“There may be small variations amongst districts due to peculiar circumstances. In case the district has a small private Dedicated COVID-19 Health Centre (DCHC) or Dedicated COVID-19 Hospital (DCH), then probably, the oxygen cylinder requirement would increase. As these cylinders are going to be in limited supply, it would be prudent to consolidate and bring patients to a smaller number of locations instead of scattering them,” said the DOMP. It further added that the experience with PSA plants has not always been good. Therefore, it cannot be exclusive and the only source of medical oxygen. Alternate arrangements of oxygen supply are required. Further PSA plants need regular maintenance.
“In view of this, it has been decided that, henceforth, no new PSA plant would be set up at public health institutions other than medical colleges, district hospitals, general hospitals, women hospitals, sub districts hospitals and major hospitals of municipal corporations. There should be exceptional reasons, if at all, to set up PSA plants at levels below the sub district hospital (SDH) (at rural hospitals),” said the Health Department. It has asked the district administration not to set up any new PSA plant at rural hospitals or primary health centres (PHC). The state is currently in the midst of establishing 328 PSA plants.
In a bid to avoid fire or oxygen leakage as reported recently, DOMP envisages maintenance of an operation log to periodically monitor temperatures, pressures, vibrations, power, capacity and hours of functioning. Any deviation in operating values from the normal conditions as stated in the manufacturer's manuals should be noted and appropriate correction should be made.