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September 1, 2021

The latest pandemic shortage: Oxygen

Daily Briefing

    The Covid-19 pandemic has led to shortages of PPE, ventilators, blood, and health care professionals—and now, amid a delta-driven surge in hospitalizations, several Southern states are struggling to meet demand for oxygen.

    How Covid-19 will impact the supply chain

    Covid-19 surges lead to oxygen shortages in several states

    As the delta variant continues cause surges in Covid-19 hospitalizations, several hospitals across the South—including Florida, Louisiana, Mississippi, Georgia, South Carolina, and Texas—are struggling with low oxygen supplies.

    According to state health officials and hospital consultants, hospitals may soon have to rely on reserve oxygen supplies, and some may even risk running out of oxygen completely, CNN reports.

    In addition, some hospitals currently have less than a day's supply of oxygen available for patients, and shortages could worsen as Hurricane Ida threatens to send more people to EDs, Forbes reports.

    Donna Cross, the senior director of facilities and construction at Premier, a health care performance improvement company, said hospitals have not been able to keep up with the demand for oxygen as Covid-19 cases rapidly increase.

    "Normally, an oxygen tank would be about 90% full, and the suppliers would let them get down to a refill level of 30-40% left in their tank, giving them a three- to five-day cushion of supply," Cross said. "What's happening now is that hospitals are running down to about 10-20%, which is a one- to two-day supply on hand, before they're getting backfilled," CNN reports.

    In addition, Cross noted that even when hospitals are getting oxygen backfill, it is only a partial supply of around 50%. "It is [a] very critical situation," she said.

    Florida's dire situation

    The shortage is particularly worrisome in Florida where, according to a survey conducted by the Florida Hospital Association (FHA), 68 Florida hospitals have less than two days of oxygen available. About half of those hospitals have less than 36 hours of oxygen on hand. And since the beginning of July, 29 hospitals have had their oxygen supplies drop below 12 hours.

    More than 17,000 patients are currently hospitalized with Covid-19 in Florida, WUSF Public Media reports. And according to data from federal health officials and Johns Hopkins University, the state on Saturday reported the highest Covid-19 hospitalization rate in the country at 75 patients per 100,000 residents.

    According to Forbes, hospitals in Florida have been running low on oxygen for weeks, in part due to a lack of truck drivers to transport supplies.

    "Finding drivers is really difficult," Rich Gottwald of the Compressed Gas Association said. "Some companies ... are rotating in drivers from [nearby regions] of the country, to be able to service hospitals in the areas that need medical oxygen."

    Separately, Mary Mayhew, president and CEO of FHA, said hospitals are "making frantic calls, trying to find where their driver is because they were supposed to get a delivery and now it's 10 hours, 12 hours overdue."

    Affecting more than just hospitals

    Covid-19 patients are more likely to survive on high-flow nasal oxygen than mechanical ventilation, but this method can use 10 times more liquid oxygen, Axios reports.

    However, this liquid oxygen isn't used only by hospitals. It's also used to purify water, and cities across Florida have asked residents to use less water to conserve the current supply of liquid oxygen.

    For example, the Orlando Utilities Commission earlier this month asked residents in the Orlando area to conserve water by taking shorter showers and not watering their lawns.

    Similarly, the city of Winter Park asked its residents to conserve water by refraining from washing cars and using pressure washers. The city also requested residents reduce how often they water their lawns. 

    Tampa Bay last week also issued a water conservation request to its residents, saying they should cut back on nonessential water usage. In addition, the city warned its residents there could be a "change in taste and odor in drinking water" if other water purification methods, such as chlorine, had to be used in place of liquid oxygen.

    However, despite a "moderate decrease" in water usage in Orlando and surrounding areas, officials are still concerned about the area's supply of liquid oxygen, Forbes reports. Currently, there is only about two weeks of liquid oxygen available to treat the area's water system, which serves more than a million people. (Holmes/Elamroussi, CNN, 8/30; Dangor, Forbes, 8/28; Aboraya, WUSF Public Media, 8/26; Marino, Axios, 8/31; Reimann, Forbes, 8/26; Harris, Orlando Sentinel, 8/21; San Felice, Axios, 8/27)

    Learn more: How Covid-19 will impact the supply chain

    supply chain

    Covid-19 has revealed critical shortcomings in the health care supply chain. Shortages of personal protective equipment (PPE), ventilators, and other vital supplies have hindered the U.S. health care system‘s response to this crisis, and additional waves of shortages are likely in coming months.

    Read our take to learn three requirements for a more resilient, transparent supply chain in light of Covid-19.

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