Covid oxygen answer

1. GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
DEPARTMENT OF HEALTH AND FAMILY WELFARE
RAJYA SABHA
STARRED QUESTION NO.25
TO BE ANSWERED ON THE 20TH
JULY, 2021
SHORTAGE OF ESSENTIAL MEDICAL SERVICES DURING SECOND
WAVE OF COVID-19
25 SHRI M.V. SHREYAMS KUMAR:
Will the Minister of HEALTH AND FAMILY WELFARE be pleased
to state:
(a) whether there was an acute shortage of essential medical services including
availability of drugs and hospital beds in the country during the second wave of
COVID-19 in April 2021;
(b) if so, the reasons therefor;
(c) the number of patients who died due to shortage of oxygen and lack of
hospital facilities in the country; and
(d) the measures taken by Government to overcome the situation?
ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE
(SHRI MANSUKH MANDAVIYA)
(a)to (d): A Statement is laid on the Table of the House.

2. STATEMENT REFERRED TO IN REPLY TO RAJYA SABHA
STARRED QUESTION NO. 25* FOR 20TH
JULY, 2021
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(a) to (d): The health infrastructure in the country was strained due to steep rise
in COVID-19 cases during the months of April-May 2021. Although Health is a
state subject, Government of India has supported the states and undertook a
series of action including further strengthening of existing health infrastructure
to ensure provisioning of sufficient hospital beds, drugs, medical oxygen and
other consumables to aid proper clinical care of COVID-19 patients.
Some of the ongoing initiatives to strengthen hospital infrastructure include:
 With the intent to reduce the risk of cross infection to non-COVID patients
as well as to maintain continuity of non-COVID essential health services in
the country, a three-tier arrangement of dedicated COVID-19 health
facilities [(i) COVID Care Center (CCC); (ii) Dedicated COVID Health
Centre (DCHC) and (iii) Dedicated COVID Hospital (DCH)] has been
implemented in the country.
 Government of India, in addition to providing services through
hospitals/facilities available under Ministry of Health & Family Welfare,
also roped in tertiary care hospitals under ESIC, Defence, Railways,
paramilitary forces, Steel Ministry etc. for management of COVID-19 cases.
Further, many large temporary treatment facilities were established by
DRDO to manage surge in COVID-19 cases in the country.
 Due to concerted actions of Central and State Governments, the isolation
bed capacity and ICU bed capacity which was merely 10,180 and 2,168
before the first lockdown (as on 23rd
March 2020) could be increased to
18,21,420 isolation beds and 1,21,671 ICU beds (as on 16th
July 2021).
 Additionally, the reliance on imports with respect to ventilators was
mitigated with concerted efforts of Governments and industry under the
‘Make in India’ vision. Till now State/UTs and Central Governments
institutions have been allocated 56,218 ventilators of which 48,060 have
been already supplied (as on 13th
July 2021).
 Taking note of spread of the disease to peri-urban and rural areas in many
districts, Ministry of Health and Family Welfare on 16th
May 2021 has

3. issued an “SoP on COVID-19 Containment and Management in Peri-Urban,
Rural and Tribal Areas".
 With the intent to protect pediatric age group in current and any future
surges of cases, Guidelines for management of COVID-19 in children were
also issued on 18th
June 2021. The guideline provides guidance on the
management of acute presentation of COVID-19 as well as Multisystem
Inflammatory Syndrome (MIS-C) in children and adolescents found
temporally related to COVID-19.
With regards to medical oxygen supplies, the following actions were taken:
 Ministry of Health and Family Welfare closely monitored the availability
and supply of Medical Oxygen and necessary infrastructure available with
respective State/UT for management of COVID-19 effectively.
 The daily liquid medical oxygen (LMO) production, which was about
5,700 MTs per day in August 2020 was increased to a high of 10,500 MTs
as on 13th
May 2021. This was done by enhancing LMO production in steel
plants as well as in other LMO plants.
 On the recommendations of the Empowered Group II, constituted by
Ministry of Home Affairs under Disaster Management Act, Government of
India w.e.f. 22nd
April, 2021 prohibited the supply of oxygen for industrial
use and issued directions to divert the same to meet the rising demand for
medical oxygen.
 Further orders for additional 1,27,000 cylinders have been placed on
21.04.2021 (54,000 jumbo cylinders (D type) and 73,000 regular cylinders
(B type). Deliveries of the same have started and 24,207 (24,511 B-type
and 8,893 D-type) cylinders have been delivered as on 07.07.2021. In
addition, around 4,962 B-type and 1,895 D-type cylinders are in-transit.
23,247 Cylinders received from Foreign Aid have also been distributed to
States/UTs.
 In addition, 1.5 lakh SPO2 based oxygen control systems cylinders are
being procured by DRDO under PM CARES Fund.
 One lakh oxygen concentrators are in various stages of procurement and
distribution to States under PM CARES Fund.
 States are also being supported in terms of installation of Oxygen
concentrator plants/ PSA (Pressure Swing Adsorption plants) plants. In the
first Phase, 162 PSA plants (154.19 MT capacity) were sanctioned in 32
States/UTs from PMCARES fund. In addition, 1060 additional PSA plants
have been approved to be set up in various public health facilities across
the country taking the tally to 1222 PSA plants being funded through the
PMCARES Fund. Of these till 14th
July 2021 a total of 227 PSA plants

4. have been commissioned. In addition to the above, 108 more PSA plants
are being installed by Petroleum Ministry (MoPNG), 40 by Ministry of
Coal and 25 by Ministry of Power through their CSR funds.
 All the States have been advised for rational use of oxygen and to cut down
the wasteful usage by strict monitoring. The guidelines on rational use of
oxygen was issued last year on 25th
September 2020. These were further
revised and disseminated to States on 25th
April 2021.
To ensure provisioning of drugs for managing COVID-19 cases in the
country, the following actions were taken:
 A Drugs Coordination Committee (DCC) was constituted vide OM
20.05.2021 as an institutional mechanism with representation from
Deparment of Pharmaceuticals, Union Health Ministry, Directorate General
of Health services (DGHS), Indian council of Medical Research (ICMR),
Directorate General of Foreign Trade (DGFT), Ministry of External Affairs
(MEA), Central Drugs Standard Control Organisation (CDSCO) and
National Pharmaceutical Pricing Authority (NPPA) for efficient decision
making on all the issues with respect to COVID-19 related drugs and also
to formalize the inter-departmental consultations on the issues with regard
to drug availability.
 Remdesivir is a patented drug, manufactured in India under voluntary
licenses granted by Gilead Life Sciences USA (the patent holder) to 7
Indian pharmaceutical companies. The domestic production capacity of all
the seven licensed manufacturers was augmented from 38 lakh vials per
month to nearly l22 lakh vials per month. With the accelerated approval of
40 additional manufacturing sites by the CDSCO, the number of approved
manufacturing sites has increased from 22 to 62.
 Due to reports about the shortage of Remdesivir, export of drug has been
banned since 11th
April, 2021 to improve local availability.
 All States/UT and State Drugs Controllers have been requested to verify
stock of the drug and check other malpractices and also take effective steps
to curb hoarding and black marketing of Remdesivir.
 Due to the increased demand of the drug for treatment of covid-19 patients,
the Department of Pharmaceuticals (DoP) and Ministry of Health and
Family welfare (MoHFW) jointly undertook an exercise for allocation of
the drug to the states/UTs of the country in a move to ensure fair and
equitable distribution across the country for an interim period till the
ramping up of production takes place and the drug is adequately available
in the market.
 States/UTs and Central Government institutions have also been supported
with supply of Remdesivir. Till 13th
July 2021, out of a total allocation of

5. 1,23,87,892 units of Remdesivir, States/UTs and Central Government
institutions have been supplied with 1,00,37,983 units.
 Since use of Remdesivir in managing COVID-19 patients is restricted to a
select sub-group of patients under Emergency Use Authorization, an
“Advisory for Rational use of Remdesivir for COVID-19 Treatment” was
also issued by MoHFW on 7th
June 2021.
 Like Remdesivir, drug Tocilizumab was also approved for use in only a
select sub-group of patients under off-label use. No major report of
shortage of this drug was reported to this Ministry.
 Government also took various measures to improve the availability of
Amphotericin B (liposomal) through a multipronged approach of
augmenting production, and import and ensure equitable distribution to
States/UTs.
 Department of Pharmaceuticals and the Drug Controller General of India
(DCGI) have actively coordinated with the industry for identification of
manufacturers, alternate drugs and expeditious approvals of new
manufacturing facilities. The 5 existing manufacturers have also been
called upon to increase production of Liposomal Amphotericin-B.
 DCGI, after consultation with the association of Drugs manufacturers, has
issued manufacturing / marketing permission of Amphotericin B
Liposomal Injection to six additional firms.
 For equitable distribution of the drug, allotments are being made to the
States/ UTs in accordance with the proportion of their reported case load in
respect of the entire country. Supply arrangements are being monitored by
the National Pharmaceuticals Pricing Authority (NPPA) so as to ensure
expeditious availability of the drug.
States/UTs were provided with periodic projected requirement of hospital
infrastructure based on then prevalent growth rates of the infection in the
States/UTs. Further, on COVID-19 India portal, all States and Districts were
provided with a projection tool to calculate future requirements of hospital
infrastructure and other logistics.
Detailed guidelines for reporting of deaths have been issued by Union
Health Ministry to all states/UTs. Accordingly, all states/UTs report cases and
deaths to Union Health Ministry on a regular basis. However, states have at
times reported backlog deaths in case of late reporting from hospitals and
districts but, no such reports of patients dying due to shortage of oxygen and
lack of hospital facilities in the country have been received by the Ministry from
any State/UT.
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