Medical oxygen scarce in Africa, Latin America
DAKAR, Senegal — A crisis over the supply of medical oxygen for coronavirus patients has struck nations in Africa and Latin America, where warnings went unheeded at the start of the pandemic and doctors say the shortage has led to unnecessary deaths.
It takes about 12 weeks to install a hospital oxygen plant and even less time to convert industrial oxygen manufacturing systems into a medical-grade network. But in Brazil and Nigeria, as well as in less-populous nations, decisions to fully address inadequate supplies only started being made last month, after hospitals were overwhelmed and patients started to die.
The gap in medical oxygen availability “is one of the defining health equity issues, I think, of our age,” said Peter Piot, director of the London School of Hygiene & Tropical Medicine, who said he survived a severe coronavirus infection thanks to the oxygen he received.
Doctors in Nigeria anxiously monitor traffic as oxygen deliveries move through the gridlocked streets of Lagos. Desperate families of patients around the world sometimes turn to the black market. Governments take action only after hospitals are overwhelmed and the infected die by the dozens.
In Brazil’s Amazonas state, a pair of swindlers were caught reselling fire extinguishers painted to look like medical oxygen tanks. In Peru, people camped out in lines to get cylinders for sick relatives.
Only after the lack of oxygen was blamed for the deaths of four people at an Egyptian hospital in January and six people at one in Pakistan in December did governments address the problems.
John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said medical oxygen is a “huge critical need” across the continent of 1.3 billion people and is a main reason that COVID-19 patients are more likely to die there during surges.
Even before the pandemic, sub-Saharan Africa’s 2,600 oxygen concentrators and 69 functioning oxygen plants met less than half the need, leading to preventable deaths, especially from pneumonia, said Dr. John Adabie Appiah of the World Health Organization.
The number of concentrators has grown to about 6,000, mostly from international donations, but the oxygen produced isn’t pure enough for the critically ill. The number of plants that can generate higher concentrations is now at 119.
Yet without formal requests from governments, nearly $20 billion in World Bank coronavirus funds for the world’s poorest countries remains unspent so far, the organization told The Associated Press.
Nigeria was “struggling to find oxygen to manage cases” in January, said Chikwe Ihekweazu, head of its Centre for Disease Control.
A main hospital in Lagos, a city of 14.3 million, saw its January virus cases increase fivefold, with 75 medical workers infected in the first six weeks of 2021. Only then did President Muhammadu Buhari release $17 million to set up 38 more oxygen plants and another $670,000 to repair plants at five hospitals.
Some oxygen suppliers have dramatically raised prices, according to a doctor at the Lagos University Teaching Hospital who spoke on condition of anonymity because he was not allowed to talk to reporters. That has driven up the cost of a cylinder by 10 times, to $260 — more than the average monthly wage — and a critically ill patient could need up to four cylinders a day.
Money and influence don’t always help.
Femi Odekunle, a Nigerian academic and close ally of the president, went without adequate oxygen for nearly 12 days at the Abuja University Teaching Hospital until two state governors and Ministry of Health officials intervened. He died anyway, and relatives and friends blame the oxygen shortage, the Premium Times newspaper reported. The hospital attributed his death to his severe infection.
AUSTIN, Texas — The catastrophic Texas blackout was a wider failure than the state’s power grid, which teetered on the brink of an even bigger collapse during a freeze that knocked out electricity to 4 million customers, energy executives said Thursday.
One CEO said he sounded warning days before what became one of the worst power outages in U.S. history, including to the office of Republican Gov. Greg Abbott, whose regulatory appointees came under sharp criticism during the first investigative hearing since last week’s crisis.
Leaders of other power companies said they thought the system would hold, while also acknowledging that a failure to buttress their generators against subfreezing weather contributed to the outages.
“Who is at fault?” state Rep. Todd Hunter, a Republican, demanded of witnesses during hours of testimony at the Texas Capitol.
President Joe Biden is set to fly to Texas on Friday, in what will be his first visit to a major disaster site since taking office.
Abbott has zeroed in almost singularly on the Electric Reliability Council of Texas, accusing the state’s embattled grid operator of misleading the public about the readiness of a system that was minutes away from total collapse in the early hours of Feb. 15, when temperatures plunged and demand for electricity vastly outstripped supply.
But energy executives, including those whose companies lavishly donate to Abbott and lawmakers, made clear that the fault is far wider.
The testimony offered a troubling new look at how quickly America’s energy capital ran out of energy. Curtis Morgan, the CEO of Vistra Corp., told lawmakers at the outset that the blackouts affected plants that could have generated more power that was urgently needed. He said when officials from his company called utility providers, they were told they weren’t a priority.
“How can a power plant be at the bottom of the list of priorities?” Morgan said.
“You-know-what hit the fan, and everybody’s going, ‘You’re turning off my power plant?’” he said.
At least 40 people in Texas died as a result of the storm, and 10 days after the blackout started, more than 1 million people in the state were still under boil-water notices.
ERCOT officials have claimed that the scale of the forced blackouts — the largest in Texas history — were necessary to avert an even more catastrophic failure that would have wiped out power to most of the state’s 30 million residents for months.
“Obviously what you did didn’t work,” said Democratic state Sen. John Whitmire of Houston, which had more than 1 million outages.
“It worked from keeping us (from) going into a blackout that we’d still be in today, that’s why we did it,” ERCOT president Bill Magness said. “Now it didn’t work for people’s lives, but it worked to preserve the integrity of the system.”
Among Vistra’s subsidiaries is, Luminant, which operates nearly two dozen plants across Texas. Morgan blamed outdated lists of critical infrastructure in Texas for darkening gas processers and production sites as grid managers began shutting off parts of the system.