Amid spike in Covid-19 cases, a major controversy has erupted in Maharashtra over the Maha Vikas Aghadi government's move to ration oxygen in wards and ICUs.
Professional doctors’ bodies like the Indian Medical Association’s Maharashtra chapter are up in arms against the Uddhav Thackeray government’s circular, that came last week.
The state government issued the order in the wake of very high consumption of oxygen – more than three times the national average.
According to the order issued by Principal Secretary (Health) Dr Pradeep Vyas, oxygen consumption in wards should not be more than 7 litres per minute in wards and 12 litres per minute in ICUs.
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“Please do a consumption audit of oxygen in private hospitals calculating 7 liters per minute for patients in wards and 12 liters per minute for ICU patients and ensure that no medical oxygen is wasted due to leaks etc,” said the order issued to district collectors, municipal commissioners, district civil surgeons, district health officers and executive health officers of municipal corporations.
“We condemn the unscientific restriction of using oxygen at 7 liters per minute for oxygen beds and 12 liters per minute for ICUs,” said Dr Avinash Bhondwe, President, IMA-Maharashtra.
The government in its order said that oxygen consumption in the state is being monitored regularly and it has been noticed that it has crossed 600 MT per day and is growing at a very rapid rate. “The consumption is not commensurate with the reported number of patients needing oxygen. There is a gross mismatch in private and municipal hospitals,” Dr Vyas said, adding that it was clear that oxygen was not being used judiciously.
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He, however, had pointed out that the oxygen production is much more than what we are consuming but there is a risk of the stocks getting exhausted at this rate. “There is a tendency in private hospitals to put patients on oxygen for duration more than necessary for commercial reasons. We need to monitor such activities scrupulously,” he said in the strongly-worded note.
Explaining the issue further and the objections, Dr Suhas Pingle, Chairman, Action Committee, IMA-Maharashtra, said: “There cannot be rationing of Oxygen. The need would vary from person to person…you cannot decide on an average, it is on a need to need basis, case to case basis and it may vary from case to case, whether in Oxygen beds or ICUs…it is given as per doctor’s knowledge and experience…the government has taken an unscientific approach.”
Dr Pingle said that since the beginning of the Covid-19 crisis, the doctors have been at the receiving end. “If anything happens to the patients, doctors are beaten up,” he said.
“It’s yet another direct battering on the professional autonomy of clinicians. It is an attempt without a thought to cover up bad governance of supply of oxygen by unprofessional and unethical notification. The curb on Oxygen use is unprincipled. It is an unwarranted question on clinical acumen of doctors,” said a note issued by Dr Bhondwe and Dr. Pankaj Bandarkar, Honorary State Secretary, IMA-Maharashtra.
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