Crisis of Oxygen Cylinders: Demand sky high, prices too

Faruk Mia came to Dhaka on Saturday, all the way from Narsingdi, to buy an oxygen cylinder for his 65-year-old ailing father as it could not be managed in his district.

He found that only one shop at the BMA medical equipment market in Topkhana still had a few in the stock. But the price was sky high.

"Now it's Tk 35,000. It was Tk 16,000 a week ago, and Tk 11,000 a few months back," a salesman of Alfa Surgical store told Faruk about 1,400-litre cylinders.

Faruk had Tk 18,000 in his pocket. He called home, asking for more money through mobile phone transaction but failed to arrange the amount, and went back without a cylinder.

On Friday, the family took his father, an asthma patient, to a government hospital in Narsingdi for Covid-19 test as his breathing problem had become severe. 

This was when a doctor said, "No matter what the test result is, a cylinder must be ready as a precaution."

Like Faruk, many are looking for oxygen cylinders desperately while most of the public hospitals across the country, including those dedicated for Covid-19 treatment, lack a central oxygen supply.

The hospitals without a central oxygen supply use cylinders, in many cases inter-connected large cylinders, as critical Covid-19 patients need oxygen supports.

Besides, a section of affluent people is reportedly buying cylinders just in case someone in the family tests coronavirus positive and suffers breathing problems. 

'DEMAND SKYROCKETING'  

Visiting the BMA market on Saturday, these correspondents found customers being turned away as the cylinders were almost out of stock. 

A salesman at Alfa Surgical said the demand for cylinder has been high for the last one month. But since the last week, the "demand is skyrocketing".

"Earlier, our supplier used to import cylinder through the sea port. As it is closed now, he is importing it by air from China. Due to the increased transportation cost, the price has gone up," he said.

Siddiqur Rahman, a retail seller at Makkah Surgical Market, said they used to sell or rent out maximum 10 cylinders a month. "But now there is a demand for at least a hundred oxygen cylinders every day."

The suppliers said they were unable to supply oxygen cylinders in bulk right now, he added.

According to the official website, supplier company Linde Bangladesh is selling an oxygen cylinder set at Tk 26,522. A 1,400-litre cylinder costs Tk 16,100, oxitherapy set Tk 8,970, face mask Tk 161, nasal cannula Tk 104, and trolley Tk 1,087, while oxygen refill charge is Tk 100.

A 1,400-litre cylinder can be used for 10-11 hours continuously at 2 litres per minute.

During this coronavirus outbreak, Linde has limited its sales with some restrictions, said a source from the company.

It decided that to get a cylinder set, one must bring a photocopy of National ID and recommendation of a doctor stating that the patient needs 24-hour oxygen support.

One customer will be able to buy only one cylinder. To get two cylinders or more, one must contact their territory officer of business head, according to an internal circular of Linde, formerly called Bangladesh Oxygen Company.

An official of Linde, wishing not to be named, said there is no dearth of oxygen gas but they are facing crisis of cylinders because of the high demand. And they also did not hike the cylinder prices.

In retail market, a Chinese cylinder now sells at Tk 26,500 while Linde's cylinder costs Tk 30,000 to Tk 35,000. But Linde's cylinder is mostly stock-out at retail market.

Mr Azam, a depot manager at Spectra Oxygen, another supplier, said there is a crisis now as many people are buying and stocking cylinders out of panic. "But we have recently imported cylinders. Hopefully, we will start meeting the demand."

Sellers in the BMA market said of the customers, most are from private clinics and hospitals. Some people are also coming to keep cylinder at home.

Haji Md Reazaul Islam, president of Medical and Surgical Equipment Market at BMA Bhaban said, "As there is a huge demand for cylinder, some sellers are taking advantage of it."

DEMAND AT HOSPITALS

Gobinda Acherjee, general secretary of Private Hospital Owners Association in Savar, said the demand for oxygen cylinder has risen five times in Savar and Ashulia.

Apart from those admitted in hospital, there are many patients staying in isolation at home. "Every day, we get calls over phone to get them oxygen cylinder service. But we fail to meet this demand."

Masud Parvez, managing director of Regent Group, said they have two private hospitals in Mirpur and Uttara that are dedicated Covid-19 treatment and both have a central oxygen supply.

"Still we need cylinders to meet the huge demand as most Covid-19 patients need the oxygen," he said.

"Earlier, we had 30 cylinders at Mirpur Regent Hospital. Now we kept 73 cylinders. Uttara Regent Hospital had 10 cylinders; now it has 30."

According to Prof Dr Mujibur Rahman, head of Medicine department at Dhaka Medical College and Hospital, said the demand of oxygen gas has increased at hospitals, giving an example of a ward at DMCH.

"Out of 80 Covid-19 patients admitted here, 60 needed oxygen support," he said.

GOVT POSITION

DGHS Deputy Director (Hospital and Clinic) Younus Ali said there is crisis of cylinders. "The government procured a good number of cylinders to support the hospitals after the pandemic began in the country."

Habibur Rahman Khan, additional secretary (admin) at Health Services Division of Ministry of Health and Family Welfare, also chief of the ministry's media cell, said the government is trying to import cylinders but the situation is difficult all over the world.

"Still the ministry is trying … Let's see, how many days it takes."

He also said they requested the private companies to increase their oxygen production and cylinder import.

CALLS IN SOCIAL MEDIA

Meanwhile in social media, relatives of many Covid-19 patients or who have severe breathing problems, are seeking cylinders.

Volunteers of a Facebook group "Songjog: Connecting People" are requesting people to give them the unused or empty cylinders.

"We will refill the cylinder and deliver it to the people who need it at this time," reads the Facebook post.

In another post, a volunteer of Bidyannondo Foundation yesterday wrote, "Can you lend us if you have an unused cylinder in your house? We will refund it within two months or if you need. We will pay the price if needed."

RAJSHAHI

In Rajshahi city, the authorities of hospitals and clinics expressed worries that they would face a crisis of oxygen cylinders when the number of patients cross 200, reports our correspondent Anwar Ali. 

The authorities said they have kept arrangements for oxygen supply ready as the situation has begun worsening this week. Nearly a dozen Covid-19 patients have got admitted to different hospitals. 

Right now, Rajshahi Medical College Hospital (RMCH) has 300 cylinders while each of 46 large private hospitals and clinics have a stock of at least a dozen.

"None of us invested in buying new cylinders; we just kept our existing cylinders refilled," said Mokhlesur Rahman, general secretary of Rajshahi Private Hospital and Clinic Owners' Association.

A new cylinder costs around Tk 16,000 while refilling costs less than Tk 200. Besides a depot of Bangladesh Oxygen Limited, there are offices of two private oxygen suppliers in the city.

The RMCH has an underground plant for supplying oxygen and they never ran out of the gas, said RMCH Deputy Director Dr Saiful Ferdous M Khairul Ataturk.

"Yet we have raised our stock of cylinders as those might be necessary for the three corona units set up outside the hospital."

CHATTOGRAM

The dealers in Chattogram blamed it on the rich who are hoarding cylinders for a situation when a coronavirus case will found in their families, reported our correspondent Mostafa Yousuf.

Jamal Uddin, an oxygen dealer at Chattogram Medical College Hospital (CMCH) gate area, told The Daily Star yesterday that the rich people were buying oxygen cylinders in bulk.

Yesterday morning, he sold 50 cylinders but could not supply to those who came in the afternoon. However, oxygen cylinders and oximetre started to come in the market and hopefully the crisis will be eased from tomorrow (today), he added.

In mobile court drives in the day, two dealers in Sadarghat and CMCH areas were fined Tk 2 lakh for selling 6.8-cubic-metre cylinders at Tk 2,000 each. The maximum retail price of these cylinders is Tk 5,000.

Sylhet

Aminul Islam, a businessman in Amberkhana area, said, "I have breathing problems and as the crisis over cylinders is intensifying, I decided to buy one. I visited all stores in the city on Sunday."

He found either the price was too high or there was no supply.  

"Then I contacted a supplier. I am going to rent an industrial oxygen cylinder and buy a medical metre, the price of which also doubled these days."

Harun Ahmed, proprietor of Central Surgical Store at Chowhatta, said, "The small cylinders, which used to sell at Tk 13,000 before, now costs Tk 26,000.

 "Many people, who don't need it right now, are buying the cylinders and the suppliers are struggling to meet the demand."

Meanwhile, the authorities of Sylhet Saheed Shamsuddin Ahmed Hospital, which is dedicated for Covid-19 treatment, fear they could be in trouble soon because of the rising number of coronavirus patients, reports our Sylhet correspondent Dwoha Chowdhury.

"We have 131 large cylinders and 125 small one in stock. Our daily demand is around 80 to 90 large cylinders and it takes couple of days to send and receive cylinders refilled from Manikganj," said Dr Sushanto Kumar Mahapatro, resident medical officer of the hospital.

"We need at least 500 large cylinders (6.8-litre capacity each) so we can avoid a crisis. Or, a refilling plant for liquid oxygen needed to be installed in Sylhet soon."

THE RISK

Some suppliers, however, said the use of a oximetre could be helpful during this coronavirus pandemic. It can determine if a patient needs oxygen supply or not.

Attaching this small device to one's finger will tell him his oxygen level in blood. It would be considered normal if a person's oxygen level in blood is between 94 and 98 percent.

But the price of oximetre has also doubled -- the Chinese one used to sell at Tk 1,200; it is Tk 2,200. The Korean oximetre was priced Tk 2,500; it is now Tk 4,000.

Experts say there are some risks in using oxygen cylinders without the supervision of a health worker.

Prof Dr Mujibur Rahman of DMCH said many people are buying oxygen cylinders in panic. But they have to know how to use it. Otherwise, it may be harmful.

"If oxygen is pushed more than necessary, it may harm the patient's lunge, even the patient may die."

Besides, Oxygen has no smell, no colour; if the cylinder leaks, there is no way to understand. "If it leaks, it may cause or intensify fire. Because oxygen in the cylinder is a highly combustible substance," he said.