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Would Ukraine manage to provide its hospatals with oxygen concentrators?

Author : Anna Peshkova

Source : 112 Ukraine

Why are hospitals not equipped with oxygen in the required amount since April and will the authorities have time to fix it by the end of the month?
12:00, 4 December 2020

Open source

Ukrainian authorities finally cease to defend the "Big Construction" project: they decided to cut funding for the roadbuilding next year, and redirect part of the funds allocated by the end of 2020 to oxygen for patients. Health Minister Stepanov promises that by the end of November the country would have 42,000 beds with supplied oxygen.

Only thanks to the scandal caused by the redirection of funds from the treatment of coronavirus to the roads, the attention of officials were able to turn on one of the most painful topics - the lack of O2 for patients. The authorities became concerned with this issue only in November when the daily number of cases already reaches 12,000.

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Chances of getting to bed with oxygen

When lung tissue is affected, it is unable to absorb oxygen from the air. In this case, patients, in particular coronavirus patients, need to artificially saturate the body with O2, otherwise, the patient may feel significant discomfort, suffocation, and even loss of consciousness.

Physicians use oxygen cylinders, special containers for storing O2. Today in Ukraine there is a high deficit of these containers. In addition, these cylinders must be specially transported to refueling, often for 50-100 km. Such antediluvian methods are fraught with the fact that in the case of force majeure, patients may simply be left without oxygen.

Therefore, it is more logical to use not cylinders, but oxygen concentrators, which are not storage facilities, but special mini-factories. The concentrator receives air from the environment, compresses it, and passes it through special sieves. It cannot completely replace breathing, as a ventilator does, but it is extremely necessary for patients of moderate severity.

According to the standards of the Ministry of Health, oxygen should be supplied to 80% of all beds (not only "coronavirus"). Now, this figure is significantly lower. In total, 20,000 beds are equipped with oxygen concentrators in Ukraine. At the same time, more than 44,000 beds were installed for Covid patients alone.

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Regions report a significant lag behind the standard. In Cherkasy, ​​for example, only 62% of the bed capacity is equipped with oxygen, in the Zhytomyr region - 48%. Doctors in some hospitals are faced with difficult choices.

In some healthcare settings, oxygen concentrators have to be rolled between floors from patient to patient. This is fraught with the spread of not only Covid but also other viruses, as well as tuberculosis. When reconnecting, high-quality disinfection is necessary, for which there is no time, as well as replacement of cannulas (devices for supplying or removing substances). But there are not enough consumables for hubs either.

A few months ago, the oxygen situation was even more critical. As of September, only 8,800 beds had access to O2. Thus, over 5 months of the existence of the Covid Fund, only 5,300 beds were equipped with oxygen.

Such efficiency of utilization of public funds is outrageous because of the growth of morbidity in the country and, accordingly, an increase in the number of beds was highly expected. And the officials also knew that the country had a problem with oxygen cylinders, which were taken to hospitals like bottles of water to offices. But the priorities were set differently: the "extra" funds were put on the roads. So we paid for the stubbornness and populism of the authorities with the health of our citizens.

Related: Ukraine may gain accelerated access to Covid-19 vaccine

Why concentrators are bought only now

After the creation of the fund for fighting coronavirus, the Ministry of Health refused from centralized procurement of concentrators. The head of the department clarified that the hospitals had to decide for themselves whether they want to purchase concentrators or use an alternative – a centralized oxygen supply.

Buying hubs in large quantities is really not the best option. Oxygen stations are used all over the world. They allow you to bring O2, which is almost wastelessly produced from the air with the help of special equipment, immediately to a hundred beds in the hospital. Such a presentation could be seen in films. There is a special stand at the head of the patient's bed, and at any second, if he gets worse, the patient can put on a mask and connect the cable channel.

The ministry is poorly guided by the needs of local hospitals. But in fact, the responsibility was simply shifted to the local authorities.

In practice, the volume of subventions from the state budget did not allow some hospitals to even consider this option. Now, it makes no sense to consider its implementation at the state level. To install a station, you need to place the equipment on the street, at a distance from hospitals, since oxygen is explosive. It is necessary to build a foundation, to stretch highways to the chambers. All this is a long and laborious process. To do this, they would have to vacate the chambers and announce repairs, which is impossible today in a pandemic.

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If the issue of oxygen stations had risen at least in April, the funds allocated by the state could really have been used effectively. Perhaps this option was not considered initially due to the financial issue. After all, the equipment of all hospitals will require about 70,000 USD. Now, almost 53,000 USD are allocated for concentrators.

Returning to purchases from hospitals, in the absence of large-scale production of oxygen concentrators in Ukraine, it was difficult to carry them out. Suppliers have inflated prices due to the high cost of transportation.

The allocated 20 million USD was quickly utilized. No new funds were allocated. So hospitals were forced to turn to charitable foundations for help. But they primarily help individual palliative (incurable) patients. Help was provided by caring citizens and representatives of international organizations (for example, UNICEF).

Minister Stepanov announced the state purchase of oxygen concentrators only on September 7. And then on November 5 - about the need to cover the rest of the beds with oxygen.

Will it be possible to provide hubs for another 22,000 beds.

Ukraine does not produce concentrators, some of them are also made in the USA, but usually, Asia becomes the supplier: Taiwan, Korea, China. Production takes about 30 days. But the products still need to be delivered to the country. The only Ukrainian company that has begun to experimentally produce hubs is doing it from Chinese components, which also need to be brought.

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It is easier and cheaper to ship the concentrators by sea, but then they will sail to the country for about 45 days. The officials do not have that much time.

As for whether the funds allocated by the state (almost 32 million USD) are enough, the assessments are more positive. One plane can fit up to 4 thousand concentrators. In order to bring the required amount of equipment to the country, it is necessary to make six airplane trips. According to Davidenko's estimates, one such trip will cost about 4 million USD, including shipping costs. Thus, 22 thousand concentrators will cost the country 21 million USD.

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