The Delhi government inflated its oxygen requirement by four times during the peak of the second wave of the coronavirus pandemic in May, several news outlets reported on Friday. They attributed the information to a committee constituted by the Supreme Court in May to conduct an oxygen audit for Delhi.
However, a closer look at the 163-page “interim report”, part of an affidavit filed by the Union Ministry of Health and Family Welfare in the Supreme Court on June 22, suggests that the four times figure is a gross exaggeration.
In fact, a note by Max Healthcare’s Dr Sandeep Budhiraja, the only non-government member of the committee, attached as an annexure to the report makes that abundantly clear. Budhiraja’s note clearly indicates that the oxygen requirement that the committee took as the basis for its calculations was itself inaccurate and an underestimate of Delhi’s actual requirement.
Yet the committee, headed by director of the All India Institute of Medical Sciences Dr Randeep Guleria, chose to emphasise the claim that Delhi’s oxygen demand was four times its requirement by italicising the section that details the calculation, ignoring the fact that it was based on incomplete data.
The Delhi government’s representative in the committee Bhupinder S Bhalla, the state’s principal secretary (home), did not attend the final meeting of the committee. In a dissent note, he said the committee was functioning with a “pre-conceived and predetermined conclusion and narrative”.
How the audit was conducted
On May 8, the Supreme Court set up audit committees in each state to “ensure a measure of accountability for the proper distribution of oxygen supplies made available by the Union Government to the States/UTs”. This was in the wake of heated contestations between several states and the Centre over supply of oxygen, the requirement of which outstripped supply in the country in the peak of the second wave.
It was on May 10 that the Delhi committee first met. Apart from Guleria and Budhiraja, it comprised three government officials, two from the Union government and one representing the Delhi government.
On May 12, the committee agreed upon the method to assess Delhi’s oxygen requirement: it sent out standardised proformas to all hospitals asking them to report their actual oxygen consumption levels.
Of the 260 hospitals the proformas were sent to, 183 responded with oxygen consumption data of May 12. The Delhi government sent and received these proformas on the behalf of the committee.
On May 13, the committee analysed the responses and found discrepancies. The total oxygen consumption of the 183 hospitals added up to a whopping 1,140 metric tonnes. This, according to the committee, was a result of misreporting by four hospitals: Singhal Hospital, Aruna Asaf Ali Hospital, ESIC Model Hospital, and Liferay Hospital.
The committee calculated Delhi’s ideal oxygen consumption level for May 12 at 289 metric tonnes, using the Centre’s formula for oxygen requirement based on the number of hospitalised Covid-19 patients. This is where the four times figure comes from: 1,140 is around four times of 289.
However, the Delhi government’s calculation pegged the oxygen requirement for the day at 391 metric tonnes. The difference is on the account of the fact that while the Centre’s formula assumes that only 50% of the non-ICU beds need oxygen, the Delhi government supposed that that all non-ICU oxygenated beds use oxygen.
Irrespective of this, for the panel to conclude on the basis of this that Delhi exaggerated its oxygen requirement by four times makes little sense.
Why the conclusion is flawed
First, the 183 hospitals that reported their oxygen requirement to the committee did not include two of Delhi’s largest Covid-19 facilities: GTB and LNJP hospitals, which had 500 beds each for Covid-19 patients.
Second, the 1,140 metric tonnes-figure was not part of any official demand made by the Delhi government. It emerged erroneously during the preliminary stages of data collection for an audit and was later rectified.
As the committee’s report itself states, it was hospitals that had misreported the data, not the Delhi government. Bhalla from the Delhi government, in fact, admitted to the errors in his comments in the report. After verification, he said, the total consumption of the 183 hospitals on May 12 added up to 390 metric tonnes.
Subsequently, a total of 214 hospitals submitted data. As Budhiraja of Max Healthcare laid out in his note: “After repeated corrections (as hospital medical superintendents used a different format), the total O2 consumption (based on actual consumption data of 214 hospitals) came to around 490 MT.”
The actual number is likely to be even higher because as it did not take into account:
- The requirement of patients being administered oxygen at home.
- All 260 Covid-19 hospitals in the city. In fact, the data for the 214 hospitals again did not include LNJP and GTB hospitals.
- Non-Covid-19 requirements of hospitals.
All of these concerns were flagged by Budhiraja and Bhalla.
Third, even at the peak of the pandemic in late April and early May, the highest official demand raised by the Delhi government for oxygen was 700 metric tonnes per day – far short of the 1,140 metric tonnes figure now being cited as Delhi’s inflated demand in news reports. In an affidavit submitted in the Supreme Court on April 23, the Centre itself had stated that Delhi’s projected daily demand as of April 20 was 700 metric tonnes.
After much friction with the Delhi government, based on orders by the High Court, the Centre finally allocated 590 metric tonnes of oxygen to the state. But the amount was fulfilled only three times between May 4 and May 14.
Even the committee’s report acknowledges, using the Centre’s own formula for calculating oxygen requirement, that on May 3, the day the Covid-19 caseload peaked in Delhi, just its hospitals needed 415 metric tonnes of oxygen.
The committee’s report also notes that the corresponding figure for oxygen requirement in Delhi’s hospitals on May 3, going by the Delhi government’s formula for calculating oxygen demand, was 568 metric tonnes.
This is double the 289 metric tonnes figure of May 12 now being cited as the basis for the claim that Delhi government inflated the city’s oxygen requirement by four times.
These numbers aside, the scores of people who died struggling to get a hospital bed in the national capital are testament to the fact that Delhi’s actual oxygen requirement was much higher.