In Latin America, the second region in the world with the most deaths from Coronavirus, the same scene of despair is repeated. Hundreds and hundreds of people standing in endless lines or paying high prices for an oxygen tank while many patients die from suffocation in hospitals.
Under a scorching sun in the Amazon Manaus, in Brazil, or in the cold night on the outskirts of Lima, in Peru, thousands of people have made a pilgrimage in recent weeks in search of vital gas to relieve their infected relatives.
The Pandemic has skyrocketed the demand for medicinal oxygen. In the region, the Virus already leaves 19.1 million infections and more than 606,000 deaths since the first confirmed case almost a year ago.
A harsh reality
Yamil Antonio Suca arrived in the early morning at a distribution center in El Callao, the port next to the Peruvian capital, hoping to be among the lucky ones that he managed to fill his cylinder. Others by his side had been waiting for two or three days. “My father has COVID, he is 50 years old and needs oxygen, his saturation is very low,” this 20-year-old university student said.
The World Health Organization (WHO) estimates that around one in five COVID-19 patients requires oxygen at concentrations higher than those found in the environment. “Without such therapy, COVID-19 can be fatal,” said emergency medicine expert Priyanka Relan, in the Bulletin of the WHO, the organization’s scientific journal.
But addressing these respiratory insufficiencies can be a big challenge in countries considered by the World Bank as low- and middle-income, notes the Seattle-based nonprofit PATH global health organization. Its Global Response to COVID-19 Respiratory Care project created an interactive tool to estimate the daily oxygen need for Coronavirus patients.
Brazil was the only one to appear in red on Thursday, with more than 2.2 million cubic meters required. In orange were Mexico (628,000 m3) and Colombia (537,000 m3) and, in yellow, Argentina (393,000 m3) and Peru (257,000 m3). Medicinal oxygen is on the WHO essential medicines list, but the cost of gas and the lack of infrastructure to install and maintain the supply complicate access and distribution.
Chaos in Manaus
In Brazil, the second wave of the Pandemic depleted oxygen reserves in the jungle state of Amazonas. This country has more than 226,000 deaths and is the second country in the world after the United States with the most fatalities from COVID-19 in absolute terms.
In mid-January, the daily demand in Amazonas was around 76,000 m3 of oxygen, but the supplying companies were unable to produce more than 28,200 m3. In the capital Manaus, the only one of the state’s 63 cities with intensive care units, dozens of people died in health centers due to lack of oxygen.
Overwhelmed, state authorities had to impose a curfew, while the Brazilian government evacuated patients to other states, organized oxygen shipments to Manaus, and even received a donation from impoverished neighboring Venezuela.
Peru, which has been facing a lack of medicinal oxygen since May, declared a “strategic resource” by the government, the increased demand caused some plants to skyrocket prices by more than 300%.
Currently, 10 m3 oxygen tanks sell for between $ 330 and $ 690, and a cubic meter of oxygen sells for $ 5 to $ 13. The government, private companies and the Church have installed new oxygen plants in Lima and the most affected regions to try to supply people and hospitals, but the shortage persists.
In Mexico, where President Andrés Manuel López Obrador is currently among those infected with COVID-19, the Mexican authorities assure that they have not detected a shortage or hoarding of oxygen, but they observed a 700% increase in gas demand between the 20th of December and January 20th. “There is enough of the product, but not of tanks,” Jesús Montaño, spokesman for the Federal Consumer Prosecutor’s Office declared.
According to this institution, the maximum variation in the sale and rental price of tanks in formal establishments has been between 5% and 7% between August and the last week of January. But on the black market, consumers report abusive prices of 45,000 pesos (2,230 dollars) for a 9,500-liter tank and 32,000 pesos (1,585 dollars) for another 6,000 liters, triple the normal amount.
In addition, presumed doctors and patients promote on social networks the development of handmade devices, such as oxygen concentrators from air pumps such as those in a fish tank. But specialists and authorities warn against its use due to its ineffectiveness and potential health risk.
Nicaragua, where more than a third of the population lives in poverty, suffered an oxygen shortage in May and June. “It was very expensive, an oxygen tank could cost between 1,000 and 1,500 dollars. This generated a higher mortality rate because not everyone had the capacity to supply themselves,” Roger Pasquier, President of the Nicaraguan Association of Anesthesiology.
The Pan American Health Organization (PAHO), WHO regional office, this week ruled out a generalized emergency in Latin America for lack of oxygen due to the Pandemic. “I really don’t think you can talk about a regional oxygen crisis,” Sylvain Aldighieri, PAHO’s incident manager, said Wednesday.
However, the expert highlighted an “important impact” of the arrival of critically ill patients with COVID-19 in hospitals in Manaus in recent weeks, and in the Andean region last year. And he said that “the local oxygen production capacity in some cases has not been enough to supply hospitals. Some countries have been challenged in significant ways in recent months,” Aldighieri told reporters. PAHO supported local governments, as in Manaus, by sending a supplementary amount of medical oxygen.
In recent months, it has donated more than 600 oxygen concentrators to more than 20 countries in the region. Unlike tanks, which have a limited amount of oxygen and do not produce it, concentrators guarantee an infinite supply if they are connected to a power source. And on some occasions, Aldighieri said, PAHO supported the development of local oxygen production in remote areas, such as in the Colombian Guajira.
PAHO experts told that the Latin American countries reported the biggest oxygen problems have been Brazil, and Peru, at the previous peak of the outbreak in the Amazon area, although they also noted difficulties in Bolivia and Ecuador. In Mexico there were “indications of an availability crisis” last week, but authorities took steps to contain it, they said.