Supplying oxygen to COVID-19 patients: Essential, and a huge challenge (EN)

We cannot treat a person seriously ill with COVID-19 without oxygen. 80% of people hospitalised because of COVID-19 need between three and 15 litres of oxygen per minute. For the 20% who remain, the needs are more severe: more than 20 litres per minute.

Oxygen is therefore vital for them: without it they risk dying. But how do we give oxygen to our patients? What are the constraints of these various methods? And how do we put these systems in place in the countries where we work?

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Supplying oxygen to COVID-19 patients: Essential, and a huge challenge

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Unique Identifier Code / URN MSF323974

Date taken / Date Recorded 22/06/2020 12:00 AM

Country Yemen

Commissioning section MSF-FRANCE

Usage Rights (MSF) External Media, MSF Fundraising, MSF Publications, Social Media

Formal Consent Copy available no

Editor's rating ★★★ (F)

Video format h264 (Main) (avc1 / 0x31637661)

Duration 3m30s

Maximum Size 1920px × 1080px 300.91 MB

Additional Information / Shotlist Supplying oxygen to COVID-19 patients: Essential, and a huge challenge

We cannot treat a person seriously ill with COVID-19 without oxygen. 80% of people hospitalised because of COVID-19 need between three and 15 litres of oxygen per minute. For the 20% who remain, the needs are more severe: more than 20 litres per minute.

Oxygen is therefore vital for them: without it they risk dying. But how do we give oxygen to our patients? What are the constraints of these various methods? And how do we put these systems in place in the countries where we work?

Let’s head to Aden in Yemen to understand better. In the COVID-19 centre that MSF has set up in Aden there are 40 beds. To keep as many of those patients breathing as we can, we use a massive 250 bottles a day.

Every day, the trucks arrive, the bottles are unloaded, and changed for each patient. The bottles are connected to the piping by a regulator: it is a long and exacting job, which monopolises the time of many workers, and costs a lot of money.

To give you an idea of the price: $12 per bottle in Aden at the moment, which means more than $90,000 - around 80,000 euros - is spent on oxygen there per month.

We also have to find the parts that allow the bottles to function, such as the flow meters, in a market extremely stretched by the COVID-19 pandemic.

Thankfully, there are alternatives: oxygen concentrators and oxygen plants.

Supply is a problem, however. Because of the coronavirus it is more difficult to find oxygen concentrators for sale, and those that are available cost more than normal.

Illustration: €11,500 for a concentrator capable of producing 30 litres of oxygen per minute.
Easy to transport, a concentrator weighs around 100 kilos, but it needs electricity to work.

Another option is an oxygen plant, the XL version of the concentrators. In Aden we have ordered a plant with a flow of 500 litres per minute that will help 30 patients to breathe.

Illustration: It looks like a big cube, with a tank attached, it weighs 1.5 tonnes and costs around €140,000.

The two constraints at the moment are the availability of this type of machine and its delivery. How can one of these be delivered from Shanghai in China, where it is made, to Yemen, a country at war and difficult to access?
There are a couple of options. Either it is delivered to Dubai or Djibouti and then goes on a ship towards the port of Aden or is delivered by a cargo plane.

The problem is that each stage means time in quarantine, and that means time that it is not in service in the COVID-19 centre in Aden. And, once delivered, it takes a week for the machine to be installed, along with the piping system necessary to get the oxygen from the machine to the patients’ beds.

During that time, the patients will continue to be given oxygen via our other, more constrained solutions.

illustration: between April 31st and June 10th, 307 patients were admitted at Aden Covid-19 centre, and 159 of them died.

The provision of oxygen is still a major challenge for our COVID-19 projects around the world. Other oxygen plants are on their way, or have already been installed, in Bangladesh, Burkina Faso, Chad and Haiti, places affected by COVID-19 where MSF is intervening.

Covid-19 treatment center