Updated September 2026: this article was written in early 2022, during the COVID-19 pandemic, and describes the oxygen shortages of that period. The World Health Organization ended the COVID-19 global health emergency in May 2023. The explanation below of how medical oxygen is produced and delivered still applies.
Medical oxygen shortages persisted throughout the COVID-19 pandemic. Although vaccinations are being distributed in some countries, many may have to wait years before the bulk of their populations are immunized. In the meanwhile, medicinal oxygen will continue to be a crucial necessary treatment.
Most lately, the world’s attention has been focused on oxygen supply, where growing infection rates indicate demand is surpassing supply-with disastrous consequences. Global efforts to meet immediate needs are ramping up, but building medical oxygen access systems is complicated.
Why Is Oxygen So Important In The Treatment Of Covid-19?
Covid-19 pneumonia and hypoxaemia are caused by the Sars CoV-2 virus. Hypoxaemia is a lack of oxygen in the blood, and it is the most serious complication of Covid-19 pneumonia, as well as a leading cause of death.
A few antiviral drugs have been shown to be effective in treating Covid infection; however, oxygen relieves hypoxaemia in severe pneumonia. It can give the infection time to clear and the lungs time to heal. For many Covid patients, oxygen is life-saving.
Oxygen Treatment Classifications
There are several methods for administering oxygen. Patients with mild to moderate oxygen deficiency can be fitted with a nasal cannula – a medical tube that passes through both nostrils – or a basic or reservoir face mask. In certain circumstances, one to fifteen litres (3.3 gallons) of oxygen per minute is provided to complement a patient’s normal breathing.
If larger amounts of oxygen are necessary, patients may be put on a high-flow nasal cannula, a CPAP machine, or a ventilator. In these instances, the oxygen cylinder supplies up to 100 per cent of the oxygen that a person inhales.
Weighing The Alternatives For Producing Oxygen
Oxygen is a vital drug and a critical treatment for a wide range of disorders that impact all sectors of the population, including obstetric crises, preterm delivery, and pneumonia.
Indeed, the demand for medical oxygen has been increasing for more than a decade, since disorders needing oxygen for treatment account for a growing part of the disease burden.
Meanwhile, low- and middle-income nations have been chronically underfunded for decades. Oxygen administration necessitates a host of complex equipment, as well as accessories for measuring and giving the medication. All of these need training in their usage as well as frequent maintenance.
But it all starts with making or obtaining oxygen. There are three primary methods for producing oxygen.
Oxygen Concentrators
Oxygen concentrators pull in ambient air and remove nitrogen, concentrating the oxygen and delivering it to the patient’s bedside continually. Concentrators are most effective in situations with clean air, low humidity, and consistent electricity-as well as for individuals who require lower airflows.
Concentrators are frequently the favoured choice during an emergency since they are a very simple and low-cost solution that requires less infrastructure, logistics, or equipment.
The least effective approach is oxygen concentrators. One unit generates enough oxygen for one patient. And the items frequently fall into disrepair due to the cost and complications of maintaining thousands of devices, which frequently break due to power surges. It is there important to invest in electrical enclosures for electrical safety purposes. They should not be used in place of long-term remedies.
But the alternative solutions come with problems as well
Pressure Swing Absorption(PSA)
Pressure Swing Absorption plants are stand-alone oxygen generation systems that extract oxygen from the air using a flow and compression methodology. They are essentially very large oxygen concentrators that can produce oxygen for a large number of patients at the same time.
These are frequently used in hospitals that produce their oxygen. Oxygen can be delivered straight to patients’ bedsides or compressed and stored in gas cylinders before being supplied.
Building a PSA plant necessitates rigorous study to verify that the specs match the environmental conditions of the facility, and, like concentrators, it necessitates dependable energy.
It takes a significant amount of money to build, but ongoing operating costs-for technicians, electricity, maintenance, and spare parts-account for a significant portion of total costs. These elements rapidly multiply the initial investment.
ASUs
ASUs create highly pure liquid oxygen in bulk tanks via a technique called cryogenic fractional distillation fitted with 13X Zeolite molecular sieves commonly used to remove carbon dioxide and moisture from the air.
It can then be turned into gas and stored in cylinders, or it can be loaded onto a liquid tanker truck and sent to facilities with liquid storage tanks.
In most high-income nations, when there is a consistent demand for medical oxygen and adequate means to buy a steady supply, this is how oxygen is generated and delivered to hospitals. We may expect a comparable, steady level of need in larger institutions in low-resource countries.
However, until that requirement is quantified and a proper operating model is developed, it may not be an appealing possibility for an industrial gas supplier.
Conclusion
To respond to COVID-19, low- and middle-income countries require more than 2.4 million cylinders of oxygen.
Meeting this unprecedented demand for oxygen and its supply networks would necessitate multi-sector alliances and a systems-level approach to oxygen and its supply chains.
