Even though a shortage of oxygen cylinders resulted in the death of many Covid-19 patients in the second coronavirus wave, accumulating such cylinders is off the government’s priority list as it prepares for a potential third wave.

Health Ministry officials said they have taken oxygen cylinders off a highly prioritised list of logistics required to combat a potential third wave of the coronavirus.

The ministry has already warned about the potential third and fourth waves of pandemic, telling the hospitals to arrange 20 percent beds targeting children below 18 years, who could be the next victim group from a new wave.

“We have delisted oxygen from high priority as cylinders are in adequate supply even though we faced an acute shortage at the height of the second wave,” Dr Madan Upadhyay, director of the Curative Service Division at the Department of Health Services, told the Post. “The ministry has stopped encouraging the import of oxygen cylinders.”

He said the government’s biggest priority to prepare for the third wave was vaccines.

“Managing intensive care units with particular focus on children, consumable goods and equipment for ICU patients and ventilators are other key priorities while the supply of some oxygen concentrators and liquid oxygen are also on the list,” Upadhyay said.

Nepal received over 6,000 oxygen cylinders from various sources—including foreign governments, their international cooperation agencies, domestic and international non-governmental organisations, the private sector and the Nepali diaspora, according to a list of donated medical goods made public by the Department of Health Services on June 4.

Before the second wave hit the country, oxygen manufacturers in Kathmandu had said that they had 70,000-80,000 oxygen cylinders.

A total 1,086 oxygen concentrators were received from different sources and 150 liquid oxygen cylinders arrived from the Tibet Autonomous Region government of China, according to the list. The government, however, did not purchase oxygen-related equipment or supplies during the second wave.

Amid the lockdown imposed since late April in most parts of the country, Covid-19 cases have been decreasing while the demand for oxygen has also fallen. According to the Health Ministry, 1,963 new cases were reported on Saturday, a sharp drop from 8000-9000 cases per day in early May.

“The oxygen cylinders available to us are enough at the moment for Covid-19 patients,” Krishna Prasad Paudel, spokesperson for the Health Ministry, said. “The supply of oxygen concentrators and liquid oxygen in some big hospitals also eased the situation.”

Even though the supply of oxygen-related materials increased, there has not been proper management of these materials.

Oxygen manufacturers have been complaining that many cylinders are lost in circulation. “We have been asking the government to help us search for the cylinders which have not been returned,” Gaurav Sharda, president of Oxygen Industries Association of Nepal, told the Post. “In case of a deterioration in the Covid-19 situation, we may not be able to produce enough oxygen if our cylinders don’t return.”

Upadhyay also acknowledged the need for proper management of available cylinders amid complaints from manufacturers. “We have written to the authorities concerned to locate the misplaced oxygen cylinders,” he said.

Even though the government is more or less confident that the available oxygen cylinders are adequate for dealing with any future surge in cases, not all stakeholders agree. Nepal Medical College Chairperson Dr Bhola Rijal said he would not comment on whether currently available oxygen cylinders would be enough to tackle a potential third wave of the pandemic. “We don’t know how many people will fall ill and how many will need oxygen,” Dr Rijal said.

According to Rijal, his hospital is preparing to procure an oxygen plant from China which would be useful for both filling cylinders and supplying oxygen directly to hospital beds. In early May, amid rising Covid-19 hospitalisations and an acute shortage of oxygen, his hospital had issued a notice asking patients to get discharged citing oxygen shortage.

As the second wave of the pandemic continues, health officials and experts in both Nepal and India are saying a third wave is also imminent.

Health experts from around the world are saying that a third wave is likely to hit India by October, according to a poll conducted by the Reuters news agency.

According to a Reuters report, 85 percent of respondents—health care specialists, doctors, scientists, virologists, epidemiologists and professors from around the world said the next wave would hit by October.

Nepali health officials said that they are well aware of the possibility of a third wave hitting Nepal. “So, we have been asking hospitals to set aside 20 percent beds for children who may be easy targets of the coronavirus in the third wave after adults were affected in the first and the second wave,” said Upadhyay.