The Mumbai oxygen model has received praise from all sections of society, including the Supreme Court. Senior IAS officer P Velrasu, who is the Additional Commissioner (Projects), for the Municipal Corporation of Greater Mumbai (MCGM), has been at the helm of affairs for managing the oxygen supply for the city. In an interview with BusinessLine , Velrasu shared his strategies and insights in managing and supplying the crucial medical gas to the Covid hospitals. Excerpts:
How has the oxygen worked for Mumbai city?
The total allotment of medical oxygen to Mumbai city is 235 tonnes a day, which is not very high. This quota had to be used in such a manner that would keep the supply running continuously so that end-users such as hospitals and nursing home would not get into a panic mode when the supply dipped. The MCGM management devised a system for judicious distribution of the vital gas, which is the Mumbai oxygen model. The success of the model lies in the fact that supply has remained uninterrupted when the total available stock is close to the actual consumption of oxygen by the patients. It has worked despite disruptions.
What were step initiated by MCGM management for seamless supply of oxygen?
In the Mumbai oxygen model, certain aspects are centralised and some services decentralised. The central dashboard provides a live status of beds availability across Mumbai hospitals. The SOP and policy formulations are managed centrally.
Large infrastructure needs are taken care of by the Central Purchases Department and oxygen storage structures in different hospitals of MCGM are managed by CPD and the health infrastructure cell. The SOPs and Covid treatment protocols were developed at the headquarters in discussion with the State Covid Task Force members and deans of medical colleges. Setting up of 24 ward-level rooms, patient admissions and powers to spend for Covid at the ward levels are decentralised.
How did you handle emergencies and at the field level what were changes brought about for handling such situations?
Emergency reserves and delivery teams play a crucial role in SOS situations. All hospitals were instructed to create alerts at least four hours before the oxygen available is likely to exhaust. MCGM identified six strategic points from, which all the hospitals could be reached within half an hour. These six strategic points are equipped with six vehicles having 25 jumbo cylinders each. Whenever emergency calls are received from hospitals, after ascertaining the emergency, these vehicles are deputed to help those hospitals by providing temporary stock from these 25 cylinders. MCGM has also installed a redundant capacity of 26-kilo litre in two tanks where the Liquid Medical Oxygen (LMO) is kept for emergency situations. This redundancy helped when there were delayed arrivals of tankers or some other unexpected supply disruption.
Carrying out this kind of management requires exclusive teams. A physically fit, talented, quick and self-motivated team that delivers under stressful condition was identified and put in place. MCGM has a dedicated Central team that does all the management. Each ward has two officers assigned exclusively to look after oxygen problems within their jurisdiction. There are six officers deputed to Food and Drug Administration Office to resolve the supply issues from oxygen manufacturers. MCGM has a team, which tracks the movements of tankers and their locations. We also have identified persons who look after the oxygen supplies in each of the hospitals and real-time information is collected from them.
How is MCGM planning for the third wave of Covid and future requirements of oxygen in the city?
Currently, the oxygen team of MCGM is working on the future-proofing of Mumbai from the shocks of oxygen supply. We will be installing self-generating oxygen plants in all hospitals of MCGM as augmentation measures. The new plants will be able to cater to a hundred per cent of patients in normal times and during extreme situations also there will be a redundancy of 50 per cent. This means the oxygen supply systems will work well without stress even if there are supply disruptions. MCGM will also install 40 tonnes storage capacity for LMO one each on the Eastern and Western side of the City within two months.
The Dura cylinders (roughly equal to 0.25 tonnes) refilling will be created within Mumbai city and plans are in the advanced stage to create Jumbo cylinders (roughly equal to 0.1 tonnes) refilling stations also within city limits.