Researchers outlined steps the state of California has taken to conserve oxygen over the course of the pandemic in a report published last month in Disaster Medicine and Public Health Preparedness.
Hospitals across the country have seen their oxygen supplies strained as COVID-19 cases surge due to the delta variant.
Eight key takeaways from the report:
- Oxygen shortages aren't always caused by a lack of oxygen. Los Angeles in early 2021 went through an oxygen shortage because its infrastructure to distribute liquid oxygen was outdated and couldn't handle the strain, according to the University of Minnesota's Center for Infectious Disease Research and Policy. In Florida currently, one of the main issues with oxygen supply is there aren't enough drivers licensed to transport liquid oxygen.
- Some rationing of oxygen did have to occur in California this year, but the state was able to create a centralized request and allocation system, which included regional oxygen depots, procurement contracts, and tip sheets on oxygen safety and conservation.
- To conserve oxygen, healthcare workers used concentrators with long tubing instead of E-cylinders, and activities that required more oxygen, such as going to the lounge or physical therapy, were reduced.
- When the state ran out of additional oxygen concentrators, providers bought oxygen-conserving devices that could increase the oxygen concentration delivered through a nasal cannula, according to CIDRAP.
- Groups including the California Office of Emergency Services and the Emergency Medical Services Authority worked together to procure and optimize oxygen and oxygen products. The Emergency Medical Services Authority worked on the transfer, stocking and urgent distribution of oxygen and other respiratory equipment. It increased its ventilatory equipment stock from fewer than 500 pieces before the pandemic to more than 30,000.
- Hospitals were also able to submit requests for oxygen supplies to their county public health officer or regional medical and health operational area coordinator. A state coordinating center with a 24-hour oxygen hotline and the Emergency Medical Services Authority synthesized all of the requests.
- Other oxygen supply efforts have included oxygen weaning guidelines, safety education and at-home discharge services, although the researchers noted the latter was used more to free up hospital beds than to conserve oxygen supply.
- "Oxygen plans are required at every level of disaster and pandemic response, from logisticians to end-users. Assumptions that oxygen is an endless supply are erroneous and oxygen conservation and supply should be part of every current and future planning efforts," Asha Devereaux, MD, one of the authors of the article, said in a news release.