India's Multi-Sectoral Response to Oxygen Surge Demand during COVID-19 Pandemic: A Scoping Review.

Oxygen support became one of the rate-limiting steps for medical care during COVID-19 pandemic in India. The primary aim of this study was to appraise the manufacturing, supply, and distribution of medical oxygen during the pandemic. The secondary objectives were to highlight the coordination of various stakeholders to mitigate the oxygen surge and to present a critical analysis of India's response to the emergent situation. Using an analytic approach, we have delineated India's response to mitigate the medical oxygen surge during the distressing second peak between March-May 2021. In the pre-COVID-19 era, of the total 6900 MT of oxygen produced in India, only 1000 MT was available for medical usage, which was increased up to 19940 MT through the strengthening of in-house oxygen manufacturing, low-cost innovations, and enhanced storage facilities. High-burden states were identified, and transport was facilitated through departments of railways, defence and civil aviation. Real-time scrutiny of the oxygen supply was provided. Essential customs duties on importing oxygen and vital equipment were exempted, along with other swift decisions. National Oxygen Stewardship Program' was initiated to build the capacity of health care workers in oxygen therapy and rational use of surplus oxygen. The pandemic overwhelmed the health system. But a coordinated multi-stakeholder approach facilitated the fight against oxygen surge. However, a comprehensive pandemic response will need more than just oxygen. This resourceful utilization offers a silver lining and facilitates the improvement of health systems and health outcomes in the long term.