Gasping for Air: The deadly shortages in medical oxygen for COVID-19 patients, MSF Briefing Paper, May 2021

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Medical oxygen is the single most important medicine for treating patients with COVID-19. Yet this effective and lifesaving treatment for critically ill patients has been scarce in many health facilities in countries where MSF has been responding to the pandemic. This is not new. MSF has witnessed these structural issues for some time in places where healthcare is under-resourced.

MSF has responded to the COVID-19 pandemic in both high-income and middle- to low-income countries. Whilst some hospitals in the US and Europe have struggled with a shortage of ventilators for critical patients, oxygen in highincome countries is piped to patients’ hospital bedsides, and supply has mostly been able to keep up with demand.

In low and middle-income settings, the lack of medical oxygen and supply shortages during the COVID-19 pandemic have caused patients to face delays in receiving critical assistance. MSF teams have witnessed first-hand the avoidable deaths and complications these delays have led to. Health workers – in desperate attempts to save lives – have had the impossible task of rationing oxygen, leaving them to carry the mental health burden of being unable to provide essential care to all their patients.

More than a year since COVID-19 first swept the globe, attention and hopes are pinned on the roll-out of COVID-19 vaccines. However, the countries most affected by the lack of medical oxygen are also the ones with the least access to vaccines. This is why it is critical to ensure the sufficient supply of medical oxygen for those people who will still become ill.

Governments must not only consider oxygen supply when patients are gasping for air in overflowing hospital beds when cases peak. Long-term solutions are needed to secure supply. But, in the meantime, medical oxygen supplies must be urgently made available to health facilities battling COVID-19, particularly when the virus surges.

This briefing paper describes MSF’s experience of the critical role of medical oxygen in treating COVID-19; the challenges of accessing it, particularly in rural settings, and of ensuring its proper use; and the impact oxygen shortages have on patients and healthcare workers.