Widespread media reports suggest that hospitals in the Brazilian city of Manaus have reached ‘breaking point’ in their treatment of growing numbers of Covid-19 patients, as oxygen shortages take hold in the region.

The city, with a population of 2.1 million inhabitants, in Amazonas state and around 3,900km North of the city of Sao Paulo, is understood to be experiencing a surge in both infections and fatalities and now at the mercy of dwindling oxygen supply.

gasworld understands from its sources in the region that there were already local reports about shortages in distant cities in the north of Brazil and in the state of Amazonas in the months leading up to this new crisis in Manaus.

It comes as headlines concerning oxygen shortages continue to re-emerge in different regions, notably the US and UK in the last week, with the resurgence in Covid-19 (coronavirus) numbers around the world and the emergence of new, often more transmissible variants of the virus.

Read more: UK oxygen capacity “remains in place”

Read more: CGA, Chart explain how industry is meeting demand for medical oxygen

As in other parts of the world, Amazonas state in Brazil was hard-hit by the first wave of Covid-19 but is also becoming overwhelmed by this latest rise in infections.

According to gasworld sources, demand for medical oxygen increased five-fold during the last week, as indicated both by White Martins, the Brazilian subsidiary of Linde, and the Amazonas State Health authorities. Several state hospitals had either reduced oxygen stock, or in some cases no oxygen at all.

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‘Complicated logistics’

White Martins, responsible for supplying all state-owned hospitals in the Amazonas State, expressed in a company press report cited by Brazilian newspapers, that its local production capacity is around 25,000 m3/day of oxygen – while demand has risen to 75,000 m3/day (from a pre-Covid level of 15,000 m3/day) as a new wave of infections spread in Manaus.

The other two local oxygen producers (Itron and Carboxi) have small plants which cannot cover the peak demand, so the immediate solution is to bring product from other White Martins plants – but logistics are complicated due to the sheer distances involved and the fact that the city of Manaus is located in the confluence of the Negro and Amazonas rivers, with the traditional road and 1,000km by barge supply taking time and providing no immediate solution.

The Brazilian Air Force is reported to be shipping cylinders and small liquid oxygen ISO tanks to cope with the short-term situation, and liquid oxygen is already in its way through the road-barge route. The Amazonas Governor received early morning on Saturday 16th (January) at the docks in Manaus, 75,000 m3 of liquid oxygen that came through the river from other White Martins plants outside the state of Amazonas.

It was also informed on Friday 15th that Air Liquide Brazil is supplying – through road and barge – six liquid oxygen trailers with a total of around 100,000 m3 that were purchased by the Brazilian Federal Government.

Other measures were also taken to deal with the emergency, gasworld understands.

Several patients that required oxygen were transferred by the Brazilian Air Force to other states, oxygen was brought from some industries located in the Free Industrial Zone of Manaus, and a curfew was declared to decrease the circulation of people.

Additionally, ANVISA, the Brazilian medical product regulator, authorised for 180 days the emergency request of White Martins to deliver 95% oxygen (instead of the usual 99% purity) to medical patients in order to allow additional supply of product from other company plants.

It was only in June that gasworld reported how the Covid-19 crisis had deepened in Peru, where there existed a significant supply shortage of oxygen and individuals were pictured taking supply into their own hands.

Catch-up: Peru coronavirus crisis deepens