Blighted by ongoing outbreaks of the Covid-19 pandemic, the past two years have exposed numerous weaknesses across the global medical oxygen supply chain, from challenges relating to domestic oxygen production to inadequate supply infrastructure, and everything in between.

Densely populated low and middle-income nations were hardest hit by the virus, spurring on international oxygen-relief efforts. With so many question marks around preparedness, gasworld’s latest webinar, ’Medical Gases: A Picture of Health?’, featured discussion on lessons learned during the pandemic, challenges faced, and how to better shape our healthcare systems of tomorrow. 

Hosted by Global Managing Editor, Rob Cockerill, and Broadcast Journalist, Thomas Dee, the webinar featured guest speakers Leonardo Daniele Ferrari of the SOL Group, Fabio Pinzi, Business Strategy Manager at Ambra Sistemi, and Gareth Pemberton of the GCE Group. 

Specialising in multiple areas within the healthcare sector, the SOL Group runs the gamut of technical and medical gases, as well as operating in the Home Care services sector, biotechnologies and the production of energy from renewable sources. 

Discussing the company’s experiences during the pandemic, SOL Group’s Corporate Quality Director, Leonardo Daniele Ferrari, elaborated on challenges faced when it came to meeting unprecedented medical oxygen demands. 

“Well, it was a was a real wave of patients reaching the hospital with respiratory and other disorders. So, as a medical gases company, we saw the rapid increase in liquid oxygen consumption by hospitals and immediately understood that something major was happening,” he said. 

“Later we calculated that this rapid increase in the oxygen demand was triggered on one hand by the single patient’s consumption with values ranging from five litres per minute as to as high as 60 litres per minute per patient. This caused an increase in the demand.” 

SOL Group, alongside other medical gas companies, then helped hospitals to organise changes to adopt the medical oxygen systems. With the installation of addition cryogenic tanks, these companies also had to increase the number of cylinders available to hospital wards and in emergency rooms. 

According to Leonardo Ferrari, the national figure in Italy for 2020 is a consumption rate of 125.4m litres of liquid oxygen (LOx) compared to an average annual consumption of 95m. 

Moving forward 

To help mitigate the risk presented by future pandemics, Ferrari elaborated on the upgrades and innovations that have been – and are still being – implemented at healthcare facilities across Italy.

“As far as upgrades in Italian hospitals are concerned, 3,777 new intensive and sub intensive care beds were created with the help of companies associated with the country’s national association of companies operating in the field of technical special and medicinal gases.” 

“182 extra cryogenic oxygen tanks were also installed in hospitals,” he added. 

Medical gas companies across Italy have deployed significant technical, human, and financial resources to help support the country’s health care systems. The full supply of medicinal LOx in tanks has constantly been ensured.

The heightened demand for oxygen cylinders was compounded by users not returning emptied containers following use. 

“It’s a fundamental importance that, in such a state of emergency, the containers are returned as soon as they’re emptied to make them immediately available for filling and subsequent use,” stated Leonardo Ferrari. 

“Covid has set forth unprecedented augmented needs, which have forced hospitals to expand their acute treatment capability and medical gases distribution and adding extra LOx tanks. These improvements need to be consolidated and adopted as a standard. European long-term funding can definitely help in this respect.”

Ambra Sistemi, an Italian electrical solutions expert, has spent the past 25 years advancing technology within the industrial and medical gas world. Fabio Pinzi, the company’s Business Strategy Manager, provided further insight into Ambra Sistemi’s inner workings, in particular its control and monitoring products. 

Describing the European medical cases market as the most challenging in the world of medical applications, Pinzi explained that this is due to three main reasons. The first focusing on rules - or ISOs, a set of rules established by the International Organisation for Standardisation. 

“Medical gas plants and devices design rules that we simply call ISO. The second one, digitalisation, is deeply changing the market, especially for smaller gas producers and distributors, creating habit changes that require investment capabilities sometimes not planned,” he began. 

“And the third, the world Covid-19 emergency experience.”

For the first issue, medical gas plants, one of the main issues centres around medical oxygen quality control. In the pharmaceutical world, medical oxygen is considered a medicine and as such the hospital quality control monitor also requires the introduction of a device to control the production process continuously. 

This type of control, Pinzi explained, can be visualised by imagining a ‘sophisticated architecture’ in a large hospital where cryogenic gas storage systems co-exist, consisting of tanks, vaporiser, pressure regulator, synthetic air generating system, medical oxygen backup systems and distribution systems for oxygen, air and vacuum in surgery theatres, patients, rooms, laboratories and other controlled areas. 

“Being able to control the entire environment means having system architecture that is designed from the beginning with the use of devices that are connected by wire or by a radio to specialised networks,” he said. 

The company manufactures systems that can be hooked up to such a network, for example cryogenic tank telemetry monitoring systems, compressed gas cylinder telemetry monitoring systems, and local and remote alarm systems for medical gases distribution in pipeline. 

The pandemic 

The extent of the Covid-19 pandemic has seen major players in the medical oxygen market affected in some way by the subsequent events. A technology that Pinzi recognises as making a considerable difference when it comes to medical oxygen supply in hospitals is cryogenic systems, which have ‘largely ensured’ the operational continuity. 

Commenting on the heightened demand, Pinzi said, “The real problems encountered in the undeniable increase in medical oxygen consumption and for effective sampling equipped with, for example, vaporisers that were not cited for the required volumes, but which have been fixable by upgrading the plants and by constant and careful monitoring of overall operations.” 

“I have to say that the examples I have mentioned are part of a number of systems, design and production experience, and we are proud to say that we cover more than anyone else the possible requirements for solutions in medical cryogenic gas control systems.”

Regarded as one of the world leaders in the field of gas control equipment, GCE Group (GCE) has spent almost 100 years manufacturing and supplying high-pressure gas equipment. Recent activities conducted by the company have seen it work on the frontline of the global medical emergency, helping to secure essential gas delivery devices such as oxygen concentrators, valves, regulators, and flowmeters. 

Director of Innovation at GCE, Gareth Pemberton, is responsible for heading up product development in fields such as oxygen concentrators, speciality gases, medical gases and cutting and welding equipment.

Focusing on medical gases, Pemberton spoke about GCE’s movement in the field. 

“The world has really changed its perspective on medical gases, and I think that’s such an important part for our overall gas industry, that this isn’t just a commodity product which we provide. It’s so much more than that,” he said.

The company provides the medical gas industry with a range of solutions from a variety of valve types, emergency oxygen supplies, home care technology, regulators and concentrators.

“Since the post pandemic era, there’s been a lot of innovation opportunities,” revealed Pemberton. 

“We’re best known as one of the pioneers in the integrated valve section. More than 20 years ago GCE entered that space of integrated valves and we now have a market leading range of products in that area.” 

Touching on what GCE learned from working through the ‘eye of the storm’ during the pandemic, Pemberton called it a ‘once in a lifetime experience.” 

“The pandemic taught us so many things,” he said. “Though I hope we don’t see the same scale of shortages and have to treat people with oxygen. We actually saw the start of this with our team in China and, as things progressed worse and worse in China, we switched our supply chains to Europe.” 

Following its shift to Europe, GCE quickly adapted to a ‘new normal’ way of working to ensuring uninterrupted output of medical oxygen related solutions. Having alternated to working-from-home arrangements, the team narrowed its focus from four different areas to just one medical space, requiring the company to change production methods, supply chains, and how the business was run. 

“It’s just been an absolutely incredible situation to learn from. The other key learning point, I would say, is around prioritisation,” explained Pemberton. 

“There was a lot of projects running and we had to prioritise against those as well. We had to find out which of the ones that this is going to be the most helpful with. Prioritisation was certain a key skill that we really learnt.”

The full webinar can be watched for free on-demand at www.gasworld.tv.