Uganda Oxygen Failure Kills 30 COVID-19 Patients At Mulago

17 JUNE 2021

The Monitor (Kampala)

By Tonny Abet

By Nobert Atukunda

At least 30 Covid-19 patients are reported to have died at Mulago National Referral Hospital on Tuesday night after the facility's oxygen supply malfunctioned, highly-placed sources said.

Officials were reluctant to discuss the matter which, if true, presents the biggest single-day Covid-19 death reported at the country's largest Covid-19 treatment centre since the outbreak of the disease in the country in March 2020.

Senior Mulago Hospital staff, speaking on condition of anonymity due to sensitivity of the matter, said 18 bodies had by 2pm yesterday been released for burial.

There were differing accounts of what exactly happened. One version is that oxygen supply to the Intensive Care Unit and High Dependency Unit failed at night while the other explanation, one corroborated by officials, is that the oxygen supply pressure dropped dramatically due to high intake by patients.

Dr Rosemary Byanyima, the Mulago Hospital deputy director, said she was not sure about the deaths, but admitted that the facility had been grappling with problems of oxygen supply from the plant.

"I don't have statistics yet and oxygen did not go off, but because of the high demand, the pressure reduced. When the pressures go low, can you deliver as much (oxygen)? When the pressures drop because of high demand, then it puts a strain on how you deliver," she said.

In a statement on Monday, the Mulago Hospital administration noted that: "Currently, the plant is operating at the capacity of 2,999 litres per minute due to high demand for oxygen and this forces the oxygen pressure to fall in some units, especially ICU which uses ventilators that require high pressure."

The recommended production capacity of the plant, officials said, is 2,083 litres of oxygen per minute.

Shortly after news of high overnight deaths at Mulago, the Health ministry announced that 49 new Covid-19 deaths occurred on Tuesday, the highest single-day reported fatalities in the country. Total deaths from the pandemic are now 508.

The ministry later clarified that new deaths include those that occurred on previous days.

The defective oxygen supply at Mulago affected non Covid-19 patients, according to a man who only identified himself as Nathan.

Non Covid patients affected

He was taking care of his father who was admitted to the hospital due to pneumonia, but died the same Tuesday night as the Covid-19 patients.

Nathan said his father was at Orthodox Hospital in Namungoona, Kampala area, but was referred to Mulago hospital to be put on oxygen.

On arrival at Mulago, they were told the oxygen supply was limited, although they were admitted.

"The oxygen was not enough. The patient who was beside us died due to oxygen problem. So, I told the health workers that my dad needs oxygen, but they told us they will bring ... after a few minutes they brought about six cylinders for about 12 patients," he said.

At about 10pm, the facility ran out of oxygen, triggering panic among health workers and alarm for patients and their attendants.

Nathan said he sought additional oxygen for his father, but "I was told [that] there was no oxygen.

"But some person told me to deal with health workers [signalling] that they could get me a cylinder of oxygen, but the health workers told me it was finished... [at] 1:16am [Wednesday morning] there was no oxygen, so he (the father) died," said Nathan.

Many cases of deaths in Intensive Care Unit for Covid-19 patients are due to faulty oxygen supply deficiencies, officials said, including during Uganda's first pandemic wave.

Mulago Hospital said last week that it planned to install more oxygen plants to meet increasing demand.

Mr Emmanuel Ainebyoona, the Ministry of Health spokesperson, said they got information about the Tuesday night Covid-19 deaths in Mulago Hospital, but that they were investigating circumstances under which they happened.

Dr Byarugaba Baterana, the hospital's executive director, said on Monday that in addition to planned new oxygen manufacturing plant, they are purchasing 100 cylinders of oxygen from private suppliers to supplement existing supply.

He said a Covid-19 patient consumes as high as 70 litres of oxygen per minute when in critical state, making demand to outstrip supply.

"It is true that we need more oxygen. [However], our plants can produce enough oxygen for non-Covid-19 patients in the Intensive Care Unit," he said. 

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