COVID cases stress South Florida hospitals’ oxygen supplies

MIAMI – The Delta-variant-driven surge in COVID hospitalizations is putting pressure on both the production and distribution of oxygen, according to the Florida Hospital Association. To treat the new wave of COVID patients, some hospitals are having to use three to four times the amount of oxygen that they would have normally used.

Mary Mayhew, the president of the Florida Hospital Association, said Florida was among the first states to experience the Delta variant and the associated COVID hospitalizations surge. She said many hospitals had been on allocations, meaning the suppliers were not filling their tanks up, and some had less than 48 hours’ worth of oxygen on site.

“There is a shortage or a challenge is getting the supply distributed, which is both as a result of fewer drivers, because of the overall demand, but there is also a demand regionally and nationally as COVID cases increase, hospitalizations increase, in other states,” Mayhew said, adding “It was really bad last week.”

Mayhew said this week hospitals were starting to see more timely deliveries of oxygen and the situation has improved slightly over the last several days. COVID hospitalizations were just a little more than 15,400 earlier this week and more than a week ago there were 17,000.

“The suppliers have brought additional drivers into the state. They have diverted trucks into Florida in order to respond to the demand here, all of that together has helped to improve the situation and specifically to improve the timeliness of deliveries,” Mayhew said.

There were fears that Hurricane Ida was going to disrupt supplies to Florida coming from a plant in Louisiana, but as of Tuesday, that wasn’t a concern. Mayhew said flooding could still be a disruption, but hospital administrators are doing everything possible to ensure that they have an adequate supply of oxygen.

“They are also managing as appropriate the use of oxygen. As they are taking individuals off of ventilators, making sure that is clinically and timely supported. All of those efforts to ensure that we have an adequate oxygen supply and that includes raising awareness among state officials, federal officials,” Mayhew said.

In the U.S., the Food and Drug Administration regulates medical gases as pharmaceuticals. Premier Inc., a hospital-supply purchasing firm based out of North Carolina, reported notifying the White House, the Federal Emergency Management Agency, and the Health and Human Services about the scarcity in the region. FEMA formed a task force to come up with solutions.

“Speed is critical, as concerns about oxygen could move from a regional problem to a national problem given the course of the latest surge if not addressed now,” said Amanda Forster, Premier’s vice president of public relations.

Forster said there were hospitals in South Florida with a supply of oxygen of only 12 to 24 hours. Some had tanks of compressed liquid oxygen, compressed gas cylinders, oxygen concentrators, or on-site pressure swing adsorption plants. There are COVID-19 patients who require routine oxygen therapy at home.

Dr. Fernando Bayron, Florida Medical Center’s chief of staff, said there is a shortage of high-flow oxygen therapy, which has become the first-line mode of support for home use.

“The cascade effect of that is that these patients are staying longer in the hospital because we cannot arrange for them to get oxygen to go home so that compounds the problem we have with bed availability,” Bayron said.

Another shortage

Dr. Ralph Zagha, Broward County Medical Association Board of Trustees chair, said there are also concerns about not having enough refrigerated trailers and mortuary coolers to hold the bodies of the patients who are going to die of COVID.

“We do have the caseload of deaths and each hospital has its capacity on the morgues,” Zagha said.

The majority of the patients who are being hospitalized with COVID-19 in South Florida are younger than 65 years old and unvaccinated. Zagha said the unvaccinated are dying and much of the suffering can be prevented with the vaccine.

“The issues are multifactorial: It can be cultural, it can be political and it is just a matter of everyone getting the same message,” Zhaga said. “Please get vaccinated!”

Related statement

Here is the complete statement that Premier Inc. released on Tuesday:

COVID-19 treatment protocols have changed, and best practice is moving away from ventilator usage as the first option for critical patients, in favor of high-flow oxygen. As a result, oxygen demand is up 2-3X, and growing as COVID-19 caseloads increase.

Hospitals across the Southeast, including those in South Florida, have been running low on oxygen, with the worst-hit left with only 12 to 24 hours’ of supply. We have recently been hearing that as the COVID-19 census levels off, there is corresponding decrease in oxygen.

Fortunately, hospitals in the path of Hurricane Ida were able to get their oxygen tanks filled before the storm hit. However, we’re still dealing with storm assessments, evacuations and road closures, so we continue to watch this situation very closely.

Premier has notified the White House, Federal Emergency Management Agency and Health and Human Services department about the scarcity of oxygen in the region, as well as the implications on a national level given the current surge of COVID cases. FEMA has formed a “task force”/ working group on oxygen, which is a positive development. However, speed is critical, as concerns about oxygen could move from a regional problem to a national problem given the course of the latest surge if not addressed now.

— Amanda Forster, Premier’s vice president of public relations

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