- Patients who rely on private oxygen concentrators at home are at risk due to Eskom load shedding.
- There is a national shortage of oxygen cylinders, used during emergencies like power cuts, and expensive portable units are only recommended for supplementary use.
- Batteries and inverters can be used to power oxygen concentrators – but cost around R8,000.
- This safety mechanism pushes the price of an entry-level concentrator beyond R20,000.
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Eskom’s electricity rationing is disruptive at the best of times - and the added pressure placed on patients requiring oxygen can be deadly, as South Africa battles its second wave of coronavirus infections.
While the latest round of power cuts has also impacted under-resourced healthcare facilities – which have failed to service generators and other back-up power facilities – the toll on non-hospitalised patients requiring oxygen is pronounced.
The issue of oxygen supply, availability and delivery is intrinsically tied to the spread of Covid-19. The need for medical-grade oxygen has surged in both private and public hospitals, and demand has far exceeded supply in Covid-19 hotspots. This coincides with a dire lack of beds and overworked medical staff, forcing out-patients and those opting for home treatment to rely on their own oxygen concentrators.
Although portable concentrators could provide uninterrupted supply during load shedding, stock is seriously limited, prices are high – starting at over R40,000 per unit – and the rate of oxygen supplied is not adequate for patients suffering from severe respiratory incapacity.
“The portable unit sends the oxygen in a pulse, which is much less than what you’re getting out of a [mains-powered] home machine,” says Neil Forbes of Limitless Health in Johannesburg. “They’re supplementary, not for primary use."
Portable units supply intermittent-flow or on-demand bursts of air which are measured according to the patient's breathing rate. Continuous-supply oxygen concentrators do not rely on breath detection and instead supply a steady flow of oxygen throughout the day.
Oxygen concentrators, depending on their capacity and integrated tech, range from R15,000 to more than R30,000 per unit. Battery-operated portable units are even more expensive and, according to Forbes, are not fit for use among Covid-19 patients.
“We got 150 [oxygen concentrators] in this morning [18 January] and there’s only two left… there’s nearly 180 units coming on Wednesday [20 January] and they’re almost all pre-sold,” says Forbes.
This spike in demand for personal home-care units has forced Limitless Health, which supplies medical-grade oxygen and concentrators, to shift the business model away from rentals and into sales.
Most suppliers urge patients to have at least one back-up oxygen cylinder, specifically for when load shedding occurs, and the concentrator unit is robbed of power. These cylinders cost upwards of R1,000 to buy and at least R450 to refill, depending on the tank’s capacity.
While many patients have relied on these back-up cylinders during critical load shedding periods in the past, the demand for oxygen – and, in particular, the cylinders – has skyrocketed amid the Covid-19 pandemic. These cylinders are now extremely hard to come by and medical-grade oxygen refills have been diverted to hospitals.
“We’re inundated with people phoning us and asking for oxygen tanks and doctors are telling patients who leave hospital to get a cylinder,” explains Forbes. “Now, this doesn’t work during Covid. A cylinder only has approximately seven hours of oxygen in it and then it needs to be refilled. At the moment you can’t even get them filled up.”
The inadequacy of portable machines and the unavailability of cylinders leaves out-patients in a serious predicament when it comes to load shedding. Unless an oxygen concentrator is connected to a back-up power source, the patient will be starved of air when load shedding kicks in.
“It is a major concern and a danger… it has happened and will happen again,” says Forbes of patients, without backup power supplies, dying due to unexpected and prolonged power cuts.
A concentrator does not rely on oxygen cylinders but instead draws in surrounding air, compresses and purifies it, and then delivers oxygen-rich air, concentrated at around 93%, to the patient.
To keep the oxygen flowing during a power outage, oxygen concentrators need to be connected to a generator or inverter. These oxygen machines – with mid-level units power rated at 390W and 220V – require a hefty back-up electricity supply.
Suppliers recommend a Pure Sinewave Inverter which feeds smooth power to the oxygen concentrator and limits dangerous fluctuations. The inverter needs to be powered by a battery or series of batteries, depending on the extent of use during load shedding.
Inverter systems used to power oxygen concentrators range upwards of R8,000 and the batteries will need to be replaced over time. The added security, and price of these inverter systems, pushes the cost of entry-level oxygen concentrators to more than R20,000. These inverter systems can be purchased from electrical retail outlets like Ellies and Builders. Makro and Takealot also offer sinewave units, although stock is limited.