Supply shortages of oxygen for hospitals have plagued many countries, but the U.S. has averted the most dire — partly because the industry figured out new ways to share resources and anticipate needs.



Hospitals in Brazil and in Mexico and across much of Africa face shortages of oxygen for COVID-19 patients. Some U.S. hospitals have also run short. Now the industry that supplies medical oxygen is learning how to anticipate and correct those shortfalls. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: A cold snap late last year hit El Paso at the exact wrong time. New COVID-19 patients streamed into hospitals, many needing high flows of oxygen to live. But huge volumes of the gas created problems. It froze the hospital's pipes and vaporizers.

ESTEBAN TREJO: Depending on how cold it can get, they can reduce their efficiency by 70%.

NOGUCHI: That threatened the supply reaching patients. Esteban Trejo is general manager of Syoxsa, an oxygen distributor in El Paso. It wasn't just the gas in short supply, but also things needed to make the gas breathable - tubing, meters and storage cylinders.

TREJO: And things got pretty bad in our area. We saw the demand for the cylinders at least triple.

NOGUCHI: El Paso then also confronted a reality facing other COVID hot spots.

TREJO: Oxygen isn't easy to transport.

NOGUCHI: It must be liquefied and stored at minus-288 degrees Fahrenheit. It's unstable, flammable and requires special trucks to transport. Rich Mansmann is vice president of the Industrial Welding Distributors Cooperative. He says because of its volatility, oxygen is typically produced within about 100 miles of where it's used - near steel factories, for example. Oxygen producers dot the Rust Belt and the East Coast, but few exist out West.

RICH MANSMANN: That's kind of the problem El Paso has, Albuquerque has, even Denver has.

NOGUCHI: And why, for example, oxygen produced in Texas cannot ship to hospitals in Brazil. But unlike toilet paper or medical masks, demand for oxygen doesn't hit everywhere at once. So as hot zones travel from coast to coast, so too do the demands on oxygen. Mansmann says companies sought new ways to coordinate the transfer of oxygen and supplies across longer distances. His trade group started acting as a clearinghouse to exchange resources.

MANSMANN: Who has excess cylinders? Who has excess storage equipment? Who can lend somebody something for a short period of time? And it's everything from the oxygen itself to the storage tanks to even the people to come out and help set up an installation.

NOGUCHI: Companies like Norco, an oxygen producer in Boise. Its president, Elias Margonis, tracks the virus like a weatherman watches hurricanes.

ELIAS MARGONIS: Every day, I start my day to look at where case trends are moving.

NOGUCHI: Data, he says, helps him anticipate what's needed where. One time he had an excess supply of portable oxygen machines.

MARGONIS: We then quickly had the ability to move those into the market that really needed them. And at the end of the day, you know, 50 patients in one market is a significant amount. You know, every life matters.

NOGUCHI: This collaboration doesn't just help with tanks and tubes. When hospitals overflowed, the industry learned to quickly build pop-up hospitals to work around the problem of freezing pipes. Richard Gottwald is the president of the Compressed Gas Association.

RICHARD GOTTWALD: Rather than trying to upgrade those systems in the hospitals, like, let's just build a whole new system, put it in the parking lot so we can begin treating patients.

NOGUCHI: Esteban Trejo, the El Paso oxygen distributor, says such work is unrelenting, but he's inspired by the humanity of his industry colleagues - those who drive all night to truck in oxygen or one-time rivals who ship him their oxygen cylinders.

TREJO: All competitive thoughts go out the window. You're just trying to help.

NOGUCHI: Yuki Noguchi, NPR News.

(SOUNDBITE OF FRAMEWORKS' "SAND AND STONE") Transcript provided by NPR, Copyright NPR.


The audio and online version of this story as originally published characterized oxygen as flammable, which it is not.