Not ventilators, lack of oxygen will kill more

As the coronavirus pandemic bears down on vulnerable nations in Africa and South Asia, experts say there are only weeks to help fill chronic shortages of what medics need to help people breathe.

Not ventilators, but oxygen itself.

Medical oxygen is a core component of the life-saving therapies hospitals are giving patients with severe cases of COVID-19, as the world waits for scientists to find vaccines and treatments.

The pandemic has pushed even the most advanced health systems to their limits, with concerns often focused on the supply of mechanical ventilators at the high-tech end of the breathing assistance spectrum.

But experts fear this has distorted the narrative about what constitutes an effective response, giving the wrong blueprint for nations with under-funded health systems.

"The reality is that oxygen is the only therapy that will save lives in Africa and Asia-Pacific now," said Hamish Graham, a consultant paediatrician and research fellow at Melbourne University Hospital and International Centre for Child Health.

"I fear that undue focus on ventilators without fixing oxygen systems will kill."

One report in February on thousands of cases in China's epidemic found that nearly 20 percent of patients with COVID-19 required oxygen. Of those, 14 percent needed some form of oxygen therapy, while five percent required mechanical ventilation.

In severe cases of COVID-19, the virus attacks the patient's lungs in the form of pneumonia, causing inflammation that prevents them from absorbing oxygen. This can cause their blood oxygen levels to fall well below normal, a condition known as hypoxaemia that can deprive critical organs of oxygen and "substantially" increase the risk of death, Graham said.

A 2018 report published by Every Breath Counts, a coalition of UN agencies, businesses, donors and aid agencies, said supplies of oxygen were "severely limited" in countries across South Asia and Sub-Saharan Africa.

"These health systems in Africa and South Asia could not be more exposed to a pandemic like this one because they haven't been investing in respiratory therapy," Leith Greenslade, the lead coordinator for Every Breath Counts, told AFP.

"This is what terrifies me."