The largest domestic hospital suppliers on the market can meet many times the current demand for medical gas required for oxygen therapy and ventilation of Covid patients, despite the fact that with the surge in the epidemic, both Messer and Linde have seen a significant 30-50 percent increase in demand from institutions in the last week or two alone, and the situation is expected to be getting worse.
Since nearly all Hungarian hospitals have to receive coronavirus patients who need oxygen therapy or ventilation, a lot more medical oxygen is being used than ever before.
Zsolt Bohner, Managing Director of Messer Hungarogáz Kft told növekedés.hu that by the end of October demand for liquid oxygen had increased by an average of 50 percent compared to normal conditions.
Since the beginning of November demand has already doubled; while since last week demand for bottled oxygen has also increased exponentially, to about three times the usual amount.
Ákos Hegedüs, CEO of Linde Gáz Magyarország Zrt also reported a similar increase in demand: they currently supply 30-35 percent more liquid and bottled medical oxygen to hospitals than before.
At the same time, both companies are preparing for an even bigger demand for liquid and bottled medical oxygen in hospitals after an exponential rise in the number of Covid-19 infections and with that, the surge in the number of patients in need of hospitalization. F
ortunately, air, which is used for the production of oxygen, is available indefinitely; which does not mean, however, that there are no challenges to overcome in the current situation.
Coronavirus patients who have only minor respiratory problems receive extra oxygen through oxygen masks or nasal cannulae in order to avoid the need for mechanical ventilation. Oxygen is basically and ideally supplied through oxygen outlets next to patients’ beds, where it arrives through pipelines connected to huge containers located outside the hospital buildings, after being transformed from liquid to gas.
There are no publicly available data on how many of the more than 66,000 hospital beds in Hungary have a direct oxygen outlet, but Linde, for example, has been continuously expanding this capacity since this spring.
This year alone, oxygen and compressed air pipelines and oxygen outlets have been installed for more than 2,800 beds in about 30-40 hospitals so far,
(compressed air is needed for older types of ventilators), Ákos Hegedüs noted. Such works are still underway, for example in the hospital in Sopron, Ajka, and St. Margaret's Hospital in Budapest, while a new liquid oxygen container is currently being installed in the Uzsoki Street Hospital.
Although pipeline systems are a more complex and costly solution than transporting bottled oxygen, the latter only appears to be a simpler solution. Hospitals use mainly small, 5 or 10 litre cylinders containing 1-2 m3 of compressed oxygen, which are easy to handle but can only ventilate a patient for up to 1-2 hours, so the cylinders need changing very frequently, Zsolt Bohner explained.
Larger, 40-50 litre cylinders can provide breathing support for much longer, the logistics between the hospital and the bottle filling plant is better, but a major disadvantage is that they are heavy and require special staff to move them within the hospital. According to the managing director of Messer Hungarogáz Kft it would still be important for hospitals to be able to use these large cylinders, without putting this extra burden on healthcare workers, as the transportation of the large cylinders only requires physical strength and no healthcare qualifications. Zsolt Bohner added that if the demand for bottled oxygen continues to grow at the current pace, the full range of cylinder sizes must be put in use, including the larger ones.
Oxygen manufacturers are upgrading their logistics capacities
Both Linde and Messer have been installing larger liquid oxygen containers in many places; they have expanded their production capacity and reinforced their logistics processes. Linde purchased a new liquid oxygen delivery trailer last month so that they could fully satisfy the demand of hospitals.
Ákos Hegedüs also said that in addition, several vehicles were transferred to hospital deliveries, as the cylinders now have to be replaced up to three times a week or even every day.
Also, in order to ensure that there are enough cylinders, the National Institute of Pharmacy and Nutrition allowed the use of industrial cylinders for medical oxygen, of course after proper cleaning.
The two company managers are confident that there is likely to be a sufficient supply in both liquid and bottled medical oxygen. The CEO of Linde Gáz Magyarország Zrt said there was sufficient production capacity for 8-10 times the current demand; and further capacities can be transferred from the industrial production, or medical oxygen could even be imported from abroad. The supply chain can guarantee safe delivery to hospitals.
Linde and Messer
Linde is one of the largest global gas and engineering companies, and its gases are used in many areas, such as life-saving oxygen in hospitals, high-purity, specialty gases in electronics, or hydrogen as a clean fuel. Linde Gáz Magyarország Zrt is one of the most significant manufacturers of industrial, medical and special gases and gas equipment in Hungary, with production capacity and filling plants in Budapest, Répcelak, Miskolc, Kazincbarcika and Dunaújváros. Apart from gas production, Linde is also involved in the construction, operation and maintenance of gas networks. They built the medical gas supply system for the Temporary Epidemic Hospital in Kiskunhalas and at the Hungexpo exhibition centre in Budapest.
Messer Hungarogáz Kft Magyarország supplies nitrogen, carbon dioxide, oxygen, argon, helium, hydrogen and many other gas products to various industrial sectors, healthcare and research and development areas. The company has three air separation plants, five cylinder filling plants, an acetylene plant, a laboratory gas plant and two hydrogen plants in Hungary; and it supplies 140 healthcare facilities with a variety of gases in bottled or liquid form, supplying medical oxygen to 33 percent of the facilities. Its clients include the South Pest Central Hospital, Semmelweis University, and the hospitals in Szekszárd, Győr, Debrecen, Ajka and Szeged.