The Norman Water Treatment Plant, at 3000 E. Robinson St., uses liquid oxygen in its purification process. During the hospitalization surge, the city government asked residents to be mindful of their water use to shore up oxygen for hospitals. (Photo by Catherine Sweeney, October 2021.)

Oklahoma’s recent COVID-19 hospitalization spike created a strain on oxygen — and not just for hospitals

As thousands of Oklahomans battled COVID-19 in ICUs earlier this year, hospitals’ demand for liquid oxygen skyrocketed.

  • Catherine Sweeney

Throughout late August and early September, Oklahoma’s COVID-19 hospitalization figures rivaled those of the post-Christmas surge.  Oklahoma was back to shipping patients out of state because of capacity issues, which ranged from nursing shortages to a simple lack of empty beds. One resulting strain kind of missed the spotlight: oxygen.

Nancy Foster is the vice president for quality and patient safety policy at the American Hospital Association. In her role connecting hospitals with the resources they need to care for COVID-19 patients, she heard about the strain from members across the country.

“We heard from hospitals who saw their oxygen usage skyrocket,” she said. “I mean, I’ve heard reports of anywhere from 200 percent of their normal usage to 800 percent of their normal usage. So eight times what they would normally be using.”

The COVID-19 hospitalization surge obviously meant more patients needing oxygen. But each of those patients needed high levels of it, too. Hospital engineers oversaw the mains as they carried significantly higher loads of oxygen from a central location out through their facilities, to the operating rooms and intensive care units.

“It was really putting stress on the infrastructure of the hospital,” Foster said. “Let’s just use me as an example. There’s the jeans that I wear when I’m happy with the swimsuit I can fit into, and then the jeans I wear when, you know, post-holiday gluttony. And if I try to put myself into the swimsuit-favoring jeans after the holidays? It just doesn’t look too good. And it puts stress on all those seams. Well, the same thing happens to the interior of the hospital — putting stress on all the pipes and the junctures and so forth.”

Outside the hospital, the issue was how to get oxygen at all.

“And in part, that was because there’s a shortage of drivers who have that special hazardous material provision in there in their license that allows them to transport something that’s highly flammable, like oxygen,” she said.

A shortage of specially certified truckers has been a problem nationwide for the past decade, and it’s definitely present in Oklahoma. The Legislature has attempted to tackle testing delays and other roadblocks for years.

So the manufacturers are weathering a worker shortage themselves. They faced tanker shortages. Of course, hospitals across the country were seeing high demand. But hospitals aren’t the manufacturers’ only buyer.

A few weeks into the surge, city governments began asking residents to be mindful and maybe cut back on their water use.
Norman utilities director Chris Mattingly said his facility got a heads-up from their oxygen provider, Airgas, to recommend cutbacks in an effort to conserve oxygen for hospitals.

“Ozone generators use liquid oxygen in the presence of electricity — that generates ozone,” he said. “Ozone can be used as a disinfectant. It also treats for taste and odor, can treat algal toxins in the water. It has a lot of benefits for water treatment.”

Several local governments use similar technology to treat their water. Mattingly says the strain concerns never really came to fruition, especially because Norman already observes the policies Airgas recommended, such as having the city’s residents water their lawns every other day.

Oklahoma Hospital Association President Patti Davis says several members were facing the same skyrocketing oxygen demand, and that it’s likely going to be costly for them.

“It’s just part of the supply chain-increased costs that hospitals are facing,” she said. “And the other side is that, you know, nobody budgeted for the pandemic. Hospitals are going to do what they need to do.”

Oklahoma’s COVID-19 hospitalizations have been falling precipitously. Barring a new variant’s arrival, officials don’t expect another major spike soon. That being said, there are concerns the disease could become endemic — coming back in force every year like the flu. Foster says that means hospitals need to pay attention to the lessons they learn in each surge.