Paris          -          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 a further 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.  

“In hospitals in high-income countries, we take oxygen for granted,” he told AFP.

“In low-resource settings, healthcare workers are acutely aware of the challenges as they fight to get oxygen to patients every day.”

                  Many larger hospitals across Sub Saharan Africa and South Asia will have some oxygen cylinders in operating theatres and wards, as well as concentrators -- portable devices that filter and purify the surrounding air.  

                  But surveys throughout Africa and Asia-Pacific have shown that less than half of hospitals have oxygen available on wards at any given time, Graham said, and even fewer have the pulse oximeters that allow medical staff to measure blood oxygen levels and guide dosages.