Oxygen Becomes a Scarce Resource in Latin America’s Two Largest Economies

In the case of Mexico, criminal gangs are taking full advantage of the medical oxygen shortage, with deadly consequences.

[Warning to readers: the first two paragraphs of this post include spoilers for one of the greatest movies of all time, The Third Man, the screenplay for which was written by Graham Greene. If you’ve never seen it before, you might want to skip to the third paragraph] 

In Graham Greene’s classic The Third Man the antagonist Harry Lime makes a killing — literally — in post-WW2 Vienna by stealing penicillin from military hospitals, diluting it, and selling it on the black market, resulting in the preventable deaths of countless people. That doesn’t seem to trouble Lime’s conscience. During the famous Ferris Wheel scene Lime (played by Orson Welles) is asked by his friend Holly Martins (played by Joseph Cotton) whether he has ever seen any of his victims, to which Limes responds:

You know, I never feel comfortable on these sort of things. Victims? Don’t be melodramatic. Look down there. Tell me. Would you really feel any pity if one of those dots stopped moving forever? If I offered you twenty thousand pounds for every dot that stopped, would you really, old man, tell me to keep my money, or would you calculate how many dots you could afford to spare? Free of income tax, old man. Free of income tax – the only way you can save money nowadays.

All countries, unfortunately, produce their share of sociopathic opportunists like Harry Lime. Some of the most accomplished end up occupying the C-suites of global corporations and banks, heading up hedge funds or scaling the ranks of political parties. Others make a fortune in the grey or black economy, running arms, selling fentanyl-laced opiates, trafficking children or… stealing oxygen.

From Oil to Avocados, to Oxygen

In Mexico, where the second wave of Covid-19 is proving to be a lot worse than the first,  criminal gangs have taken to stealing tanks of medical oxygen. Given Mexico’s recent history, this is not really surprising. In the last 20 years the narco gangs have diversified so successfully from their original line of business that their reach extends to just about every corner of the national economy. They have taken over the avocado trade in Michoacan, inserted themselves in Quintana Roo’s tourism industry and made billions pilfering oil from the Pemex-owned pipelines that crisscross the country. Now they are hijacking lorry loads of oxygen tanks.

Websites offering to sell the tanks, at hugely marked-up prices, are sprouting up all over the Internet. Sometimes the tanks never arrive. Some are not even suitable for medical use since they contain acetylene, which is used for welding.

One of the main reasons why narco gangs have suddenly developed an interest in medical oxygen is the acute scarcity of the resource due to the pandemic. According to the World Health Organization (WHO), one in five Covid-19 patients ends up requiring oxygen. In severe cases, this rises to three in five. Some hospitals have seen demand for oxygen increase between five and seven times above normal levels. This is putting huge pressure on many countries’ supplies of medical oxygen. 

Some of the less well-funded public hospitals in Mexico, as in most other Latin American economies, do not have the infrastructure to pipe liquid oxygen directly to the patient’s bedside. As a result, they depend on Oxygen cylinders for their supply. The cylinders are more expensive and harder to transport but a lot easier to steal and sell on to people in desperate straits, as El País reports:

“We have already pulled down more than 100 websites for fraudulent pricing and abuse and removed more than 700 (social networking) profiles. There will be another 1,000 by the end of this week,” said [Ricardo] Sheffield, [the director of the government’s consumer protection agency Profeco]. Of those profiles [that are fraudulently selling Oxygen on social networks], around 100 “will face prosecution”… Sheffield acknowledged that oxygen tanks are also being stolen, forcing the National Guard to escort vehicles transporting oxygen tanks.

“For the Love of Life, Return the Tanks”

The resulting shortages risk undermining a vital health program in Mexico’s Valle region. The program aims to relieve the pressure on hospital beds by bringing forward, by two or three days, the medical discharge of patients recovering from covid-19 or other respiratory ailments. But the only way of doing that is to provide those patients with oxygen tanks so they can complete their treatment at home.

With many hospitals already at bursting point, the success of the program is a matter of life or death. But for it to work, the hospitals need sufficient oxygen tanks.

Sheffield and Claudia Sheinbaum, the head of Mexico City’s local government, have repeatedly urged former patients to return any oxygen tanks they no longer need. If patients have bought oxygen tanks with their own money and are covered by medical insurance, the costs will be refunded, they say, adding: “For the love of life, return the tanks”.

Unfortunately, some recovering patients don’t want to part with their tanks, just in case they might need them later on. Others are selling them via social media.

To compound matters, Mexico’s sole producer of medical oxgygen, Grupo Infra, has been accused of exacerbating the shortage by cutting out small-scale vendors and forcing consumers to buy exclusively from its own outlets. The result, predictably, has been higher prices, bigger queues and longer waits. The government has responded by importing additional supplies from the U.S., according to El País, 

A Global Trend 

The oxygen shortage is not limited to Mexico. Global demand for medical oxygen has increased by more than a fifth in the past three months, with many countries experiencing larger rises, says The FT.

“Supplies are super tight everywhere. In Africa, Europe and North America, needs have gone through the roof with this second wave. The issue is not so much the availability of molecules as the people, logistics [and] connecting to hospital networks and facilities,” Jean-Marc de Royere, a senior vice-president at France’s Air Liquide, one of the world’s largest producers, said.

In Peru, some hospitals have been unable to meet the demand. As a result, patients’ relatives have had to track down oxygen on the black market, sometimes without success. In Manaus, Brazil, the Amazon rainforest’s largest city and the epicenter of the Brazilian variant’s outbreak, oxygen supplies have been running low for weeks, with harrowing consequences, reports the BBC:

Before the clinic ran out of oxygen, Maria Auxiliadora da Cruz had been showing encouraging signs of progress against Covid-19. On 14 January, her oxygen levels had been above the normal level of 95% but, within hours of being deprived of that vital resource, her stats plummeted to 35%. 

At this point, patients would normally be given intubation and oxygen by machine. Instead, the 67-year-old retired nurse died. “It was horrible,” her grieving daughter-in-law Thalita Rocha told the BBC. “It was a catastrophe. Many elderly patients began to deteriorate and turn blue.”

In an emotional video that went viral on social media, she described what was happening at Policlínica Redenção in the northern Brazilian city of Manaus. “We’re in a desperate situation. An entire emergency unit has simply run out of oxygen… A lot of people are dying.”

Brazil has the world’s second-highest Covid death toll with more than 221,000 fatalities. In Manaus, the health system has collapsed twice during the pandemic and deaths doubled between December and January.

“The Capital of Covid-19”

So bad is the situation in Manaus that local authorities have even accepted help from neighbouring Venezuela. But it’s not nearly enough. The local healthcare infrastructure is just not up to the challenge, says epidemiologist Jesem Orellano, from the Fiocruz Institute in Manaus. Orellano also laid part of the blame for the latest outbreak on the local population:

“If you go to the poorer neighborhoods of Manaus, people continue to live as if there were no pandemic. They do not respect social distance, disinfect their hands or even wear a mask”.

This is hardly surprising given that Brazil’s proto-fascist President Jair Bolsonaro has consistently played down the risks posed by the pandemic, calling it a “little flu” and minimising the importance of mask-wearing and social distancing. There’s also the fact that poorer communities in Brazil cannot stop their day-to-day activities, even if they wanted to; otherwise people would have nothing with which to feed their families. 

The local governor last week decreed a one-week total lockdown. But with many local people living hand to mouth, they can hardly afford to take a day off, let alone a week.

The same goes for countless towns and cities across Latin America, including Mexico. As I feared at the beginning of this pandemic, locking down entire cities or countries and paying millions of non-essential workers not to work while healthcare workers battle to contain the virus is a luxury only afforded to countries with first-world economies, huge public debt capacities, relatively stable currencies and big central banks. And even in many of those countries the pandemic continues to rage.

Meanwhile, in some of the world’s low- and middle-income economies basic medicines and other resources grow increasingly scarce. That means that business opportunities for the Harry Limes of this world are growing. Just four days ago, a clinic in Ecuador was busted for injecting 70,000 people with fake vaccines. At US$15 a jab and with patients instructed to receive a total of three, it was easy money. Free of income tax, no doubt. Lime himself would have been impressed, until they got caught of course.