Efforts to keep the sickest COVID-19 patients breathing are draining resources across the state and in Tampa Bay — creating competition between hospitals and municipal water systems for crucial supplies of liquid oxygen.
For hospitals, oxygen is easier to store as a liquid in the large volumes they now require for COVID-19 patients. For many municipal water systems, liquid oxygen is a key component in water purification.
Now, water wholesaler Tampa Bay Water is asking that everyone in its three-county service area help conserve water by cutting back on non-essential uses like washing cars, watering lawns and pressure washing.
“At this point, it’s great if everyone in our region can conserve water,” Tampa Bay Water spokesman Brandon Moore said Thursday. “If we can reduce water demands, that means there is less to treat, which saves on treatment supplies including liquid oxygen.”
On Thursday, the utility made a temporary change to the way it treats potable water at its Lithia Hydrogen Sulfide Removal Facility in east Hillsborough County, replacing liquid oxygen with sodium hypochlorite, commonly known as bleach. It’s a common method of water treatment, Moore said, and most customers won’t notice a difference. Some, though, may detect a slight change in odor and taste.
Starting Friday, the city of Tampa’s water treatment system will undergo a similar change, said department Director Chuck Weber. Instead of using bleach as a substitute for liquid oxygen, though, the city will use chlorine as its primary disinfectant. Then, the city will follow its usual method of treating water a second time with chloramine, a mixture of ammonia and chlorine.
“Most importantly, residents should know that their drinking water remains safe,” Weber said. “At this time, the Water Department has sufficient water to meet customer needs and we do not anticipate implementing water restrictions.”
The new process in Tampa is nearly identical to one long in place in St. Petersburg, said that city’s Public Works Administrator Claude Tankersley. Water is aerated, softened, and treated with fluoride. Using liquid oxygen to purify water is a relatively new process never adopted by St. Petersburg — fast and effective but more expensive than using chemicals like bleach and chloramine.
Liquid oxygen is used to create ozone gas, which breaks down the hydrogen sulfide that gives Florida’s untreated water its brown tint and rotten egg-like smell.
Tampa Bay Water supplies water to utilities serving more than 2.5 million people across Hillsborough, Pasco and Pinellas counties, including the cities of New Port Richey, St. Petersburg and Tampa.
The reduction in liquid oxygen wasn’t a choice, but a necessity, water managers say.
Tampa was still waiting Thursday on a much-needed truckload of liquid oxygen that was supposed to arrive Wednesday, Weber said. Tampa Bay Water has also seen disruptions in deliveries, Moore said.
“But we’re not in crisis mode,” Moore said. “A significant benefit to having multiple drinking water sources is the ability to shift sources for any reason. We’ve adjusted the regional blend of water sources to accommodate the change in available deliveries of liquid oxygen.”
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Tampa’s water treatment plant uses a tanker-truck full of liquid oxygen a day, about seven trucks a week, Weber said. In Orlando, the city-owned treatment system typically goes through 10 trucks of liquid oxygen a week. In a statement Friday, Orlando’s utility commission said it hopes to decrease that to five to seven per week as water customers there were urged to cut back on non-essential usage.
At the same time, state Sen. Annette Taddeo, a Miami-Dade Democrat, sent a letter to Gov. DeSantis calling on him to declare a state of emergency. Such an action would involve the federal government in state efforts to conserve liquid oxygen supplies and temporarily suspend statewide restrictions on how many hours truck drivers can be on the road to meet shipping needs.
Rafael Lopez, spokesperson for the AdventHealth West Florida Division and its medical centers, said he hasn’t heard of any liquid oxygen shortages at local hospitals. Health system managers say that’s likely because supplies are being sent where they are most needed.
Tampa area hospitals are keeping a close eye on liquid oxygen supplies as more people become infected by the fast-moving delta variant of the coronavirus. The virus attacks the respiratory system, causing airways and lungs to swell and fill with fluid.
Over the course of the pandemic, medical providers have learned that COVID-19 patients struggling to breathe have a higher rate of survival when placed on “high flow nasal oxygen” instead of mechanical ventilation, senior scientist Eric Toner wrote in a January study for the Johns Hopkins Center for Health Security.
This treatment requires five to ten times more oxygen than used in a mechanical ventilator, Toner said, putting more of a strain on hospitals already flooded with COVID patients. Hospitals can store much more oxygen in its liquid form, the study said. Storage in gas form could cause pipes to freeze over.
In a survey Thursday by the Florida Hospital Association, 68 hospitals statewide reported they have less than a 48-hour supply of oxygen on hand for COVID patients and nearly half of those have less than 36 hours of oxygen left.
The number of patients in state hospitals now exceeds 17,000, the association reported Thursday, about one in four of them in intensive care and most of them unvaccinated. The share of COVID-19 patients on ventilators is 17 percent and growing.
Nearly 30 Florida hospitals reported having less than 12 hours of oxygen in July.
“Right now, we’re focused on how to make sure that does not happen,” said Mary Mayhew, president of the Florida Hospital Association.
Phone calls and emails to both DeSantis’ office and the state’s emergency management team were not immediately returned Thursday.
Also competing for the supply of liquid oxygen in Florida are some cars, as well as rockets launched by SpaceX and others in the commercial space industry.
“We’re actually going to be impacted this year with the lack of liquid oxygen for launch,” SpaceX President Gwynne Shotwell said during a Space Symposium panel on Wednesday. “We certainly are going to make sure hospitals have the liquid oxygen they need.”
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