This short post is partly speculative (as are a lot of things about the 2021 Everest season). It will raise more questions than it answers, but now is the time to ask.
First off, I have neither a medical nor an engineering background, so I would welcome thoughts from anyone who has.
First, some background. As you will know if you read my previous post, the 2021 Everest season has gone ahead despite the global pandemic. It has coincided with a major second wave of COVID-19 across India and Nepal. Nepal currently has one of the highest infection rates per capita in the world. There has also been an outbreak of COVID-19 at Everest Base Camp, the extent of which is not yet known.
There have been calls for operators to cancel their expeditions and donate their oxygen to hospitals. Despite the developing situation in both base camp and throughout Nepal, operators have decided to continue with their expeditions. To date, only one major operator, Furtenbach Adventures, has cancelled its expedition due to the COVID-19 outbreak.
The issue of oxygen is controversial, as I discovered when I wrote an opinion piece for UKClimbing (while the article covered wider issues, almost all the comments concerned oxygen).
Hospitals in Nepal are experiencing an acute shortage of oxygen, yet mountaineering operators have been busy stocking higher camps on Everest with oxygen cylinders in preparation for their summit pushes. Some operators have even been bragging about it on social media. With some 400 climbers plus Sherpas on Everest this year, it is estimated that 3000 to 4000 oxygen cylinders will be used.
Nepal’s government has requested that operators donate their used oxygen cylinders once their expeditions are over. Some reports have suggested that operators are responding.
But I’ve not yet seen any reports of 2021 Everest operators giving away either full or empty oxygen cylinders. If you have, then please post in the comments.
Operators will be reluctant to give away their oxygen cylinders because they reuse them from year to year. Unused cylinders are kept in storage to be used on subsequent expeditions. Used cylinders are refilled. A typical 4L oxygen cylinder, which can hold up to 960L of compressed oxygen, costs around $500, but much of that cost is the cylinder itself: refilling it is much cheaper.
There are additional complications, and I’ve seen a few posts on social media in the last few days describing these.
Expedition oxygen cylinders are much smaller than oxygen cylinders used in hospitals. They are typically designed to dispense oxygen at 2-4 litres/minute, although some operators are now advertising flow rates of up to 8 litres/minute. These rates are as much a function of the regulator attached to the bottle as the shape of the bottle. With a different regulator attached to the bottle, they can presumably dispense oxygen more quickly, the only limiting factor being the diameter of the opening on the bottle (engineers, please feel free to chip in).
As I understand it, COVID-19 patients need oxygen at much higher flow rates, 10-15 litres/minute. The problem seems to be either that the regulators needed for these flow rates do not fit the typical mountaineering cylinder, or the medical mask used does not fit the regulator. There is also, obviously, an additional logistical problem with getting oxygen cylinders off the mountain and down to hospitals in Kathmandu. These arguments are already being cited by at least one operator as reason enough for not giving their cylinders away.
There are obviously better ways of getting oxygen to hospitals in Kathmandu (and elsewhere) but are these just excuses? In any ordinary medical situation, using oxygen from mountaineering expeditions on Everest would be silly. But we’re not in an ordinary situation; this is a humanitarian crisis and every little helps.
It seems to me — and I’m happy to be told otherwise — that if you get those oxygen bottles to Kathmandu, it must be possible to swap the regulators for those with a larger flow rate and find masks that are suitable for medical use. There must be a way to get at that oxygen. Nepalis are nothing if not resourceful.
And in any case, we are talking about intensive care use in Kathmandu. There are patients who cannot find a hospital bed or who are being treated at home. Some of these may be patients at the medical facilities in Pheriche and Khunde. Surely even these smaller cylinders and slower regulators may benefit them while they wait for a hospital bed?
As for the logistical difficulties in getting the cylinders to Kathmandu: well, some operators this year have been using helicopters to ferry their clients from Camp 2 back down to base camp, and from base camp to the teahouses of Namche Bazaar. So they can’t seriously use logistics as an excuse.
I have been outspoken about Everest 2021. I felt the season was ill-advised from the start. The dangers were obvious: of taking our Kent variant into Asia, and bringing an Indian variant back again. It seems that both these things have come to pass.
I felt even more strongly when the second wave swept across Nepal and all the way to base camp. I could not believe that operators continued with their expeditions. They are now playing Russian Roulette with their clients’ lives and cannot guarantee their safety if anyone catches COVID-19 up the mountain.
Yet these operators still have a chance to redeem themselves. They still carry the means to help the people of Nepal. There is now a flight ban in place until the end of May. They have time on their hands to help find a solution to these problems.
IMO, if they refuse to help with oxygen, that will be their final sin.
