Recent disruption of medical oxygen during the second wave of coronavirus disease 2019 (COVID-19) has caused nationwide panic. This study attempts to objectively analyze the medical oxygen supply chain in India along the principles of value stream mapping (VSM), identify bottlenecks, and recommend systemic improvements.

Process mapping of the medical oxygen supply chain in India was done. Different licenses and approvals, their conditions, compliances, renewals, among others were factored in. All relevant circulars (Government Notices), official orders, amendments, and gazette notifications pertaining to medical oxygen from April 2020 to April 2021 were studied and corroborated with information from Petroleum and Explosives Safety Organization (PESO) official website.

Steps of medical oxygen supply chain right from oxygen manufacture to filling, storage, and transport up to the end users; have regulatory bottlenecks. Consequently, flow of materials is sluggish and very poor information flow has aggravated the inherent inefficiencies of the system. Government of India has been loosening regulatory norms at every stage to alleviate the crisis.

Regulatory bottlenecks have indirectly fueled the informal sector over the years, which is not under Government’s control with difficulty in controlling black-marketing and hoarding. Technology enabled, data-driven regulatory processes with minimum discretionary human interface can make the system more resilient.

Digital surveillance has shown mixed results as a supplement to traditional surveillance. Google Trends™ (GT) (Google, Mountain View, CA, United States) has been used for digital surveillance of H1N1, Ebola and MERS. We used GT to correlate the information seeking on COVID-19 with number of tests and cases in India.

Data was obtained on daily tests and cases from WHO, ECDC and covid19india.org. We used a comprehensive search strategy to retrieve GT data on COVID-19 related information-seeking behavior in India between January 1 and May 31, 2020 in the form of relative search volume (RSV). We also used time-lag correlation analysis to assess the temporal relationships between RSV and daily new COVID-19 cases and tests.

GT RSV showed high time-lag correlation with both daily reported tests and cases for the terms “COVID 19,” “COVID,” “social distancing,” “soap,” and “lockdown” at the national level. In 5 high-burden states, high correlation was observed for these 5 terms along with “Corona.” Peaks in RSV, both at the national level and in high-burden states corresponded with media coverage or government declarations on the ongoing pandemic.

The correlation observed between GT data and COVID-19 tests/cases in India may be either due to media-coverage-induced curiosity, or health-seeking curiosity.

This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask.

This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute’s register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets.

A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer “cup-shaped N95 mask with respirator”. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each.

It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.