Hawaii’s hospitals could run out of oxygen supply as the influx of COVID-19 patients strains available resources, according to the Healthcare Association of Hawaii, a trade group for the state’s hospitals.

“Because of the significant increase in the number of COVID patients in our hospitals over the past month, oxygen consumption has increased to the point where demand could exceed the supply,” the association said in a press release.

HAH says that the current daily consumption statewide for medical grade oxygen has increased approximately 250% since the beginning of August.

Oxygen is used to assist patients with conditions such as emphysema and lung cancer, as well as COVID-19. The majority of patients hospitalized with COVID-19 are given high-flow oxygen, while patients in intensive care units are generally on high-flow oxygen or a ventilator.

The state has two liquid oxygen plants, Airgas and Matheson Tri-Gas, both of which are operating at full capacity and have switched to producing medical gas only, according to HAH.

Liquid oxygen can be shipped in from the mainland in ISO tanks, but HAH says that these tanks are in short supply due to the pandemic and increased need for oxygen.

The Federal Emergency Management Agency, Assistant Secretary for Preparedness and Response, the Department of Defense, Hawaii Emergency Management Agency, the Hawaii Department of Health, the Healthcare Association of Hawaii and the liquid gas suppliers have been meeting to discuss the situation and discuss possible options, including oxygen conservation measures.