Hospitals across the country are doing everything they can to acquire ventilators as they prepare for the onslaught of intensive-care admissions due to the coronavirus. Hospital administrators, manufacturers, and lawmakers are sprinting to find a solution before hospitals are overwhelmed.
“We’re working with health-care providers around America,” said Vice-President Mike Pence at a press conference on Thursday. “We’ve literally identified tens of thousands of ventilators.”
The White House has not provided detailed information about Pence’s numbers — at the same press conference, President Trump said the federal government was not a “shipping clerk” and the onus was on governors to acquire medical equipment — but even tens of thousands of ventilators may not be enough. To fill the gap, hospitals are tapping distributors, searching warehouses, and repurposing animal ventilators (which are designed for human use) to increase capacity. But like the shortage of N95 masks that is endangering health-care workers, the need for ventilators is global. The health-care system in Italy is inundated with ICU patients, and at least one Italian doctor has taken to GoFundMe to buy ventilators, which can cost as much as $50,000. (He’s raised nearly $1 million so far.) Global demand has made finding the machines almost impossible, no matter how much someone is willing to pay.
Manufacturers in the United States have committed to boosting their production. Ventec Life Systems, a respiratory-device company based in Seattle, has said it would increase its output from 150 ventilators a month to up to 1,000 ventilators a month. Respironics, a medical division of the Dutch company Philips, is hiring workers at its Murrysville, Pennsylvania, factory to increase production, as is GE Healthcare at its factory in Wisconsin.
Earlier this week, British officials sent ventilator blueprints to Rolls-Royce and Jaguar Land Rover. In Italy, Fiat and Ferrari have offered their factories. On Wednesday, Trump economic adviser Larry Kudlow said that General Motors has offered to help. Elon Musk, who has downplayed the threat of the coronavirus, has said Tesla could be of service, an offer that New York City’s mayor, Bill de Blasio (who downplayed the threat in his own signature way by visiting the Park Slope YMCA), was eager to accept. Even if car manufacturers marshaled their resources and focused on ventilators, it’s unclear if they’d be able to make a difference.
“It’s ridiculous,” said Robert Chatburn, an associate professor of medicine at Case Western Reserve University who has authored a number of books on respiratory care and mechanical ventilation. “It’s laudable that car manufacturers would want to help. But there’s only a handful of people in the world who know how to design a ventilator, much less manufacture one safely at scale.” Even if carmakers could magically figure out a way to churn out ventilators, Chatburn said the bigger issue would be training people to use the machines.
That hasn’t stopped designers and engineers determined to create a bare-bones alternative to the state-of-the art ICU ventilator. On Friday, U.K. officials said that engineering companies had created an emergency-ventilator prototype designed to treat coronavirus patients. But even if the design receives approval next week, mass production is still weeks away. In Canada, the Montreal General Hospital Foundation and McGill University’s health-care center is offering $200,000 for a team to design a simple, cheap ventilator. Rushing a new design through may be risky, said Gail Baura, director of engineering science at Loyola University in Chicago. “Medical devices, when they’re not designed properly, kill the people they’re supposed to be saving,” said Baura. “If you cobble something together, are you going to meet the safety standards?”
Using a newly designed, cheap ventilator would require a cost-benefit analysis. “The modern ICU ventilator is in its sixth-generation for the last 40 or 50 years. It’s a marvel of technology. It’s as much an art as it is a science to build one of these things,” said Chatburn. “You’re not going to find a quick and dirty design to replace a modern ventilator. At best, you’ll get something that is easily and quickly manufactured that is just better than manual ventilation.”
A “just better than manual” ventilator may have to be good enough: According to 2015 New York State guidelines on ventilators, in the event of a severe pandemic, New York could need as many as 18,619 ventilators during its peak — 15,783 short of the number the state currently has on hand.