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Ventilator maker: we can ramp up production five-fold
- rectang 7y ago> What’s the U.S. government doing about a potential shortage here? Not much, it seems. > The ventilator industry is getting a burst of desperate orders from China and Italy. Why don't the feds see the urgency here? Is it not predictable that the US will be in the same situation shortly? If the feds won't take action, can state governments work around them and order directly?
- cultus 7y agoThe states have effectively been going it alone this whole time.
- wlesieutre 7y agoI heard through the grapevine that the feds deliberately put the brakes on UPMC working on their own COVID-19 testing. They've been an active hindrance. EDIT: via Pittsburgh Post-Gazette https://www.post-gazette.com/news/health/2020/03/14/covid-19-upmc-testing-coronavirus/stories/202003140044 https://www.post-gazette.com/news/health/2020/03/14/covid-19... At 20 patients a day (aiming for 100 by the end of the week) this isn't an industrial scale testing scheme, but given how slow we've been that's still a significant chunk of testing capacity and it would've been great for Pittsburgh to have access to it sooner.
- fma 7y agoAnd yesterday, Trump reiterated that states will be going alone in the future. He's refusing any responsibility to have a coordinated action plan. “Respirators, ventilators, all of the equipment — try getting it yourselves,” https://www.seattletimes.com/nation-world/nation/try-getting-it-yourselves-trump-tells-governors-seeking-ventilators-in-coronavirus-outbreak/ https://www.seattletimes.com/nation-world/nation/try-getting...
- Super_Jambo 7y agoCan't suspend elections if it's not a real disaster after all .
- dmix 7y agoYes Trump said in one of the press conferences that he gave states permission to bypass the federal gov to buy what they need directly from manufacturers.
- ceejayoz 7y agoThat's a... charitable interpretation. https://www.nytimes.com/2020/03/16/us/politics/trump-coronavirus-respirators.html https://www.nytimes.com/2020/03/16/us/politics/trump-coronav... > “Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.” Distributing these is the sort of thing the federal government can do far more effectively than an "every man for himself" approach.
- JoeAltmaier 7y agoNot sure we can find a citation for that? Govt is notoriously criticized for inefficiency during crisis.
- ceejayoz 7y ago"New York has plenty, Ohio needs a bunch" is precisely the sort of coordination that the Feds are there for.
- JoeAltmaier 7y agoAnd "Ohio Governor calls New York Governor, who dispatches a truck to Ohio" is also coordination. Where each understands local conditions on the ground and can perform the necessary tasks to actually get something done.
- ceejayoz 7y agoThe worse it gets, the less willing states will be to do that. No one wants to be the governor who gave supplies to another state when the next election comes up.
- pdonis 7y agoThe government is not the one who should be seeing the urgency here. Hospitals and other health care facilities should. They are the ones who should be placing orders for ventilators. If the hospitals and other facilities need funding to help with that, that's something governments might be able to help with. But it's still the facilities themselves that should be forecasting an obvious future need and taking steps to meet it.
- wtvanhest 7y agoI think its reasonable to expect the gov to step in here, and order the ventalators or at least enter in to contracts to pay for them if they are not used.
- rectang 7y agoFrom the article: > If there is a risk of a surge in need, and if it takes three months to boost part deliveries, somebody ought to be placing orders right now. But a hospital might well hesitate, given the perhaps equal risk that the extra machines will never be used. Who would eat the cost? That explains why the German order came from the government.
- SketchySeaBeast 7y agoNo, the government should be doing this. God willing, not every hospital will need every ventilator at once, but at some point they may, and that's why it needs to be a shared, transferable resource. They are going to need a way to deploy a hundred ventilators to a stadium or conference center, and that just makes sense to come from a government, instead of scrounging from various hospitals.
- wtvanhest 7y agoYeah, I really don't understand it. We knew there was a serious problem by mid-jan. The federal gov could have known by early Jan by sending someone to Wuhan. We are almost 90 days from then. I assumed (incorrectly) that we would have already ramped mask/glove/sanitizer/ventilator production and would just now be getting the supply. I'm kind of in shock at how exposed we all are.
- tathougies 7y ago> Why don't the feds see the urgency here? Because the United States is a collection of fifty sovereign states, not a centralized government. Why is the EU not taking EU-wide action here, and leaving responses up to constituent governments?
- scott_s 7y agoThis is demonstrably not true. The constitution clearly states that federal law is supreme in the US. That means the states are not sovereign.
- sojournerc 7y ago>The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. That's the 10th amendment. Pretty sure it says the exact opposite of what you just stated.
- scott_s 7y agoIt agrees with what I said. Calling states sovereign means they answer to no higher authority. The constitution clearly states that the federal government is a higher authority than state governments. The 10th amendment basically means that powers the federal government has not claimed belong to the states - but federal law is still supreme, and the federal government can always claim more powers through amendments.
- sojournerc 7y agoHow are those amendments passed? By state representatives and senators. The _only_ powers the Federal Gov. has are those granted by the constitution. They cannot go claiming powers not specified therein. That is in direct contradiction with this statement: > powers the federal government has not claimed belong to the states The Fed Gov. can't just claim supreme power. That's exactly what the 10th amendment is intended to address.
- obilgic 7y ago"... in 90 to 120 days"
- makomk 7y ago"in a 90 to 120 day period", and "Ventec is a fairly small player". A five-fold increase in production of a company that's not making many ventilators to start with, in 3-4 months, isn't going to do a whole lot even before you get into the problem of finding the staff to actually run the things correctly and not kill the patients.
- woofie11 7y agoIt will solve one part of the equation. We can figure out the other parts in the 90-120 timeframe.
- ben_w 7y agoI think the point is you don’t have 90-120 days, you have 15-30. I mean, don’t get me wrong, everything you can do is going to be another life saved – it’s just that that is because everything we can do is still not going to be enough to save everyone.
- deleted 7y ago[deleted]
- zerkten 7y agoYou are still going to need these in 90-120 days. There is the potential for a horrible situation soon, but that doesn't mean they shouldn't make an effort. I would only argue against, if the effort was somehow detrimental to the next 15-30 days.
- gvjddbnvdrbv 7y agoAll social contact has a cost.
- woofie11 7y agoProjecting out, we'll be overrun in 15-30, but we'll still be overrun in 90-120.
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- beamatronic 7y agoIn the future, I see a robust economy built around communicable disease prevention. This was a wake up call for the world. The free ride is over. But this virus can’t overcome humans making a concerted effort to beat it. Worldwide we see the need for increased sanitization and emergency treatment and having lived though this we will all be properly motivated. There’s a lot of jobs to be created and money to be made in our new health oriented economy.
- concerned_user 7y agoIn my humble opinion wake up calls were in 2003 SARS and 2009 H1N1, but we decided to ignore those, now we get the real thing, that has improved and evolved.
- gnulinux 7y agoMaybe, maybe not. I predict we're not gonna take any lessons from this either; 10 years from now people are gonna write comments like this saying "2020 COVID19 was the wake up call, now we get the real thing, that has improved and evolved".
- Consultant32452 7y agoI think at the very least some regulations/restrictions have been lifted which are never coming back. Examples might include allowing doctors to practice telemedicine accross state borders and allowing local labs to create their own tests without waiting for federal approval.
- concerned_user 7y agoIf the following calamity will not fix USA healthcare I don't know what will.
- beamatronic 7y agoAnytime someone questions a healthcare investment, from now on, it must be met with “this will happen again”.
- acd 7y agoWe are going to need the ventilators by 2020-03-22 - 2020-04-10. We also need to distribute oxygen tanks and regulators in the community.
- beamatronic 7y agoAnd there may be a second bump in the fall. There’s no reason not to build out our healthcare infrastructure.
- swader999 7y agoThis is where emergency government powers to temporarily take over industry and direct production would be appropriate.
- Ericson2314 7y agoYes. They should commandeer production enough to reel in vulnerable supply chains too.
- Ericson2314 7y agoDo build a bunch of these, and do create a nursing nation guard (though not under military control please!) as soon as possible.
- growlist 7y agoI was reading about ventilators the other night. On the principle that surely even a rudimentary ventilator is better than no ventilator, why can't we revert to basic designs? 'Manley Mark II' and 'Bird Universal Medical Respirator' are two that are cited on wikipedia. These were manufactured in the 1950s. I can't see that it's that difficult to spool up a production line for a similar model today.
- ptero 7y ago> surely even a rudimentary ventilator is better than no ventilator This is not a given. Ventilators damage alveoli, which (I am not a doctor, so not 100% sure) I think is not recoverable. Thus increasing air flow with a basic ventilator might do more harm than good, so whether it is worthwhile depends on the patient. That said, building good ventilators should be very easy as well with the modern industrial base.
- wefarrell 7y agoIt's fortunate that this started out in China, where the bulk of manufacturing takes place. Hopefully they've been able to rapidly shift production to meet the upcoming demand for respirators and other products this pandemic will need.
- arbuge 7y ago> The seven-year-old, 135-employee Ventec is a fairly small player in a market dominated by Medtronic (under the Puritan Bennett brand), GE Healthcare and Allied Healthcare in the U.S., and Hamilton Medical, Getinge, Drägerwerk and Philips Healthcare in Europe. Kiple estimates that worldwide production capacity is in the range of 40,000 to 50,000 units a year, but some of this output is of machines not suitable for intensive care units. Forget about start ups and tiny companies now. The government needs to call on the big players here - those mentioned in the quote above look like a good start. Not just for ventilators but for everything else like masks and gowns that will be needed. And field hospitals capable of handling massive numbers of people. Something will need to be done about training and deploying large numbers of medical staff quickly too. In WW2 Roosevelt commandeered the car factories to build planes and tanks. It didn't hurt the car factories as far as I know - the government paid them in full. We sorely need a leader of that caliber at this time with the vision and capacity to make bold moves like that.
- themantra514 7y agoHello! Please take a moment check out opensourceventilator.org and get in touch if you can contribute to this initiative.
- davidw 7y agoWe know how to make ventilators. What we need to do is make them at scale.
- themantra514 7y agoTrue. And finding a way to do that is part of our initiative. If you would like to contribute to it please get in touch :)
- whatshisface 7y ago>The government needs to call on the big players here Call on them to do what, stand behind the President in a press conference and give short speeches? They manufacture ventilators for hospitals, and it's the hospitals who pay for them.
- 2T1Qka0rEiPr 7y agoThis might well be a very naive question, but, provided the peak rate of infection differs between nations, could a part of this be solved by borrowing from abroad?
- eezurr 7y agoMy thoughts on this virus. I am NOT an expert (no where close. But if people respond it will shed some light for everyone): * Since the federal government has be slow to respond, I am beginning to wonder how much of our emergency supply chain is NOT located within the US. In a pandemic situation, every country is going to be looking after their population first. We may have lost the capacity. * The expected death count is 1-2 million. Our country is full of people with preexisting conditions. * Heart Disease: 22,000,000. Death rate due to Coronavirus: 10% * Diabetes: 34,200,200. Death rate due to Coronavirus: 7.3% * Chronic Respiratory Disorder: 16,000,000. Death rate due to Coronavirus: 6.3% * High Blood Pressure: 108,000,000. Death rate due to Coronavirus: 6.0% * Cancer: 1,735,000. Death rate due to Coronavirus: 5.6% Granted, there is a lot of overlap, but even if we just use High Blood Prease, that's 6,000,000 deaths alone (multiplied by expected spread of virus e.g. 70%). This excludes death rates for all healthy people over 60. All sources are from coronavirus related wikipedia articles and .gov sites dedicated to American health statistics.
- brutt 7y agoItalian doctor advice is to skip ventilator and go straight to intubation instead, because intubation is used anyway later.
- snowwrestler 7y agoVentilators are how intubated patients breathe. That's what the tube is hooked up to.
- airbreather 7y agowhat is the ifference between a ventilator and one of the $500 oxygen generators that does 6 litres a minute of 30-40% O2? And I mean in terms of practical outcomes of home use.
- shademaan 7y agoThe bottleneck is a lack of people to actually use ventilators an not just a lack of equipment though
- tcbawo 7y agoSome emerging theories of pathology suggest that lung function can be increased by reinflating collapsed alveoli with constant pressure: https://emcrit.org/pulmcrit/cpap-covid/ https://emcrit.org/pulmcrit/cpap-covid/. This source describes cases where oxygen supplementation could be reduced or eliminated. This development (https://www.isinnova.it/easy-covid19-eng/ https://www.isinnova.it/easy-covid19-eng/) looks very promising for 'sub-intensive' cases -- adapting decathlon masks to provide positive air pressure (to help reinflate lungs) without intubation or leaking contaminated exhaust. I don't know how many of these rapidly improvised ventilators can provide constant pressure, but if the closed mask method could be used successfully to prevent serious cases from progressing to ICU (or more importantly, keep people in their homes a little longer), it could have a huge impact.