9 ms·
Interview with German Ventilator Manufacturer
- adrianN 7y agoIt would be nice if we could at least provide everybody with simple surgical masks. It would surely help flatten the curve a lot if we could make masks in public mandatory. As far as I understand it those are basically just paper and a nose clip. They should be very simple to mass manufacture.
- hef19898 7y agoThe main problem I see regarding masks is, besides price, distribution. Now that Chinese manufacturers are running again, they are producing 24/7. Sure prices are way higher than before. But the masks are there. Problem is, Chinese suppliers sell FOB, meaning export cleared delivered to a (air)port terminal in China. Customers in Germany want to buy DDP (import cleared and delivered a specified location in Germany). There you have a structural problem. One that would be easy to overcome, if it wasn't product liability. The importer of record takes product liability in case the manufacturer is outside the EU. Good luck getting that insured (I tried). Ultimately, it will get sorted out. The easiest way to get supplies going would be if the government did these two things: - grant interest free loans for these products to allow importers to pay suppliers upfront (that's how this business works) for government orders - take the product liability risk for products wutyh the proper (paper) certification That would allow a lot of people to get this stuff. Rigjtt now it is a pain the ass.
- tyingq 7y ago"The main problem I see regarding masks is, besides price, distribution." There's a crap ton of unused aircraft right now. You would just need heads of state to direct the airlines to fulfill that need, simplify clearance, customs, etc. Treat it like wartime.
- netsharc 7y agoKeep reading beyond the 1st sentence, he's describing bureaucracy problems, not transport problems.
- tyingq 7y agoMaybe read the last 2 sentences of my comment.
- hef19898 7y agoBoth are kind of true. The air freight / train / sea freight part would ve easy enough to solve. Getting the masks distributed locally is already a little bit trickier,but I am working on something right now. Basically a regional hub, supplied by air train or sea, and a couple of Kanban loops to local distribution centers (hospitals, practices, whatever). Maybe I can convince someone to give it a try. If not, I'll just go back building my company as planned. Would still suck so, to have look at the mess from the sidelines.
- tyingq 7y agoThat is completely fair. I have little insight into the local issues. The country level issues are fairly easy to bypass with war level rules. From real level experience with Turkey, Germany, Belgium, Denmark, etc.
- raverbashing 7y agoWhat do you mean product liability? Delivery liability or faults? Ideally you would import it from a vetted manufacturer I don't think anything but FOB is common, except in specific cases.
- hef19898 7y agoThe importer is considered to be the manufacturer in case something bad happens, caused by the product. Meaning, worst case,you import a mask. It fails. Patients in the practice you supplied the mask to get infected and some die. Now we are talking tens of millions. I asked the Allianz and Munich Re (the insurers insurer). Both declined to insure that at the moment. Which sucks. Because the gap between FOB and DDP would otherwise just be logistics. Ignoring prices, that is rather easy to solve. I try to get hold of someone at the armed forces department charged with that. Hopefully it leads somewhere. EDIT: Product liability is th problem. Transport insurance is easy to obtain and no problem.
- raverbashing 7y agoYeah speaking of that: https://www.dw.com/en/coronavirus-netherlands-recalls-defective-masks-bought-from-china/a-52949216 https://www.dw.com/en/coronavirus-netherlands-recalls-defect...
- hef19898 7y agoImagine to be a e-commerce launching itself into masks now. Without insurance, proper due Diligence of suppliers and potentially no way to track batch numbers. And then something like that happens. You are in for a lot of pain. Apparently you can get coverage, or rather a waiver, from the government if you are a non-profit. As a side note, the government is now seriously launching itself into procurement. For example German states are starting procurement themselves.
- dillonmckay 7y agoMy concern is the rush to acquire PPE, rules be damned, a decent amount of counterfeit masks will make it into circulation, and will provide a false sense of security.
- adrianN 7y agoWe're not talking about FFP2/3 masks here, but simple masks that mostly prevent droplets produced by the wearer from spreading as far and slightly reduce the probability of inhaling the larger ones other people produce. Basically anything that covers mouth and nose.
- dillonmckay 7y agoWe have totally given up on obtaining N95 grade masks? The masks you are talking about, we already have citizens sewing them in a large-scale volunteer effort.
- adrianN 7y agoN95 masks, as far as I know, are fairly difficult to manufacture, so I think it's unlikely that we can scale up production to hundreds of millions per day. I'd be happy to be proven wrong though :)
- mrfusion 7y agoI bet someone could develop a simple mask test everyone could even do at home. (Let’s present solutions, HN. Don’t just tell people things won’t work.)
- hardlianotion 7y agoI think this is done in Czech Republic at scale.
- riffraff 7y agoThere are plenty of tutorials on how to make something like a surgery mask at home using basic sewing stuff or even oven paper. These help with droplets and with reducing face touching.
- onetimemanytime 7y agoNothing money or waivers cannot solve, as long as masks are being made and China allows export. I doubt Germany, USA, Italy etc care about chartering dozens of planes just for that.
- luckylion 7y agoI'm not so sure. We have an ongoing toilet paper crisis that is in it's third week now and the government is unable or unwilling to do anything about it, despite ensuring everyone that there's plenty of toilet paper somewhere in some storage of some company. If a somewhat trivial problem like coordinating a few trucks is beyond their ability, I have no hope for coordinating planes and import/export. You might say "but that's toilet paper, who cares", but empty shelves in super markets in Germany are a great way to make people remember the past and go into panic mode. What people do right now is buy masks individually from Chinese vendors on Amazon, and they are getting shipped. If you want them quickly, you can pay for airmail. China can deliver, but for some reason, Germany doesn't take them.
- dgellow 7y agoWhere do you have a toilet paper crisis? In north Germany at least shelves are refilled all the time. I’m back from groceries, Edeka, Lidl, and Rewe had all their shelves full.
- luckylion 7y agoFriends from Berlin tell me they still have empty shelves, so do the super markets in (western) Hamburg. They get refilled every few days early in the morning and are empty an hour or two later, only to sit empty for another day or two. It's gotten so bad where I live that Aldi has apparently decided to just give up and use the space for potting soil. The pasta shelves are re-stocked though, as is bread. Berlin isn't quite there yet.
- Zenst 7y agoCause and effect, it will settle down in week or two and those who overstocked won't be buying more and those who are responsible and now short due to the hoarders of panic are slowly getting back to normal. But certainly an insight into the culture and humanity of some people. Alas we have a society that seems to always see good responsible people suffer at the hands of the irresponsible.
- Gravityloss 7y agoYes. Or things like oxygen. There are so much more things than ventilators that are much easier to scale.
- deleted 7y ago[deleted]
- ben_w 7y agoMaking oxygen is easy. I’m sure half the people on this site can fill a soda bottle with pure oxygen using a machine hacked together from just things found in an average kitchen. Industrial scale production, transport, making sure it doesn’t set everything on fire, and supplying a medically appropriate quality without risking hyperoxia? That’s hard.
- Gravityloss 7y agoAt least there is industrial oxygen production that could be repurposed. Also oxygen enrichers could be made and distributed, they could also help some people. I know of a person who made one themselves in a week. Both should be a lot easier than ventilators (which of course also should be pursued). If you read the reports from Italy, they first ran out of ventilators, then CPAP machines and finally even oxygen. But for some reason the talk is very concentrated on ventilators for now. Also other equipment saves lives. Pulse oximeters so those needing help breathing can be identified. Protective equipment. A lot of things that save lives and are a thousand times easier to make than ventilators.
- terenceng2010 7y agoIt can be DIYed. https://diymask.site/ https://diymask.site/ Not perfect but any protection would be good.
- freeflight 7y agoOr you could just use a scarf/cloth mask for nearly the same effect without tapping into actual medical supplies. People who are handy with a sewing machine can even make pretty decent ones themselves [0] [0] https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/ https://smartairfilters.com/en/blog/best-materials-make-diy-...
- hejdirk 7y agoWrong. Surgical masks use exactly the same material as N95 respirators - melt-blown non-woven polypropylene, only much thinner. This material is extremely difficult to produce, which makes it hard to scale on short notice, so its price in China shot up 50 times.
- dominotw 7y agoIf a sick person wears a masks and keeps coughing into it. Does that person go around during the day with a mask filled with phlegm and spit. sounds disgusting and stupid.
- claudeganon 7y agoI love the complete lack of bullshit in this article. Everything I read about this crisis seems to be full of hedging, massaging, unquestioned vagaries and coddling of sources. Here, it just straight to the point with a knowledgeable source.
- rubidium 7y agoAgreed. My favorite quote: “ It shows that common sense is more important than we all thought. This situation is so new and complicated that the problems can only be solved by people who carefully weigh their decisions. Artificial intelligence, which everyone has been talking so much about recently, isn't much help at the moment.” I want to work for this guy!
- pyb 7y ago"I spoke with Daimler over the weekend. They would also like to help. But it’s unfortunately not so simple..." It would be interesting to hear more precisely why. We've heard more than a few well-respected industrialists essentially saying "Scaling up ventilator production ? How hard could it be?" Edit. Of course I am not suggesting that car assembly lines are suitable to build ventilator parts. That's clearly not what Daimler suggested either. The question is 'what are the actual bottlenecks to ventilator production?', and nobody seems to really be willing or able to say.
- eternalban 7y agoPrecisely what I was looking for in the article as well. Outside of logistic planning snafus, parts situation, and post production operator issues, it was silent as to why we can not scale up cranking out these machines.
- deleted 7y ago[deleted]
- justnotworthit 7y agoNext line is "We can’t build cars either." It would be interesting to hear industrialists explain how car assembly lines make them able to produce any particular hi-tech equipment. Or are you saying "why not just equip the buildings next door and quadruple everything"?
- pyb 7y agoThe second option, of course. The industrialists I mention are not just in automotive, but oil and gas, etc
- agumonkey 7y agoSomeone on reddit makes daily summaries for r/france and reports a lot of ~stupid issues blocking help. - health laws forbidding veterinarians to help (animal standard != human standard) - companies not allowed to help because some administrative formality Many systems are not ready to switch gears fast in times of crisis.
- jsilence 7y agoHome made masks are not as good as professional masks, but they have some efficiency (> 70%). https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic https://www.researchgate.net/publication/258525804_Testing_t...
- k__ 7y agoI read somewhere that it could be dangerous to wear one when you're infected, because then the virii have a much bigger chance to be inhaled again and get deeper into the lung. Is this true?
- MrBuddyCasino 7y agoYou should wash them, soap seems to be very effective against Coronavirus.
- freeflight 7y agoThere are studies out there on the use of cloth masks vs medical ones [0]. Tho it should be noted that both, cloth and surgical masks, are mostly worn to protect others from accidental discharge by the wearer. So if you the wearer wants to protect themselves, then a respirator is actually needed. But respirators should be prioritized for at risk-groups who wouldn't survive infection or work with infected people. The non-respirator masks are mostly to reign in the spread by people who could be infected without symptoms yet or as the "we got nothing else" option. [0] https://bmjopen.bmj.com/content/5/4/e006577 https://bmjopen.bmj.com/content/5/4/e006577
- dr_dshiv 7y agoWay better. Two dishtowels equals n95: https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/ https://smartairfilters.com/en/blog/best-materials-make-diy-...
- mkl 7y agoExcept they're very hard to breath through. I also wonder what kind of dish towels, exactly, since I have different towels with very different permeability.
- smoyer 7y ago"Before we invest too much thought into this, we should focus on getting devices that are sitting around in a basement somewhere back into working order." I'm mechanically and electrically handy but don't have a basement full of ventilators. I'm going to send an email to my local hospital ... we'll see how that goes. Anyone have know where else to find ventilators that need to be serviced?
- adrianN 7y agoVets, dental surgeons, people with old CPAP machines.
- stevespang 7y agoCPAP machines don't provide near the pressure needed. The pecking order is CPAP < BiPap < Ventilator. Ventilator is a BiPap on steroids.
- mike_hearn 7y agoIf you're interested in the complexities associated with retrofitting CPAP machines, I've written a couple of articles about it: https://blog.plan99.net/cpap-for-covid-d47886bf978c https://blog.plan99.net/cpap-for-covid-d47886bf978c https://blog.plan99.net/more-cpap-for-covid-b6911f806c89 https://blog.plan99.net/more-cpap-for-covid-b6911f806c89 The primary difficulties are establishing medical consensus on what kind of pressure therapy is best (continuous vs bi-level) because that affects the availability of machines a lot and there's some disagreement. Secondary is how to stop patients on CPAP machines spraying virus into the air through the masks, however, at least one CPAP machine manufacturer thinks that concern is actually overblown and points to a study showing CPAP masks don't aerosolise to the extent current medical consensus seems to think. Something very clear is that doctors are still figuring out treatment for this and there's some disagreement over what the right way to do things is. Disturbingly it may be that current medical consensus makes things worse for COVID-19 patients rather than better i.e. bi-level pressure therapy hurts the lungs in that state rather than helps (perhaps contributing to a high death rate?).
- sabertoothed 7y ago
- cenkozan 7y agoI start to think Corona is not the problem, but the solution.
- lazyjones 7y agoPerhaps intravenous oxygen supply could be a way to treat those who are't getting a ventilator due to shortages? https://www.ncbi.nlm.nih.gov/pubmed/27910706 https://www.ncbi.nlm.nih.gov/pubmed/27910706 https://www.medicalnewstoday.com/articles/247295 https://www.medicalnewstoday.com/articles/247295 Not a physician, but sounds like a more rapidly scalable method - if it works.
- Jabbles 7y ago“This is a short-term oxygen substitute – a way to safely inject oxygen gas to support patients during a critical few minutes,”
- yalogin 7y agoI hear GM and now Daimler are all offering to help. How easy are these to manufacture? Also setting up the manufacturing plant takes time doesn’t it? All these companies make it seem like it’s trivial to create the infrastructure needed to manufacture them in bulk. Or does auto manufacturers somehow have the equipment to do this already? Is that the case?
- tantalor 7y agoFinal assembly or manufacturing components like hoses.
- thu2111 7y agoCars are many orders of magnitude more complex than ventilators so it's not unimaginable. A ventilator is basically a motor/small turbine connected to a few sensors and air filters, all linked together with some fairly sophisticated software. The software can obviously be 'manufactured' at infinite speed. That leaves an assembly of pipes, valves and flow sensors - but only a few. Especially if you customise the machine to only what COVID-19 patients need and don't go general purpose, it can be done.
- sabertoothed 7y agoSome key statements: "Dräger: In Europe, the number of intensive-care beds per capita is very unequally distributed. In Italy, it is three times lower than here. In England, five times lower. The challenge in England will be greater than in Spain. And the situation in the U.S. is very alarming. The reporting system there is also underdeveloped."
- peteretep 7y agoI’ve wondered about this for a little while. Why does Germany have five times as many ICU beds than England? Until now, I’ve never heard a suggestion that England had fewer ICU beds than it needed generally, and assuming England and Germany use beds at the same general capacity, why on earth is Germany running five times more beds that it generally needs? (please don’t answer “for a case like this” unless you have some hard evidence)
- ygra 7y agoAs I understood it, a lot of countries have dismantled part of their hospital and healthcare infrastructure in the past 20 years (mostly to save money). Some countries have gone further than others in that pursuit. In Germany some of those measures have been decided, but not implemented yet.
- ReptileMan 7y agoNot saying a case like this, but don't forget that West and East Germany were supposed by the strategists to be main battlefield in eventual non nuclear WWIII ...
- deleted 7y ago[deleted]
- ramboldio 7y ago"What are the lessons to be learned from this crisis? Dräger: It shows that common sense is more important than we all thought. This situation is so new and complicated that the problems can only be solved by people who carefully weigh their decisions. Artificial intelligence, which everyone has been talking so much about recently, isn't much help at the moment."
- megous 7y agoThere are already several simplified ventilator projects in the works: https://www.corovent.com/ https://www.corovent.com/ https://www.medrxiv.org/content/10.1101/2020.03.24.20042234v1 https://www.medrxiv.org/content/10.1101/2020.03.24.20042234v... ...
- helij 7y agoSo, they have a prototype and are ready to produce 500. Impressive. And it looks like that each and every country is now designing and producing their own ventilator. Also, a lot of them outsourcing the design which is great. In unfortunate events people come together and do great stuff!
- megous 7y agoRight, they are also flying the parts and the people around in small passenger planes to speed up deliveries, and to keep key people from getting infected because of unnecessary travel. It's quite a project.
- 9nGQluzmnq3M 7y agoBit of an aside, but Dräger is a fascinating company. Aside from their core medical devices, serious scuba divers know them for their rebreathers, which collect, scrub and reuse the air you breathe, instead of just venting it out like typical scuba regulators. Rebreathers are notoriously expensive, fiddly and dangerous, because there are all sorts of ways things can go wrong if the gas mix isn't just right, but Dräger's kit is the gold standard. https://en.wikipedia.org/wiki/Rebreather https://en.wikipedia.org/wiki/Rebreather