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I don't understand why there needs to be a design effort. Other countries simply took existing designs for ventilators and shifted manufacturing capacity e.g.:

I don't understand why there needs to be a design effort. Other countries simply took existing designs for ventilators and shifted manufacturing capacity e.g.: https://www.timesofisrael.com/iai-defense-ministry-inovytec-convert-missile-factory-to-produce-ventilators/ https://www.timesofisrael.com/iai-defense-ministry-inovytec-... So overall I don't see why the "design" was ever the bottleneck.

iancmceachern 7y ago
Background: I design medical devices like this for a living and have for nearly 20 years. I also want to applaud the efforts of everyone working to leverage their professional experience toward helping us all through this. I agree with this comment 100%. What the world needs now is more of the ventilators we already have designed, not new designs. With any new medical device comes a bunch of teething pains, finding and fixing bugs in the hardware and software design, training, testing andd iterative improvement of all these things as new issues are identified. All of this requires significant clinical support and companies that do this stuff typically employ dozens of clinically trained folks to aid in the introduction and development of the clinical aspect of the device. All of this time and effort is just not available now, any and all clinical resources need to be focused on treating patients, not helping engineers find bugs in their systems. I believe this because an alternative exists, we do not need to reinvent the wheel, we just need more of the wheels we've already invented. To be clear, I do however believe there is a lot of value in investing heavily and exploring all potential novel treatments and devices that could help fight this. I just don't see a value add to designing new respirators vs. Just making more of the designs we have now. I could be wrong, there could be significant manufacturing or other clinical advantages which i am not aware of.
- bluGill 7y ago
  We might need new ventilators, but we don't know what the requirements are until then our existing designs are better than anything new : we know they work and can be made. All we need is to scale production and that is much easier. As we learn more we might discover things that make the current ventilators not optimal at which point it is worthwhile to design something new.
  - dogma1138 7y ago
    We know the requirements fairly well, we just need more ventilators not new ones. The ventilators we have aren’t the problem and their cost and design also don’t impact the production capacity that much what impacts it is the fact that most medical manufacturers never had to operate on such scales and those that even come close tend to big the big international players with global manufacturing that is heavily reliant on China. There is a plethora of designs for ventilators of all types from emergency CPAP machines to multi-mode life support for ICU’s. Those designs have already been validated and there is a huge bank of knowledge to support them. All these pump/turbine based respirator not to mention the pneumatic Ambu bag auto-squeezers don’t really bring anything new to the table they just introduce an untested hardware and software. Like seriously half the ventilators that were shown were an ambu bag and actuator and a micro controller attached to some pressure sensor yes it’s a very simple respirator but do we really need 50 university teams coming up with a design variation? And as far as discovering something new the only thing we discovered so far is that people were put on a ventilator and even more so intubation way too early and that has negatively impacted their survival rate which is one of the reasons why the demand for ventilators has dropped.
    - bluGill 7y ago
      None of that contradicted anything I said. Maybe we will learn something tomorrow that means a new ventilator design would work better, but until then like you say, there is no need to design any when the existing designs work.
      - dogma1138 7y ago
        But this is the thing these aren’t new designs. Everyone of these ventilators is basically an existing design just with different off the shelf components. None of these projects created a new design or a new ventilation mode. The vast majority of these are CPAP machines some maybe able to provide APAP in firmware. If you look at the designs they are basically split into two categories the ambu which just basically compress an off the shelf ambu bag with an actuator or pump/turbine based machines that are essentially very similar to those which are given to people suffering form sleep apnea. I don’t think there is even a ventilation mode we haven’t thought of yet even the most advanced ventilator on the market are mechanically very simply machines the cost is usually based on the brand and which modes they support. This isn’t a field in which you can have a major breakthrough and not to dismiss this effort it’s not a field in which a breakthrough is needed. Ventilators are cheap by medical standards even at $20,000 a pop the cost isn’t the issue the issue is that simply we never needed to produce them at such quantities in such a short time frame and for that you don’t need a new design you just need to accept that you aren’t going to reinvent the wheel and just take a proven design and make more of them and sort the licensing after this. The fact that some teams had a working prototype within a day should be a very strong indication that there isn’t much here. Having a turbine and a microcontroller to set the positive pressure on the outlet or having it set up how many times per minute an ambu bag should be compressed and at which rate isn’t a particularly difficult engineering challenge to conquer. This is why there are now 100’s if not 1000’s of virtually identical designs out there from various teams across the world. Yes anyone can build them in their garage and yes if the world have ended it would’ve been better than nothing but we have real options out there that can be just as easily manufactured if we actually had the will.

iancmceachern 7y ago

Background: I design medical devices like this for a living and have for nearly 20 years. I also want to applaud the efforts of everyone working to leverage their professional experience toward helping us all through this. I agree with this comment 100%. What the world needs now is more of the ventilators we already have designed, not new designs. With any new medical device comes a bunch of teething pains, finding and fixing bugs in the hardware and software design, training, testing andd iterative improvement of all these things as new issues are identified. All of this requires significant clinical support and companies that do this stuff typically employ dozens of clinically trained folks to aid in the introduction and development of the clinical aspect of the device. All of this time and effort is just not available now, any and all clinical resources need to be focused on treating patients, not helping engineers find bugs in their systems. I believe this because an alternative exists, we do not need to reinvent the wheel, we just need more of the wheels we've already invented. To be clear, I do however believe there is a lot of value in investing heavily and exploring all potential novel treatments and devices that could help fight this. I just don't see a value add to designing new respirators vs. Just making more of the designs we have now. I could be wrong, there could be significant manufacturing or other clinical advantages which i am not aware of.

bluGill 7y ago
We might need new ventilators, but we don't know what the requirements are until then our existing designs are better than anything new : we know they work and can be made. All we need is to scale production and that is much easier. As we learn more we might discover things that make the current ventilators not optimal at which point it is worthwhile to design something new.
- dogma1138 7y ago
  We know the requirements fairly well, we just need more ventilators not new ones. The ventilators we have aren’t the problem and their cost and design also don’t impact the production capacity that much what impacts it is the fact that most medical manufacturers never had to operate on such scales and those that even come close tend to big the big international players with global manufacturing that is heavily reliant on China. There is a plethora of designs for ventilators of all types from emergency CPAP machines to multi-mode life support for ICU’s. Those designs have already been validated and there is a huge bank of knowledge to support them. All these pump/turbine based respirator not to mention the pneumatic Ambu bag auto-squeezers don’t really bring anything new to the table they just introduce an untested hardware and software. Like seriously half the ventilators that were shown were an ambu bag and actuator and a micro controller attached to some pressure sensor yes it’s a very simple respirator but do we really need 50 university teams coming up with a design variation? And as far as discovering something new the only thing we discovered so far is that people were put on a ventilator and even more so intubation way too early and that has negatively impacted their survival rate which is one of the reasons why the demand for ventilators has dropped.
  - bluGill 7y ago
    None of that contradicted anything I said. Maybe we will learn something tomorrow that means a new ventilator design would work better, but until then like you say, there is no need to design any when the existing designs work.
    - dogma1138 7y ago
      But this is the thing these aren’t new designs. Everyone of these ventilators is basically an existing design just with different off the shelf components. None of these projects created a new design or a new ventilation mode. The vast majority of these are CPAP machines some maybe able to provide APAP in firmware. If you look at the designs they are basically split into two categories the ambu which just basically compress an off the shelf ambu bag with an actuator or pump/turbine based machines that are essentially very similar to those which are given to people suffering form sleep apnea. I don’t think there is even a ventilation mode we haven’t thought of yet even the most advanced ventilator on the market are mechanically very simply machines the cost is usually based on the brand and which modes they support. This isn’t a field in which you can have a major breakthrough and not to dismiss this effort it’s not a field in which a breakthrough is needed. Ventilators are cheap by medical standards even at $20,000 a pop the cost isn’t the issue the issue is that simply we never needed to produce them at such quantities in such a short time frame and for that you don’t need a new design you just need to accept that you aren’t going to reinvent the wheel and just take a proven design and make more of them and sort the licensing after this. The fact that some teams had a working prototype within a day should be a very strong indication that there isn’t much here. Having a turbine and a microcontroller to set the positive pressure on the outlet or having it set up how many times per minute an ambu bag should be compressed and at which rate isn’t a particularly difficult engineering challenge to conquer. This is why there are now 100’s if not 1000’s of virtually identical designs out there from various teams across the world. Yes anyone can build them in their garage and yes if the world have ended it would’ve been better than nothing but we have real options out there that can be just as easily manufactured if we actually had the will.