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As Coronavirus Spreads Globally, These Researchers Are Designing Ventilators That Cost Less Than $1,000

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In the beginning of April, Dr. C. Nataraj, an engineering professor at Villanova University, gathered a team of 20 faculty and students, as well as experts from Children’s Hospital of Philadelphia and Geisinger Health System. Their goal? To create a low-cost, emergency ventilator. Within three weeks, they made their first prototype of the NovaVent, a machine that automatically compresses an airbag (called an Ambu bag) and links to a ventilator circuit that includes a component for intubation. Nataraj and his team are partnering with the Pennsylvania Department of Community and Economic Development to get the ventilator manufactured by local idle businesses for a price under $1,000. 

“A lot of medical devices are out of reach for most of the world,” says Nataraj about the importance of low-cost ventilators, “and I think a lot of people like us need to step up and do something about it.” 

Nataraj, 60, and his colleagues are among several teams across the country at universities such as Georgia Tech, UC Davis and the University of Minnesota that are scrambling to design low-cost ventilators for the coronavirus pandemic. These machines include renovated ventilators from the 1950s, self-pumping bag masks and a device that can supply air to two patients at once. While some of these devices will stay in the U.S., many are designed to be easily manufactured overseas in countries that may need them more. 

The ventilators designed by these groups aren’t likely to be available in time to help American hospitals battling the first wave of COVID-19 patients, because they need to find ready and willing manufacturing partners. But this equipment could be key for assisting in the event of a second wave of the virus in the U.S. or in low-income countries where ventilators are in desperately short supply. “Globally, there’s always a need for [medical] equipment, especially ventilators,” Nataraj says.

Ventilators have been in short supply since the COVID-19 outbreak began. There are currently about 170,000 of them in the U.S., including both traditional hospital ventilators and other machines, like BiPAP sleep apnea machines, that can be used as ventilators in a pinch. That represents five ventilators per 10,000 people in the U.S., versus the 31 machines per 10,000 a Harvard Medical School study predicts could eventually be needed. Over the past month, numerous ventilator manufacturing efforts, most prominently partnerships by automakers Ford and GM, have begun and are expected to produce 100,000 new life-saving machines by July. Many of these new ventilators, though cheaper than traditional hospital ventilators that can cost up to $250,000, will still cost thousands and be out of reach for low-income countries. 

Despite the surge in ventilator production, it turns out that extras may not be needed in America after all. Hospitals haven’t actually run out of ventilators yet, and there is increasing evidence that many COVID-19 patients don’t actually need ventilation. In low-income countries, however, these low-cost ventilators could make a big impact. 

Ventilators are in particularly short supply in Africa. Some countries, like South Africa, do  have a few thousand available. But, according to the New York Times, there are 10 African countries that have no ventilators at all. There are more than 34,600 cases of COVID-19 on the continent out of a population of 1.2 billion. That’s why most of these academic efforts are giving away designs free of charge.

The course of COVID-19 in Africa and South America is several weeks behind Asia, Europe and North America, so groups are hopeful they can have completed designs available in advance says Shannon Yee, a mechanical engineering professor at Georgia Tech. “Our hope is that there is still time to get the [equipment] that they need.” 

Yee’s group, a collaboration between Georgia Tech, Emory University and Cranfield University in the U.K., has created a simple mask ventilator from less than $100 of materials that can supply air externally or internally to two patients at once. Like the Villanova group, their invention consists of a machine that can compress Ambu bags automatically to give oxygen to the patient, instead of relying on healthcare professionals to squeeze the bag continuously by hand. The machine can be powered by a wall outlet or even by a car battery. “A lot of places around the world don't have the stable electricity that we have," he says. The group intends to put all the engineering drawings and step-by-step instructions on how to make the ventilator  online so anyone who wants can download them for free. 

A different approach comes from a West Coast team that includes scientific equipment startup Livermore Instruments, UC Davis and the National Strategic Research Institute. They are developing a 21st century version of the Bird Mark 7, a popular 1950s ventilator. While Bird Mark 7s are still used around the world, “they were not designed for mass production, and they weren’t designed with all the safety features,” says David Fergenson Livermore’s CEO. His group’s MARK-19 ventilator has modern-day safety features, including alarms, safety features to avoid lung damage, fewer parts (to speed production) and a price tag of about $700. 

Despite the speed with which these academic groups are moving, all face similar hurdles bringing their designs to production. Each will need a manufacturing partner that has the ability to make a medical device and can get the design through the regulatory process. A team from the University of Minnesota, which has designed a $1,000 ventilator called the Coventor, has already signed a deal with Boston Scientific to produce an FDA-approved machine. UnitedHealth has pre-ordered 3,000 Coventors, and plans to ship them to areas, locally and globally, most in need. 

Ventilators have become controversial as a treatment for COVID-19 because long-term use can damage patients’ alveoli, tiny air sacs in the lungs, causing their lungs to collapse. Patients who are ventilated are also at higher risk of pneumonia, which can make COVID-19 symptoms worse. Currently, more than 50% of COVID-19 patients put on ventilators die. Sumit Mukherjee, a pulmonologist in Omaha, Nebraska, says doctors are now trying to avoid mechanical ventilation with COVID-19 patients by proning, or laying patients on their stomach to help with breathing. 

However, some of the most critically ill patients are still likely to need ventilators, both in America and overseas, as COVID-19 spreads. Villanova’s Nataraj says that his team is spending more than 100 hours a week working on the NovaVent and has already received interest from groups in South America and India. 

“Our goal has always been to come up with an open source design,” he says. "We ethically thought this was the right thing to do." 

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