The following was written by one of SCALE’s Operating Partners with an extensive background in medical devices.
I’ll preface this with the caveat that I am not a ventilator, respiratory therapy, PPE technology or supply chain expert, however I do have extensive experience in Medical Devices. There are obviously many well-intended efforts to tackle the supply challenges we face of critical testing, PPE and ICU/ventilator equipment. The cause of the issues aren’t as relevant as immediate implementable solutions.
The obvious and most plausible near-term solution is to source, reallocate and repurpose all available resources to our highest areas of need. Federal Government oversight may expedite this, avoid state-to-state bidding wars, and allow the most effective placement of resources to our hotspots. These efforts are underway, albeit with less than optimal Federal coordination.
With regard to manufacturing new equipment, the largest global suppliers of ventilators are all ramping up efforts to increase production. The best examples are Medtronic (Ireland), Draegerwerk (Germany), Getinge (Sweden), Phillips (Netherlands), and Hamilton (Switzerland).
There are several US companies looking in increase ventilator and respiratory imaging, monitoring, therapy equipment, supplies that include: Ventec, PMT Partners, Vyaire, Airon, Becton Dickinson, Bio-med, Bunnell, GE, Hartwell, Hillrom, Oceanic, Resmed, United Hayek.
The idea that other non-medical manufacturers can independently design, develop and manufacture ventilators may not be feasible with timing that will have any impact. The core technology of current ventilators includes sophisticated electronics, pneumatics and software and is not immediately reproducible. The more effective scenario would be partnerships between established medical ventilator companies and highly capable non-medical manufacturers. Notably GE, Tesla, Dyson, Airbus, Ford and Rolls Royce are all said to be attempting to lend assistance. The activation of the War Powers Act (for US companies) could enable and accelerate this, especially if current medical manufacturers can be protected in the long run from unfair competition from any new entrants.
What is worrisome is that all above will soon encounter a shortage of parts and materials. I assume they will all be going to the same short list of parts suppliers–who are already short on staff or material supply. Or, who may be in parts of the world that are hard hit and be unwilling or unable to share outside their region. Again, Federal or International coordination will greatly increase the likelihood of success, insuring that the parts get to the right manufacturers; meaning those that will enable maximal throughput and distribution to the global hotspots. We need to apply the most scrutiny to the supply of the complex, propriety electromechanical items that are not easily produced. This may likely be where the bottleneck and rate-limiting step results. This may very well be the core issue that effects the most lives and has the highest impact. We must ensure we are not trying to “pull every lever” and miss the most critical element in the chain.
With anticipated supply challenges, there may also be an opportunity for large scale additive manufacturing (3D Printing) companies to become parts suppliers for the simpler elements. This would be expedited by manufacturers sharing the design files thereby avoiding and delay for development. They possess significant scale and speed and could be utilized if the effort is coordinated.
For PPE (Gowns, gloves, masks, eyewear), low cost manufacturers of fabrics and plastics should be immediately activated, again with the War Powers Act if necessary. These are not complex devices; therefore, we need to radically ramp up supply with established and potentially new vendors. We should also be considering safe and effective ways to sterilize these items until we have sufficient supply. There are companies that specialize in sterilization and decontamination that could be leveraged here. We just need to ensure the safety of the care providers and patients if we will be experimenting with new options. I think donations from labs and dental offices are certainly well intended, but a really “drop in the bucket” relatively speaking. We need a national coordinated effort here to again make sure we are getting safe items to our priority regions at scale.
There are also multiple national and international efforts and innovation challenges to create new options; faster tests, new vaccines, repurposed current drugs, low-cost ventilators etc. Necessity is the heart in invention, however in our efforts to solve the immediate global crisis, we still need to be careful to insure safety and efficacy as to no create morbid or mortal issues out of haste. Standards are in place and much of what we need already exists (aside from a vaccine). To be clear, for the next several months we all share a supply issue and not a new technology hurdle. To that end, the need must focus on the most plausible and scalable options—with an eye on the rate limiting supply items. With national and global coordination, we can, and have, solved supply chain issues—which is at the heart of what we all face until we have a vaccine and/or cure.