There’s A Critical Shortage of Ventilators in the COVID-19 Crisis. Here’s How Manufacturing Can Help.

For the unfortunate critical care patients afflicted with the COVID-19 virus, it’s become clear that acute care requires mechanical ventilation to support breathing in the most serious cases. Medical ventilators perform this function in ICUs worldwide, but the Italian experience has shown that in a pandemic, there simply aren’t enough machines to go around.

In a way, this is similar to the situation at the outbreak of World War II, when shortages of weapons and support equipment were addressed by a massive mobilization of industry, which responded by retooling for war production in record time. This required the generation and duplication of millions of drawings, then the creation of dyes, molds, jigs and fixtures, and eventually entire factories which recruited inexperienced labour, often women.

The results were spectacular, with the resulting mass production efficiencies spilling into the postwar era, and creating a new era of prosperity in the West.

On a small scale, we can argue that this is the case today with one critical piece of equipment: medical ventilators. Today, it is far easier to scale up industrial production. Most Western governments have enacted emergency powers that give leaders broad scope to direct commercial activity toward a solution to a pandemic. President Trump could, for example, take measures such as these:

1. Create a special ventilator emergency production team, led by an experienced leader of a mass production enterprise. By training and capability, my recommendation would be Mary Barra at General Motors. It’s important to appoint a leader from a mass production perspective, not a medical device expert, although at least one of these experts should be appointed to the team.
2. Immediately procure a small quantity of each of the commercially available ventilators and deploy a team of production engineers from the automotive and electronics industries to choose which design is the most mass-producible. This may be the simplest machine, or the machine that contains the most domestically-sourced component parts.
3. Using the cloud, distribute tooling, component and assembly drawings plus specifications across the entire industrial supply chain and require all manufacturers large and small to assess their ability to manufacture component parts or assemblies. Sequester existing inventories of stock components and prohibit their use in other applications.
4. Use military airlift to bring tooling and parts to a single assembly operation. Eastern Michigan and one of the automotive plants is a logical choice, since a mechanical engineering-related supply chain is clustered in that area and there is a large, idle workforce skilled in tooling and assembly.
5. Establish a cross training regime immediately in all hospitals to prepare nursing and support staff for the need to monitor and care for large numbers of patients using ventilators. Video and live-streamed Internet would be useful for this training.
6. Facilitate electronic, immediate payment to component suppliers and machine builders, and include a modest royalty payment to the machine’s original copyright and patent holders.

There is plenty of precedent for industry’s rapidly retooling in order to manufacture vast quantities of complex equipment in wartime. GM and Tesla have already volunteered to set up production lines. The selection of a single model of ventilator, combined with CAD, CAM, CNC and robotic production equipment, plus transportation systems that can deliver equipment anywhere in hours, could avoid the horrendous choices being faced by acute care physicians in Italy now. No doctor should ever be forced to choose who lives or who dies because of a shortage of equipment.