Covid-19 Weapons of War: Ventilators

In just a few weeks, this life support system has become the most coveted machine in hospitals around the world. This equipment, in particular the heavier resuscitation ventilators, which allow patients to be intubated, fell far short of what was needed to cope with the Covid-19 outbreak. With the exception of Covid, the needs for intubation are not so great. On average, around thirty patients are undergoing intubation in the wards of a provincial University Hospital in France. 

In the United States, Johns Hopkins University said there were 160,000 respirators in 2018, more than half of them non-functional. The H1N1 epidemic in 2009, however, had already shown how essential they are in the event of a health crisis. This was followed by the rapid reappearance of certain strategic stocks stored in military hospitals or national reserves which were quickly mobilized.

An emergency and few resources

Specialists in the sector such as the Chinese company Mindray, the American companies GE Healthcare and Medtronic, the Swedish company Getinge, the German companies Draeger and Löwenstein and the French company Air Liquide were quickly swamped with orders. They did not have the capacity to respond quickly and by January, their stock was depleted by Chinese demand. In March, the European Commission thus put an end to these expectations, stating in a report that only about 10% of this demand could be met by classical supply chains in Europe.

Indeed, the respirators used in hospitals today can cost up to $30,000 each and are complex, innovative machines. They are too much of a challenge for the management of Covid-contaminated patients, who often suffer from the same disorders: pneumonia and acute respiratory distress syndrome (ARDS). Many manufacturers in various sectors, particularly the automotive industry, quickly understood this and saw the possibility of manufacturing simpler machines themselves, at a low cost and in tighter deadlines.

The sacred union of industrialists

Consortia around the world quickly organized themselves to take up the challenge. In Canada, the government signed development partnerships with various companies including modeling specialist CAE (Montreal), engineering firm Starfish Medical (Victoria) and Thornhill Medical to develop and produce 30,000 new machines. In France, Air Liquide led a partnership with the automotive groups PSA, Valéo and Schneider Electric to manufacture 10,000 respirators. Deliveries to hospitals began in mid-April.

Have industrialists abused the advertising effect of these orders? According to a Radio France survey, nearly 8,500 machines ordered from Air Liquide are in fact light weight ventilators, notably used in ambulances and that do not usually belong in emergency services. For its part, the French manufacturer explains that the model has been validated in the United Kingdom for the treatment of Covid patients. Indeed, some of these machines produced by Air Liquide, despite their lower efficiency, have been used in French hospitals at the height of the epidemic to make up for the lack of equipment.

Elsewhere, local initiatives led by engineers have also been able to respond to the emergency as best they can. The Mercedes Formula 1 team, with the help of researchers and doctors, has developed a respiratory assistant to relieve patients.

Emerging need in emerging countries

With the epidemic now on a declining global trajectory, it seems that the battle for respirators has been resolved. At least in the West… None of the emerging countries in South Asia or Africa have fan manufacturers, and their lack of experience in this field hinders any local initiative. This explains their complete dependence on Northern countries, even though the latter are determined to overlook them entirely. This was a huge shock imposed by governments in Europe and especially in the United States, who quickly adopted measures to ban the export of these strategic tools. While multiplying the low blows to get the maximum of supplies, Washington went as far as invoking its Defense Production Act to recover the entire production of American companies abroad.

While emerging economies still have the possibility of using production plans made available by engineers around the world to equip themselves quickly and cheaply, the risk of shortages of medical oxygen (essential for ventilators) limits their use. Covid patients usually stay intubated for several weeks. However, this situation could change in the coming weeks, as demand in Western countries is expected to decrease and manufacturers will finally regain a grip on orders.