Artificial respirators, which may cause a minor error in their operation, cross the red line between life and death

At a time when the countries of the world, particularly the United States and Europe, are preparing to reach the critical peak stage for the spread of the "Corona virus", central and field hospitals and medical centers are facing a grim reality, as there are not enough artificial respirators necessary to help the affected sick spirits. Looming near the horizon, a glimmer of hope to resolve this dilemma of deficiency before the deadly virus begins its painful attacks within the next few days.

American hospitals have announced that they are completely unable to find any source to buy artificial respirators, which doctors say are a vital part of helping those infected with the "emerging coronavirus" to keep their lungs in work, which truly form the difference between life and death in advanced disease cases . Manufacturers of respirators justify their inability to meet urgent hospital demands by saying they are unable to accelerate production enough to meet sudden dinosaur demands.

After the acute shortage of artificial respirators became a global crisis, some European governments early on adopted tactics to mobilize their industrial capabilities to allow their factories to produce more artificial respirators, and among these tactics is to ban the export of these factories' products.

By contrast, the US response has been slow, as no special national strategy has been developed to accelerate the production of respirators. This slow reaction is due to the US President Donald Trump and members of his administration reducing the serious threats to the "emerging corona virus" in the beginning of the crisis.

Tsunami requests:
"In fact, there are not enough artificial respirators at all," says Andreas Weland, CEO of Hamilton Medical, one of the world's largest respirator manufacturers.

We see that today in Italy, and we saw it in China, and we see it in France, Spain and other countries. "There is a huge demand for these devices, but I do not know how to meet them."

Hamilton Medical is shipping respirators as quickly as possible to its customers today.

Wieland ordered his company’s managerial staff to go to the factory floor and help the production lines and hire more workers. However, the tsunami could not keep pace with purchase orders. "Italy has requested 4,000 artificial respirators," he says, "but we have been able to secure only about 400."

The "emerging corona" virus intends to attack the lungs of its host, and in some cases it weakens its ability to breathe. So artificial respirators, which work to ensure air reaches the lungs through a tube placed in the trachea, are a critical tool for keeping people living with the virus alive.

These electronic devices, which are placed next to the bed of the person infected with the virus, can cost about $ 50,000. Hospitals in the United States have approximately 160,000 artificial respirators, and another 12,700 other reserves are in the National Strategic Inventory, a warehouse of medical supplies that the federal government has designated to respond to national emergencies.

The worst case scenario:
But these stocks will not be sufficient if the rocket continues to rise in the number of new cases of the "emerging corona" virus. "If we talk about the worst-case scenario, it will be very difficult to secure a sufficient number of respirators," said Thomas Frieden, former director of the Centers for Disease Control and Prevention.

According to estimates by the ECRI, an independent, non-profit group devoted to assessing medical technology assets, more than half of the respirators used in the United States were manufactured by companies from outside the country, including the well-known Drager and Getiting devices. .

There are only about ten US companies that manufacture artificial respirators, including the two giants “General Electric” and “Medtronic,” says Greg Crest, a spokesman for Avamed, the commercial group that represents American medical device manufacturers. These American companies have been working to advance and accelerate the production of these vital devices in a short time.

But the engineering of these machines is very complex. Because it consists of hundreds of small and precise parts and parts produced by companies spread all over the world, and therefore there is no magic way to increase production significantly and quickly.

"Ventilators are subject to global supply chain law, whether we like it or not," says ECRI CEO Markus Chabakir. So everyone who makes ventilators here or elsewhere will look for specific parts, often from the same specialized suppliers. "It's like a domino effect."

For his part, the CEO of Allied Health Care Products, Earl of Revsland, a company that makes small respirators in St. Louis, believes that intensifying device production within a short time is not possible. His company, which makes about 1,000 respirators annually, needs at least eight months to increase its production sharply. "These devices are designed to keep people alive," he said. We don't make bikes here, it just takes a while. ”

High hardware demand:
To make matters worse, the high demand for artificial respirators coincided with the taking of governments around the world to take measures to force their citizens to stay in their homes to slow the spread of the "emerging corona virus", which further complicated the transfer of labor to factories.

To secure the healthy working conditions of its production lines, companies producing artificial respirators are now forced to purchase protective supplies for their workers and allocate budgets that are not small to disinfection and sterilization services.

"Johns Hopkins University Hospital" was able to purchase some new respirators a few weeks ago, after the university's senior management sensed the seriousness of the global outbreak of the "emerging corona" epidemic. But the Baltimore Hospital administration, which has been late in making a similar decision, is struggling to buy more of these devices today.

The Johns Hopkins University Hospital administration is exploring the possibility of manufacturing the hospital's breathing apparatus in cooperation with the university’s engineering department, an option described by Gabi Kylin, director of the Johns Hopkins Office for Critical Events Preparedness, that “goes to great lengths, given that we have not built a machine Such devices are complicated before. ”

A series of meetings are also held with a group of doctors and specialists in medical professional ethics, to learn how to legalize the use of respirators if the number of patients exceeds the design capacity to make these devices.

Without an adequate supply of artificial respirators, physicians may find themselves having to make difficult decisions regarding which people will be given priority use of these respirators.

Export stop:
As the main epicenter of the outbreak of the "Corona virus", China absorbed everything in the bag of the respirator market. When the disease spread in South Korea and Italy, the hospitals of those countries made requests to purchase these devices, followed by other countries, which led to dumping factories in a choppy sea of ​​purchase orders. According to the manufacturers, the United States is standing behind the queue today due to its delayed reaction.

CEO of "Vintek" Chris Cable, a small company that produces artificial respirators near Seattle, says his company recently received a request to export 150 artificial respirators to Japan. Cable explains that his company has scrambled to step up production, hire more workers and increase working hours.

To prevent an outbreak of the "corona virus" emerging among its employees, Vientec conducts mandatory temperature checks for everyone who crosses the gate of its factory, while cleaners strive 24 hours to sterilize surfaces and passages. But even as production increases, Cable explains, we will not be able to meet the growing demand for our products.

And the CEO of "Vintek" confirms that, for several days, he has been receiving urgent phone calls from hospital administrators, state governor offices and other government officials who are searching for any amount of artificial respirators.

He even began to receive inquiries from a number of wealthy people wishing to purchase their personal artificial respirators, in anticipation of the collapse of the American hospital system. "I can confirm that all respirator plants around the world are facing the problem of being unable to meet purchase orders at this time," he added.

The European countries, which are already groaning under the pressure of tens of thousands of patients infected with the "emerging corona virus", responded strongly and quickly to the challenge of the epidemic.

Some European governments have prevented their national medical equipment manufacturers from implementing foreign export contracts. In Germany, where about 25,000 artificial respirators are available all over the country, Berlin has asked Drager to manufacture 10,000 new devices. The company, whose shares rose more than 50 percent last week, said it was in a hurry to meet orders, but was facing restrictions related to safety testing and the availability of components.

Italy, which has a huge stock of confirmed cases of the "corona emerging" virus, is facing a major shortage of respirators. Local media reported that officials in the northeast of the Veneto region, are looking into the possibility of using animal respirators designed for humans.

The Italian government has dispatched some 25 engineers, along with other defense officials, to assist "Siari Engineering," an industrial company near Bologna, in producing respirators.

The company, which has quadrupled production to 150 devices per week, has delayed exports to other countries such as India, to meet domestic demand in Italy. "Our country is in urgent need of our equipment," says Enrico Touzi, in charge of the export department of Cearie Engineering. We are in a state of complete emergency. ”

In Britain, where preliminary estimates indicate that the country is in dire need of far more than the 5,000 artificial respirators owned by its hospitals, its Prime Minister Boris Johnson, who has been infected with the "emerging corona virus", called on automakers and other industrial companies to start immediately contributing to the manufacture of devices Artificial respiration. London said it had received more than 400 calls from companies offering help to manufacture respirators.

On the opposite side of the Atlantic, the US administration has taken extreme measures to solve this dilemma. Yesterday, US President Donald Trump activated the Defense Production Act to force General Motors to produce more artificial respirators.

"Our negotiations with GM over its ability to supply artificial respirators have been fruitful, but our battle against the virus is so urgent that the push-pull process does not allow the contracting process to continue its normal course," said a statement from the White House.

The statement added that "General Motors" was wasting time, but the measures taken "will help ensure the rapid production of artificial respirators that will save the lives of Americans."

A presidential statement later indicated that Trump directed Health and Human Services Secretary Alex Azar to use any powers under the data protection agreement to ask GM to "accept, implement and prioritize federal contracts for respirators."

"They said they would give us 40,000 respirators very quickly," Trump said in a tweet on Twitter. Now they say they will only reach 6,000 in late April, ”describing it as chaotic.

Some US industrialists say they recently discussed the issue of production with members of the Corona virus task force at the White House with officials from the Department of Health and Human Services. However, given the size of the United States, the problem is more complicated than the figures available. For example, unused Detroit respirators cannot relieve pressure from those afflicted by a hospital steeped in Dallas.

"You may have more resources than you need across the country, but you are facing fragmentation in the process of geographical spread of people beyond the local containment capacity," says Dr. Greg Martin, President of the Association for Critical Care Medicine and Professor of Emory at the University of Atlanta.

Another important issue that arises with respect to respirators, experts say, is finding enough people trained to operate these devices.

Martin says that under normal circumstances medical workers receive years of training before they are assigned to operate ventilators, which a slight error might cause, by crossing the red line between life and death.