Global new crown pneumonia critical illness urgently needs multinational enterprises to increase production and shift production
On March 26, in Beijing Yi'an Medical System Co., Ltd.'s warehouse on the ground floor of Yanjiao, Hebei, dozens of ventilators that had been "fully armed" were waiting to be transported. They were about to be sent abroad to participate in the new crown The "fight" of pneumonia.
Ventilator is an important medical device for the treatment of severe patients with new coronary pneumonia. With the development of overseas epidemics, the demand for ventilators has risen sharply, and overseas orders received by Chinese enterprises far exceed daily production capacity. To this end, regulatory authorities, enterprises and suppliers at home and abroad have worked together to “speed up” the domestic anti-epidemic front line as soon as possible.
How a ventilator saves lives
The ventilator is a device that can replace, control or change a person's normal physiological breathing, increase lung ventilation, improve breathing function, and save heart reserve capacity. Generally can be divided into non-invasive and invasive two categories. General patients can use a non-invasive ventilator connected to the nose and mouth through a mask. If the therapeutic effect is still not achieved, an invasive ventilator needs to be used, which is inserted into the patient's airway through the mouth or nasal cavity with a tracheal tube, or intubated through a tracheotomy to achieve the treatment effect.
Wang Yihui, Department of Equipment, Southwest Hospital, Third Military Medical University, introduced that the working principle of the ventilator comes from the pressure difference of the gas. When humans use the lungs to inhale, the respiratory muscles contract, the thoracic volume increases, and the alveoli expand to form negative pressure, which sucks air from the outside. During exhalation, the respiratory muscles relax, and the alveoli contract due to elastic contraction, increasing the pressure in the lungs and exhaling air. The ventilator uses a mechanical method to achieve this pressure difference, thereby achieving a forced artificial breathing process.
As we all know, humans supply oxygen to the whole body and various organs through breathing, discharge carbon dioxide, carry out oxidative metabolism of cells, and maintain the normal operation of the human body. Normally, healthy people can meet the needs of oxidative metabolism of organs and tissues by spontaneous breathing. If the respiratory system fails, measures need to be taken to open the airway, increase ventilation, and improve ventilation.
"The ventilator can realize the artificial replacement of the autonomous ventilation function. It is widely used in respiratory failure, respiratory support treatment and emergency resuscitation. It is an important medical device that saves and prolongs the life of patients." The reporter said.
Relevant research from the Institute of Medical Information of the Chinese Academy of Medical Sciences and the Peking Union Medical College has shown that respiratory support is one of the key means to save the lives of emergency and critically ill patients. Therefore, the ventilator, as a medical instrument that assists, supports or even replaces the human respiratory function, is very important in the clinical frontline work such as first aid, postoperative recovery, and intensive care.
In this new coronary pneumonia epidemic, "Severely ill patients usually have symptoms of respiratory failure. Respiratory failure will be deprived of oxygen, which will cause the failure of multiple organs, and people will soon fail. By using the non-invasive and invasive ventilator from the outside world, Assisted breathing to ensure the supply of oxygen to the brain and organs. After passing through the respiratory failure barrier, the follow-up treatment can be observed. The ventilator is life-saving. "Zhao Weiguo said. Ma Xin, deputy dean of Huashan Hospital affiliated to Fudan University, said that the lungs of patients with new coronary pneumonia will be significantly damaged. At this time, the significance of ventilator and artificial lung is very important. "With the support of a ventilator, the patient's lungs can have a very good recovery, which is of great significance to rescue critically ill patients and reduce mortality."
The "New Coronavirus Pneumonia Diagnosis and Treatment Plan (Trial Version 7)" issued by the National Health and Health Commission mentioned that, for severe and critical cases, non-invasive or invasive mechanical ventilation is used to provide respiratory support to patients, which is an important diagnosis and treatment method. one.
Global Ventilator Supply Shortage
With the increasingly severe domestic epidemic situation in the United States, the shortage of medical equipment such as ventilators has become increasingly prominent. According to US media reports, the US federal government previously negotiated with General Motors on the production of tens of thousands of ventilators, but the negotiations broke down due to contract price issues.
On March 27, US President Trump for the first time used the powers granted by the Defense Production Law to sign a memorandum asking automakers such as GM and Ford to produce ventilators as soon as possible in response to the new crown pneumonia epidemic. The Defense Production Law passed by the United States in the 1950s stipulates that the President has the right to require private companies to produce defense-related products in an emergency and to control the distribution of these products.
On the same day, Trump issued a statement saying that due to time constraints, the federal government has abandoned related negotiations with GM and blamed GM for wasting time. He also disclosed that GM had promised to provide 40,000 respirators soon, but now says it will only provide 6,000 later in April.
After Trump announced the use of the powers conferred on him by the Defense Production Act, General Motors responded that it worked with suppliers around the clock to meet demand. Ford said the company is moving as quickly as possible and has formed a joint team with General Medical Group to find solutions to accelerate ventilator production.
On March 24, local time, Governor Cuomo of the State of New York in the United States stated at the outbreak briefing that there was a serious shortage of medical supplies such as local ventilators. In the face of nearly 26,000 patients, the federal government sent only 400 ventilators, compared with about 30,000. In an interview with US media, Como said: "Companies must be ordered to produce ventilators as quickly as possible. People will die if there is no ventilator after two weeks, which will be a tragedy for the country."
An internal European Union document shows that the supply of personal protective equipment and other medical equipment, especially ventilators, is still worrying throughout Europe. Traditional supply chains can only meet about 10% of demand. At the same time, according to foreign media news, Tesla and SpaceX CEO Elon Musk, who had previously stated that they would reopen the plant as soon as possible to produce ventilator equipment, purchased 1,225 ventilators from China for pressure. Emergency use at California hospital.
Such effective and important medical supplies are severely in short supply worldwide. The reasons for this, Zhao Weiguo said, "Because there are too many critical patients. Taking a general hospital as an example, suppose that the intensive care unit in the hospital has 20 beds, and usually needs to go There may be only a dozen people on the ventilator. In addition, the price of the ventilator is high, there are hundreds of thousands of yuan, hundreds of thousands of yuan, daily do not need and there are not too many reserves. This new crown pneumonia epidemic, the number of severe patients in the short term, The demand for ventilator is great. On the other hand, there are certain thresholds for the manufacture of ventilator, factors such as parts, technology, labor and so on. It is not easy to increase production in a short period of time, and production is limited. "
Countries actively protect the safety of the ventilator industry chain
In response to the shortage of global ventilator supplies, China has actively ensured the safety and stability of the ventilator industry chain and supply chain on the basis of its own epidemic prevention work. It has exerted sufficient power to ensure production and supported countries in need to fight the epidemic situation.
In February this year, the Ministry of Industry and Information Technology, on the basis of promoting the supply of medical supplies such as masks and protective clothing, focused on organizing the production and supply of medical equipment and therapeutic drugs such as ventilators, ECG monitors, etc., which are urgently needed for medical treatment, and fully protected the ventilator, Manufacturers of equipment such as monitors resumed production. The local industry and information departments have also actively promoted the resumption of production and resumption of production of upstream supporting suppliers of the ventilator, coordinating the resumption of production and normal supply of nearly 50 supporting enterprises.
China's ventilator parts and components can be supplied independently, but key components such as turbines and sensors still rely heavily on imports. After the outbreak of overseas epidemics, logistics and supply chains were greatly affected. Relevant departments gave their full support and introduced a series of measures to fully protect the production and export of enterprises. In order to solve the problem of "stuck neck" of key parts and components, the Beijing Municipal Bureau of Economy and Information Technology instructed relevant production enterprises to find localized alternative manufacturers. Beijing Customs helps enterprises achieve green customs clearance of key parts and components and accelerates the import and preparation of core components.
It is reported that from March 19th, the Beijing Drug Administration will reduce the time for issuing export sales certificates for medical equipment products to be exported by Beijing manufacturing enterprises from 7th to 1st. Prove that it can handle domestic export customs clearance and registration in the importing country, and press the "accelerator" for domestic medical equipment products to reach the front line of overseas epidemic prevention as soon as possible.
After the outbreak of the new crown pneumonia outbreak, Beijing Aerospace Changfeng Co., Ltd. has produced hundreds of ventilators, and there are still thousands of production orders in the pipeline. "Now the entire company is working overtime to produce ventilators, doing their best to ensure supply." Su Zihua, president of Changfeng Changfeng, a doctor of medical physics and bioengineering, said: "Compared with the 2003 SARS epidemic, the biggest difference this time is Non-invasive ventilator is widely used. The main model used in this epidemic is nasal high-flow ventilator. This model can prevent the alveoli from collapsing during the breathing process, keep the airway open, and increase the blood oxygen concentration of the patient. , Reduce the concentration of carbon dioxide in blood oxygen, to achieve a therapeutic effect. "
Jiangsu Yuyue Medical Equipment Co., Ltd. also produces more horsepower. In the company's production base in Danyang City, Jiangsu Province, the production equipment runs 24 hours, and the employees of the anti-epidemic product production workshop are working three shifts to ensure production. Affected by the epidemic situation, recent orders for anti-epidemic products such as ventilators abroad have increased, and Yuyue Medical's non-invasive ventilator collection orders have been arranged to the end of April. Chen Jian, the secretary of the board of directors of the company, introduced that after the previous domestic production campaign to fight the epidemic, there are no many obstacles in the cooperative production of Yuyue Medical and the industrial chain.
At present, China has cumulatively produced and delivered nearly a thousand ventilators in the international market, and several thousand ventilators are urgently scheduled to produce. By March 17, 50 ventilators had been chartered to Italy. On March 24, the first batch of 145 ventilators of Beijing Yi'an Medical System Co., Ltd. departed for Serbia. On March 25, the Spanish foreign bank urgently purchased 2,000 non-invasive ventilators and 400 medical oxygen generators from Yuyue Medical. After that, China will increase its supply of APIs, daily necessities, and anti-epidemic products to the international market.
Many countries around the world have also taken measures to accelerate the pace of ventilator production and research and development. After the UK proposed "fast manufacturing of 30,000 ventilators", many companies and academic institutions in the country responded positively. A consortium of British Ventilator Challenges, consisting of more than a dozen aviation, automotive and medical equipment companies including Airbus and Siemens, has submitted a plan to the government, intending to use the production and design capabilities of the companies in the consortium to achieve breathing Large-scale production increase.
However, for a professional medical device manufacturer, producing a ventilator can take up to 40 days. It may take up to 18 months for a cross-border business from scratch to achieve mass production.
The production cycle of the ventilator itself is relatively long and difficult. Affected by the epidemic, logistics blockage, shortage of key components, and insufficient raw material supporting capacity have also become the reasons why global ventilator output cannot be significantly increased in the short term. (Reporter Jiao Dan)