The MacGyvers Taking on the Ventilator Shortage

A crowdsourced effort to make more of the life-saving devices, whether from vacuum-cleaner bags, CPAPs, or snorkelling gear.

By Tyler Foggatt March 27, 2020

We need more ventilators. covid-19 attacks the lungs; ventilators help you breathe when you’re no longer able to do so on your own. There are around a hundred and seventy thousand ventilators in the United States, but, according to worst-case estimates, some nine hundred and sixty thousand people will soon need one. “Ventilators are to this war what missiles were to World War II,” Governor Andrew Cuomo said recently.

man in bed

In this war, the civilians have not been rationing (see: empty toilet-paper aisles; the rush on oat milk; the L.A. Times headline “ ‘We’ve Never Sold Out of Pork Butt Before’ ”). But Rosie the Riveter isn’t gone—she’s just working from home. The other day, Bruce Fenton, of Portsmouth, New Hampshire, posted a call for volunteers on the Web site Medium. He was leading something called the Ventilator Project—a crowdsourced effort to address the shortage. The project’s two goals, Fenton wrote, were to help existing ventilator manufacturers ramp up production, and to design an open-source plan for a cheap and simple emergency ventilator that hospitals can use. As inspiration, he reminded everyone that the Apollo 13 astronauts created a carbon-dioxide scrubber from spare parts.

Fenton is not a doctor; he’s a blockchain activist. But, in 2019, his son had back-to-back brain surgeries, and he recalls the neurosurgeons using a torque wrench to fasten pins into his son’s skull, and several bags of sand to keep his son’s head still on the hospital bed. “These were two major surgeries,” Fenton said. “And they’re talking about how much sand to put in this thing.” The surgeons hadn’t run out of normal materials; for this procedure, those were the normal materials. The takeaway? Doctors are comfortable using weird tools and archaic methods, even outside the context of an emergency.

The Ventilator Project’s three hundred and fifty volunteers do most of their brainstorming on the chat app Slack. A few proposals: repurposing cpap machines (sleep-apnea masks) as ventilators, rigging single ventilators to treat multiple patients, and using grounded airplanes as treatment facilities, in order to take advantage of the overhead oxygen masks. Many participants are medical professionals, such as Stuart Solomon, a Stanford anesthesiologist who is mobilizing equipment that functions similarly to ventilators (like anesthesia machines). Fenton has also recruited lawyers, in the hope that, should a solid design emerge from the project, mass production of these ventilators—and their use in hospitals—won’t be stalled by regulators such as the F.D.A. And he has called on “engineers, builders, and MacGyver types who can build a legit ventilator” out of “Home Depot type parts.”

Most of the volunteers are MacGyver types. Or they’re MacGruber types claiming to be MacGyver types—online, it can be hard to tell the difference. Two weeks ago, a man named Paul Côté, whose specialties include 3-D modelling and computational fluid dynamics, asked, “Could a simple water-electrolysis device work as a makeshift oxygen concentrator?”

“Risk of explosion from hydrogen,” a former tech engineer named Mark Proffitt replied. The next week, Proffitt made another contribution: he posted a YouTube video titled “Ultra-Jank Ventilator,” in which a constantly cursing Canadian man shows off his glorified gravity bong. (“Might be more peaceful to suffocate than have that thing hooked to you,” one person commented.)

How janky is too janky, in an emergency? “Doctors aren’t stupid,” Fenton said. “They’re not going to use some junk ventilator unless they need to. Hopefully it won’t be junk. Maybe it’ll be half as effective as a normal ventilator, but that’s a heck of a lot better than no ventilator.”

One promising idea is to return to the old-school ventilators of the past. Current designs are more sophisticated than necessary for treating the average covid-19 patient, and extremely difficult to produce in, say, a Tesla factory. Dave Empey is a respiratory therapist who has worked with ventilators since the seventies, before battery backups, digital displays, and remote monitoring. He wrote, “In my opinion it’s possible to pare down these design requirements.”

“Anyone have experience with the Harry Diamond Labs ‘emergency army respirator’?” Alex Izvorski, a biomedical engineer, asked, referring to a sixties-era controlled-pressure ventilator. “I’m trying to get one of the engineering prototypes—from a museum, of all places.”

Fenton is sure that the group will be able to build more ventilators, whether of vintage design or fashioned out of vacuum-cleaner bags. (A team in Italy has been successful in hacking snorkelling gear; five hundred patients are now using it to breathe.) But, as is the case with Bitcoin, Fenton anticipates a “last-mile problem.” “Let’s say we build twenty thousand ventilators in a World War II-style effort,” he said. “It could come down to, O.K., who is physically at the hospital to take delivery?” Or, “How does a doctor know that it’s O.K. to use these ventilators? Do you print a piece of paper saying ‘This has emergency F.D.A. approval’ and stamp it on each one?” He went on, “Can a doctor train up on this equipment in an hour?” And what if there are enough ventilators, but not enough doctors to operate them? What will we do then? 

Original article here.