WASHINGTON: Yesterday, Army gave two teams $100,000 each to help them develop emergency ventilators for COVID-19 patients. The service is also investing “up to $1 million” in small businesses trying to ramp up ventilator production. While these low-cost, low-maintenance designs can’t replace more expensive mechanical ventilators for long-term care, they could give overburdened hospital systems a lifesaving stopgap.
AirMid Critical Care Products, Inc. and the multi-company Emergency Ventilator Response Initiative were the first two award recipients in the Army’s COVID-19 Ventilator Challenge, which just started holding online “shark tank” pitch sessions last week. Over 150 designs have been entered, although not all will earn the chance to pitch and the $5,000 award that comes with it.
A spin-off of the service’s annual xTechSearch competition for small-business innovators, the Ventilator Challenge is looking for companies with mature technology that can move quickly to mass production. The Army’s goal is to build “more than 10,000 affordable, low-maintenance ventilators” and get them to hospitals “within six to eight weeks.”
Is that fast enough? There are some signs the pandemic has already peaked, although with a nationwide shortage of test kits, it’s hard to tell. It’s also all too possible for cases to soar again with the return of cold weather or if states prematurely lift restrictions. Even if the US is over the worst within two months – far from a forgone conclusion – many underdeveloped nations would still welcome any kind of ventilator.
“There is likely a wide application for this technology globally,” said Andrew Hunter, a former Pentagon acquisition official now at the thinktank CSIS. “The virus is really just starting to gain momentum in a lot of low-infrastructure parts of the world, like in Africa. [And] most of the health experts I listen to are also talking about the likelihood of successive waves of infection, so any given peak may just be the prelude to the next one.”
“A …cheaply and easily manufactured [ventilator] might be helpful if and when the developing world sees a widespread outbreak or we see a second wave,” agreed acquisition expert Bill Greenwalt. “The other thing to start thinking about is whether these may be the kinds of solutions that are easily deployable….in a scenario where a COVID-19-type virus that is even more lethal has been weaponized on the battlefield of the future.”
How They Work
Neither of these designs is intended to replace the expensive mechanical ventilators in short supply. Instead, they’re meant as improvements on hand-pumped ventilators used for patients in transport or waiting for one of the scarce full-scale ventilators to be available.
The obvious benefit of both these devices is that they free up overworked medical personnel from standing over a single patient, pumping air into them by hand until a full-up mechanical ventilator is available. Less obvious, but equally critical, they provide precisely calibrated airflow – a potential lifesaver because manual pumping is dangerously imprecise.
As AirMid’s website explains, it’s all too easy to give the patient too much air. That overinflates the air sacs (alveoli) in the lungs, tearing delicate tissues and can cause permanent harm or even death – with no way for the person pumping the air to tell until the damage is done. Both the AirMid Convertible Ventilator and the Spiro Wave automatically maintain the correct pressure.
The Spiro Wave, derived from an MIT student project, is the more well-known of the two designs, with FDA approval and a write-up in The New York Times. That Times report says that the New York City government has invested “nearly $10 million” to buy 3,000 units in an urgent effort to shore up the city’s overstressed healthcare system.
That figure dwarfs yesterday’s award of $100,000, but xTechSearch prizes aren’t production contracts. Instead, they combine seed money, mentoring, and networking help to put a company on a fast track for a potential production contract, which would be much larger.
Now, the Spiro Wave isn’t a ventilator itself. Instead, it’s basically a high-tech, carefully calibrated pump. You take a standard hand-pumped ventilator and stick it into the Spiro Wave, whose mechanical arms squeeze it for you, providing the correct air pressure for the patient as long it’s plugged into a power source.
By contrast, the AirMid Convertible Ventilator — invented by a former military medic — is a full-up working ventilator in itself. What’s innovative is that it has two pieces:
- One is a standard manual ventilator, with one crucial improvement: It automatically regulates the airflow so inconsistent hand-pumping doesn’t accidentally hurt the patient’s lungs. AirMid calls this a Volume-Controlled Manual Ventilator (VCMV).
- The other part of the device, the Mechanical Module, is an electrically powered pump you can put the VCMV into. It’s similar to how you can put an off-the-shelf manual ventilator into the Spiro Wave, with two big differences. On the downside, the AirMid mechanical pump doesn’t work with an off-the-shelf hand-pumped ventilator, just with its own VCMV. On the upside, it can operate either off wall current, like the Spiro Wave, or off its own built-in battery.
Both AirMid and the Emergency Ventilator Response Consortium have videos on line showing how their ventilators work. Expect to see more awards from the Army in the weeks to come.
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