Coronavirus attacks the lungs. In some cases, your throat and chest may rattle from the effort just to breathe. It’s fast become common knowledge that ventilators can be a life-saving intervention — and that there simply aren’t enough of the machines to meet the growing number of patients. As a last resort, some hospitals are deploying the experimental technique of hooking two patients up to one unit.
Without support from the government, a community of volunteers is stepping up to address the shortages. Across the globe, volunteer health care experts and engineers are building open-source ventilators so that doctors don’t have to decide who should get them.
As of Friday, more than 250 people around the world have signed up on a Google Sheet to volunteer for an effort to develop one million emergency ventilators. The document is open — anyone can add their name and information to help — and is being used to field experts and organize people into appropriate teams. The team behind the project, the 1 Million Ventilators project, wants to design a device that “will be easy to transport, sanitize, and use in low- and no-power settings” and can scale to cover at least a million minor cases at less than $200 a pop. The device, they note, should require no more than an hour of training to operate.
The 1 Million Ventilators project is just one of many ad hoc community undertakings popping up to address the life-or-death scarcity of these breathing machines. Just One Giant Lab (JOGL), a France-based nonprofit using decentralized open research to “resolve humanity’s most urgent challenges,” is also building out a collective to make open-source ventilators. As the pandemic accelerates and health care workers face ventilator shortages, hundreds of volunteers around the world are signing up to fill in the gaps.
As President Trump continues to minimize the need for additional equipment while hospitals overflow with patients urgently needing access to ventilators, these crowdsourced efforts might serve as one of the few available lifelines.
The volunteers in the 1 Million Ventilators project include a medical device software expert in London, a biologist in Switzerland, a mechanical engineer in Peru, and a supply chain expert in Canada. The project spreadsheet organizes people into working groups based on their skill set. Categories include pulmonary and critical care, 3D printing, biomedical engineering, austere medicine, public health, aerospace engineering, bronchoscopy, immunology, and ventilator training.
One volunteer is Rafi Yusuf, a 32-year-old osteopath based in New York. He worked with Italian doctors at a recent conference and later encountered a Reddit post from a doctor in Italy — where the coronavirus death toll has exceeded China’s— spurring him to think about how the pandemic would hit New York.
“We’re all volunteers giving our expertise and time to a higher purpose.”
Things have gotten dire since then: The death toll from the coronavirus in New York has grown to over 500, with more on the horizon. Yusuf, who works in family medicine, says that he wants to help streamline a system to manage patients in his own practice suspected to have the virus. To help out the 1 Million Ventilators team, he wants to use ICU ventilation texts and manuals to help “develop a crash course so people with very basic understanding and experience can assist in the management of patients who are critically ill or recovering.”
“Ventilators are indeed scarce and so are ICU beds in the hospital,” he adds, “and frequently it’s the things we need the most that we have the least.”
Irene Chen, a 39-year-old mechanical engineer at Lockheed Martin, posted on Facebook that she wanted to work on an at-home mechanical ventilation system prototype because she knew hospitals would soon run out of resources. A friend pointed her to the 1 Million Ventilators project, and now she is designing a fail-safe valve for a ventilator prototype, which she says can help prevent lungs from dangerously overexpanding.
Meanwhile, a JOGL project named Helpful Engineering has gathered more than 3,400 volunteer engineers, scientists, and doctors to help with critical needs arising from the coronavirus pandemic, including producing ventilators. “Important but complex rules usually make these products unavailable,” the project website reads. According to the organization, the collective grew from 10 members to over 100 in three days, after being shared on Reddit, and now they count 11,000 members on Slack. JOGL co-founder Chris Graham says the team is reviewing “dozens of designs” for ventilators but notes that they are still in need of more manufacturers.
These open-source efforts are complicated by the limitations on communication posed by the pandemic. Unfortunately, the need for these collaborative efforts exists at a time when social isolation is vital and often mandated. Volunteers have no choice but to use online conferencing tools. Chen says that her work process primarily involves video chat and Discord. The 1 Million Ventilators project also uses a series of Google Docs that are being live-edited by volunteers, presenting another challenge: vetting information.
Anyone can access and edit the Google Sheet operated by the 1 Million Ventilators project. Neil Thanedar, the founder of medical startup Labdoor and a co-founder of the 1 Million Ventilators project, explained that there’s a leadership team of more than a dozen people who oversee and verify each of the project’s working groups on Discord. The working groups meet two to three times a week, with leadership meetings every day.
“Our community is incredibly collaborative and self-organizes as much as possible,” Thanedar says.
Despite these limitations and the monumental task before them, volunteers are hard at work, driven by a range of motivations. Jamie Schlinkmann, a 49-year-old volunteer with 1 Million Ventilators, who works for an electronic parts supplier in Florida, hopes to contribute his input on designs, offer free prototyping, and quote the production of parts. His motivation for volunteering is not only to “help humanity” but also to help keep the small business he works for afloat. “These are quite uncertain times and a small company like ours, we have learned over the years, is at particular risk,” Schlinkmann says.
Toronto-based Shafiq Qaadri, who volunteers for the 1 Million Ventilators project, characterizes himself as a “big fan of open source.” Since he’s in self-isolation, he has time to volunteer. He is working on 3D designing and testing parts for the ventilators.
“Using the resources at our disposal and crowdsourcing designs from across the world means we can actually affect change at a global scale,” Qaadri says. “Twenty years ago, you would have needed about $100,000 of equipment and a fully salaried team of 20 to get anything done on this scale. We’re all volunteers giving our expertise and time to a higher purpose.”
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