Our society and economy is facing huge challenges currently due to the global COVID-19 outbreak. As has tragically happened elsewhere in the world, it is very likely that in the next few weeks and months the Indian hospital systems will become overwhelmed with critical COVID-19 patients. To save precious lives suffering from respiratory challenges due to COVID-19 infection, the Indian hospitals are going to need a huge volume of Mechanical Ventilators in a very short time and at a low cost.
Wherever possible, health care facilities should use conventional/standard full-featured ventilators to treat patients who develop respiratory failure or respiratory insufficiency. However, for the duration of the public health emergency, in order to help foster the wider availability of devices for patients in need of ventilatory support, some leading academic institutions and research establishments globally have conceptualized, designed and proposed a basic feature ventilator.
To understand the positioning of different solutions with respect to the need, shared below are the differences between a full Featured ICU ventilator and basic featured Emergency Ventilators for use in the Covid 19 pandemic:
|Category||Full Featured ICU Ventilators||COVID19 Emergency Ventilators|
|Type||Automated ventilator with physician assist controls||Automated ventilator with physician assist controls|
|Functionality||Includes advanced Operation Modes which are rarely required||Basic Operation Modes which are commonly required|
|Hardware and Software||Includes numerous actuators, sensors and software controls for advanced functionality||Requires few sensors and basic software modules for critical functionality|
|Manufacturing & Component Supply Chains||Large number of components source and manufacture from a predominantly global supply chain||Small number of components that can be predominantly sourced from indigenous suppliers|
|Cost||Rs 4 Lakh to Rs 10 Lakh each||Rs 50 Thousand to Rs 1 Lakh Each|
|Time for Mass manufacturing and delivery||Long||Short / Medium|
*Note: Manual Ventilation of using hand-pressing air bags (commonly called Ambu-bags) is used in some emergency situations, but is not feasible in COVID-19 conditions because continuous ventilation is required for many days for critical patients, and exposes medical support staff to Covid-19
In India and globally, there have been many media articles and videos showing designs of functioning Low-Cost Emergency Ventilators. However, it is to be noted that none of the open source emergency low-cost ventilator designs in India (or abroad) has yet qualified the rigorous medical grade testing required. This peer reviewed research paper titled “A review of open source ventilators for COVID-19 and future pandemics”, released on 30th March 2020, concludes with the following:
“….. The results of this review, however, found that the tested and peer-reviewed ventilator systems lacked complete documentation or had undergone only early and rudimentary testing. There is a large amount of technical future work needed to move open source ventilators up to the level considered adequate for scientific-grade equipment and further work still to reach medical-grade hardware. Future work is needed to achieve the potential of this approach …… “
So, developing a medical grade system is not easy. Such development is less about new idea innovation, but more about rigorous detailed engineering and testing.
A wonderful BBC Future article, “Covid-19: The race to build coronavirus ventilators” highlighting the Covid19 emergency, and the ventilator differences is worth a read!