Robert HARNEIS -TDO- (FRANCE)- There is a desperate world shortage of ventilators to treat patients with coronavirus having breathing difficulties. Italian doctor Daniele Macchini has posted a searing description of the shortage, as patients who needed help breathing could not find an available machine: "Every ventilator becomes like gold," she wrote. Doctors find themselves having to make grim decisions over which patient should be treated with a ventilator and which left to struggle without.

In a worst case scenario, experts believe the United States alone will need 500,000 ventilators operating in hospitals across the country to treat patients with severe cases of the Coronavirus. The best estimates of the total stock of ventilators currently available in the country is approximately 180,000, a staggering 320,000 short of the worst case need.

Some idea of the size of the problem worldwide is that Hamilton Medical, based in Switzerland and one of the leading manufacturers normally only produce 15,000 a year. They have ramped up production by 40% but nowhere near enough to satisfy demand. Each machine takes about 45 minutes to build, Hamilton said. Employees start with the framework, adding components as they walk it down an assembly line about the length of a bowling alley. They see it through to completion, when the ventilator is then tested and then transported to the warehouse for shipment. But even if enough ventilators are on hand as patients begin to arrive in emergency rooms, hospitals will still need to have sufficient staff on hand to operate the machines.

ABC News medical contributor Dr. Mark Abdelmalek said a typical ICU ventilator requires three primary operators: a critical care doctor, respiratory therapist, and a nurse. "ICU patients on breathing machines have to be constantly monitored," Abdelmalek said.

"Nobody in their wildest dreams would have ever thought that we'd need tens of thousands of ventilators," President Donald Trump said at the White House, although certain epidemiologists would dispute that.

The solution to the immediate shortage can only lie in wartime style emergency production and ingenuity. In the United Kingdom, British technology firm Smiths Group said it was making one of its ventilators available for other manufacturers to produce, part of a coordinated attempt to tackle a shortage of life-saving equipment as coronavirus spreads, following an appeal by the Prime Minister.

The group’s Smiths Medical unit is providing intellectual property and advice to other companies to make its PARAPAC Plus lightweight ventilators, and it was ramping up its own production at its site in Luton, just north of London.

Smiths said it was also talking to contract manufacturers to add production capacity in the United States and elsewhere.

“We are doing everything possible to substantially increase production of our ventilators at our Luton site and worldwide,” its chief executive, Andrew Reynolds Smith, said.

Smiths is a member of one of three consortia of companies set up by Britain’s government to speed up production of ventilators. The three teams are led by aerospace engineer Meggitt and carmakers McLaren and Nissan. European plane maker Airbus has offered help with 3D technology and facilities if other companies need it.

Meanwhile in Canada a doctor has converted one ventilator so that it can handle nine patients at once. Dr Alain Gauthier, an anesthetist at the Perth and Smiths Falls District Hospital in Ontario, Canada adapted a ventilator himself. He learned how to do it by watching YouTube videos by two Detroit doctors in 2006. An anesthetist, he has a PhD in respiratory mechanics. 

However to work the adapted ventilator needs patients to be paired who have similar lung size and capacity.

According to the Canadian Press, Dr Gauthier says the idea has been tried once, for victims of the mass shooting in Las Vegas in 2017.

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