As the The coronavirus pandemic is nearing a high point in parts of the United States. Hospitals train medical personnel to operate ventilators, while companies and doctors upgrade devices if the breathing apparatus is empty.
In New York City, Mount Sinai Health System doctors have converted sleep apnea devices to help some COVID-19 patients when ventilators are in short supply.
In Massachusetts, the online education company edX has launched a special class to teach medical professionals who do not specialize in intensive care how to operate ventilators.
In an agreement between Connecticut and California, Xerox Holdings and Vortran Medical Technology plan to manufacture disposable single-use ventilators.
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“At the moment, everything has to be done at warp speed. Hopefully it will help overcome the crisis,” he said Anant Agarwal, founder and managing director of edX and professor of electrical engineering and computer science at the Massachusetts Institute of Technology.
Ventilators and respiratory therapists are in short supply in some hospitals because coronavirus patients are filling newly expanded intensive care units.
Hospitals in several federal states have searched for the machines from federal and state stocks. Some in New York City have announced that they will use a ventilator to help two COVID-19 patients at the same time, which can be risky.
In on-the-job emergency training, hospitals have asked doctors and nurses to help monitor ventilators, although they have not been deeply trained in respiratory therapy.
These steps come as the coronavirus crisis approaches a turning point. The number of confirmed COVID-19 cases in the U.S. rose to approximately 400,000 on Wednesday morning, with nearly 13,000 people killed on Wednesday morning Johns Hopkins University data.
In New York City, the home epicenter of the crisis, the 4,009 coronavirus deaths and thousands of hospitalizations have strained healthcare systems to the point of failure.
Andrew Cuomo, governor of New York, said Tuesday that hospitalizations, intensive care admissions, and patient intubations for ventilators have decreased nationwide. However, he announced 731 new deaths, the largest one-day toll on COVID-19 in the state. That is, it is too early to explain that the worst is over.
“We have to keep going,” said Cuomo, referring to the closing of all but essential businesses and the social detachment he had ordered by the end of April. “Let’s not be complacent.”
How does a ventilator work? This course teaches the basics in 2-5 hours
Wilcox, an emergency doctor at Massachusetts General Hospital and an associate professor at Harvard Medical School, explained the basics of how a ventilator worksin a free online course on the edX platform. The educational company was co-founded in 2011 by Harvard University and the Massachusetts Institute of Technology.
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The course is aimed at physicians with little or no background in intensive care and the treatment of seriously ill patients with ventilators. The course can be completed in two to five hours, said Agarwal.
“The purpose is not to make someone a full-fledged respiratory therapist or emergency doctor,” said Wilcox. “It gives them a foundation for how a ventilator works and the vocabulary that helps them work better with their hospital colleagues.”
Monday afternoon, hours after the class’s debut, more than 3,000 participants attended the course and exchanged comments and questions in an online forum, Agarwal said.
“We can offer the course as long as it is needed,” he said.
Mount Sinai in New York City retrofits sleep apnea units to treat coronavirus patients
Given the possibility of ventilators going out, doctors and health experts from the Mount Sinai healthcare system in New York City developed a way to retrofit more than 1,000 respiratory devices donated by Tesla and a second benefactor.
The units, closely related to CPAP units used to treat sleep apnea, are commonly referred to as two-level devices because they offer a form of assisted breathing with alternating high and low pressure Dr. David Rapoport, director of the sleep medicine research program on Mount Sinai.
So far, the team has retrofitted around 30 devices by optimizing the electronics and replacing the mask with a connection for a breathing tube. The team added a monitor that hospital workers can use to check the system and an alarm to alert them of problems.
According to Rapoport, the MacGyvered devices are designed for COVID-19 patients who are not doing badly. This means that ventilators are fully released for the most critical cases.
“It is really a tape and press wire surgery that has been made as safe as possible,” Rapoport said, explaining that it could be used if the Mount Sinai hospitals were “down to our last ventilators.”
This time had not come until Tuesday. But the medical team is ready after testing the retrofitted units on two patients with good results on Monday, Rapoport said.
Teams at Northwell Health, New York’s largest healthcare provider, and Berkeley, California, developed similar workarounds.
The teams share their designs online so that other hospitals can use them as coronavirus cases across the country and the facilities are low on ventilators. The retrofitted units could also prove useful in Africa, India and other parts of the world where ventilators are in short supply, Rapoport said.
“There was exceptional openness and communication in the scientific community,” he said. “Everyone shares.”
Xerox, Vortan’s partner, produces disposable single-use ventilators
Xerox, known for its office copiers, is working with Vortran to develop a device for the current pandemic and future disasters.
In one The Xerox collaboration announced on Monday plans to manufacture disposable single-use ventilators developed by Vortran as backup ventilators for disease outbreaks, mass accident events, and other disasters. The units cost around $ 120 each, far less than the price of over $ 10,000 for an ICU ventilator, if available.
“It is a much simpler and cheaper device,” said Vortran co-founder and CEO Dr. Gordon Wong in an email. The devices ensure a constant air flow and can be used with a compressor.
Each unit is designed to be used once for an early stage patient with respiratory problems. A COVID-19 patient could be assisted on the device for up to 30 days, Wong said.
The machines have been used in the United States and around the world. The companies plan to produce 40,000 machines in April and increase to 150,000 to 200,000 a month by June.
“We want to make sure that doctors, nurses and paramedics have the front-line resources they need to help the increasing number of patients with COVID-19,” said John Visentin, Xerox vice president and CEO, in one Company declaration.