Commentary: The great COVID-19 race for protective medical gear and ventilators

ABU DHABI: With more than a million infections and over 65,000 deaths around the globe, doctors and other frontline healthcare responders are facing twin problems and calling for help.

First, the acute shortage of personal protective equipment (PPE) – masks, gowns, gloves and eyewear that protects them from the virus while tending to patients in healthcare facilities.

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Second, the dilemma in overwhelmed countries like the US and Italy, where some doctors say they are forced to make a difficult decision to prioritise patients, given the dire lack of ventilators as the pandemic sees an exponential rise in cases.

SHORTAGES OF PROTECTIVE MEDICAL GEAR AROUND THE WORLD

The World Health Organisation (WHO) sounded the alarm in March when they warned of the coming shortages in protective gear because of high demand, hoarding and misuse.

Highlighting that 89 million medical masks were needed each month alone, the WHO also emphasised production of these needs had to be accelerated by 40 per cent in order to meet growing demand.

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The WHO has shipped over millions of masks, gowns and gloves to mostly developing countries, but such supplies have been rapidly depleted.

Many large countries including the US, UK and India have also acted slowly in responding to the outbreak and now have to grapple with this new dual challenge.

Men wearing face masks stand near roadside food stalls in Wuhan as restrictions imposed over the coronavirus are eased AFP/Hector RETAMAL

THE GRIM SITUATION IN THE US

The US is kicking into high gear to tackle an acute shortage in ventilators, which threaten to deepen the public health crisis facing the country.

US President Donald Trump has invoked the Defense Production Act, a Korean War-era legislation that empowers the US government to ramp up production and distribution of nationally needed supplies, in this case, ventilators, masks and other protective kit items.

Trump also this week further directed the US Health and Human Services secretary to use his authority to help facilitate the supply of ventilator materials for six companies – General Electric, Hill-Rom Holdings, Medtronic, Resmed, Royal Philips and Vyaire Medical, according to a White House memo.

Confusion over whether federal or state authorities have responsibility over the procurement of such equipment in recent weeks have crippled healthcare services and sent prices of ventilators skyrocketing.

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New York, the national and possibly international epicentre of the pandemic, has about 7,000 ventilators, a far way from the 30,000 New York Governor Andrew Cuomo said the city needs, with the state already facing over 138,000 infections and a death toll of more than 5,400.

The situation has been made grim by a lack of protective gear, which has put healthcare workers and their families lives at risk, and imposed a manpower strain on already stretched healthcare facilities.

Doctors have just been advised this week to prepare to work without protective medical gear, according to a New York State Health Department memo.

Worse, many are told they do not need such equipment, contrary to WHO advice, or chided when they raise concerns.

This shortfall in protective gear has an all too human cost.

In Italy and Spain, where dire shortages have seen lower-protective grade masks and gowns used instead, healthcare workers account for 8 per cent and 14 per cent of infections respectively.

A doctor wearing a torn raincoat stands at the major coronavirus disease (COVID-19) treatment facility amid concerns about the spread of the disease in Kolkata, India, March 26, 2020. (Photo: REUTERS/Stringer)

Spanish healthcare workers have shared pictures of colleagues using disposable raincoats, garbage bags, and other improvised materials to protect themselves from the virus.

A BREWING DUAL CRISIS IN INDIA

In Asia, India is facing a similar crisis worsened by a weak healthcare system. The swift 21-day lockdown announced by authorities seems to be working in stemming the spread, but this only delays problems posed by shortages.

“We need more ventilators, exclusive infection zones, PPEs and more nursing staff if the pandemic surges. The government is helping out but it has to be done on a war footing,” Pratap Kumar, a leading surgeon in Delhi, told news outlets.

Meanwhile, some hospitals and doctors across the country, facing shortage in protective gear, are using motorcycle helmets and raincoats, while the Indian government has urged private manufacturers to speed up production.

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Indian medical equipment manufacturers have roped in auto companies such as Maruti, Mahindra and Tata Motors to ramp up the production of ventilators.

They have drawn up plans to deliver a total of 50,000 ventilators by May but this stills fall short of the 110,000 to 220,000 ventilators think tank Brookings Institute has estimated the country needs, when current capacity is low at 25,000.

THE PUSH FOR MORE VENTILATORS

Ventilators are vital lifelines for critically ill COVID-19 patients that keep them breathing and buys them time to fight the infection and recover. Shortages also mean healthcare workers are forced to make big decisions on which lives to save.

An estimated three in 10 of those infected with COVID-19 and are hospitalised need external support for breathing, according to an Imperial College London study, far behind the world's current capacity.

Employees of Metran Co. check the company's ventilators, originally developed for animals but may be used for human coronavirus disease (COVID-19) patients, at their factory in Kawaguchi, north of Tokyo, Japan Apr 2, 2020. (Photo: PREUTERS/Issei Kato)

Despite global car manufacturers like GE, Ford, Volkswagen, Mahindra, Tesla and others coming forward to meet these fresh demands, switching production lines from car assembly to ventilators is a complex task when ventilators have several unique parts and run on advanced software.

To get the production timelines down, Ford CEO James Hackett revealed in a CNN interview that the company was partnering with other automakers and suppliers to manufacture different parts across a supply chain.

More companies, including aerospace firm Virgin Orbit, are also working with hospitals and research institutes to boost production of ventilators. Virgin Orbit, has announced it aims to create a prototype for a so-called "bridge" ventilator — a simple device that the company says can be quickly manufactured on a large scale, suitable for less critically ill patients.

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