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James Anderton

Health Care

What the Trump Administration Could Do Now to Remedy the Ventilator Shortage

Could an older, simpler model address the problem?

Published: Wednesday, April 15, 2020 - 11:02

While healthcare professionals globally struggle to contain the Covid-19 pandemic, acute care patients are taxing ICU units worldwide. Critical to the care needed for the most serious cases is breathing support through mechanical ventilators. In Italy, the worst-hit nation in Europe, the lack of ventilators has forced physicians to deny life-saving breathing support to patients who could otherwise survive, in a macabre, battlefield-like triage system. Could ventilators be mass produced at lightning speed to prevent this in the United States? Possibly, but to do it will require more than consultation with large manufacturing CEOs like Elon Musk and GM’s Mary Barra.

Here are the key points:

1. The priority should be to maximize the production of current ventilator manufacturers. A  24/7 production schedule should be implemented as soon as possible, and the same for the supply chain that feeds those companies. To keep final assembly lines fed, the military should be used to shuttle components and subassemblies as needed to keep lines running. This should include helicopters and cargo aircraft as needed on a 1A priority involving state and local police and air traffic control. Attempts to add production from automakers and other nonmedical-device manufacturers will interfere with current production and must be avoided.

Restarting production of older, simpler ventilators could speed ramp-up without disturbing existing production.

2. Standard approval processes for component parts and assemblies must be waived. Non-FDA-approved plastics, for example, may have to be substituted for medical-grade materials, and nonmedical injection-molding and extrusion shops would likely be pressed into service. Post-production sterilization will have to take the place of specialty thermoplastics and elastomers, many of which are compounded with antimicrobial additives.

3. Supply chains are global today, and standard inspections and import controls must be waived for critical components. Jet cargo aircraft should be used to get parts into the country, and they should be cleared to fly to the closest airports to the factories and not cross-docked onto other modes of transportation unless absolutely necessary.

Obsolete, but still useful. General Motors took over production of F4F fighter planes from Grumman when that firm switched to the F6F. GM eventually built three times more than Grumman without interrupting Grumman’s assembly lines.

Skilled assembly labor will be necessary to rapidly ramp up production. To achieve this, assemblers from other medical-device manufacturing firms not building ventilators should be assigned to the task, paid by their parent companies and housed in local hotels as needed to staff 24/7 operations. The workers’ parent corporations would then back-bill the Federal Emergency Management Agency (FEMA) for the costs, but use existing accounting and payroll systems.

It’s likely that even this won’t be enough. To really ramp up production, U.S. manufacturers may have to take a page from the past. During WWII, Long Island, New York-based Grumman Aircraft was a primary builder of fighter aircraft for the U.S. Navy. The company’s prewar F4F Wildcat model was obsolete by 1943, and Grumman stopped production to move to higher-performance, more modern aircraft. But the F4F was still useful for many tasks, and production was transferred to General Motors, which built the airplane for the remainder of the war, eventually building three times the number assembled by Grumman. This plan prevented the interruption of Grumman’s lines; used tooling, jigs, and fixtures no longer needed by Grumman as well as an older engine design; and freed up modern engines for the urgently needed, more modern F6F.

The ventilator issue could be addressed in a similar way. President Trump, perhaps through FEMA, could appoint a team of manufacturing engineers from design/build and mass-production houses to study obsolete, simpler, and easier-to-manufacture ventilator designs from existing manufacturers. 3D printing could be used for short-run, fast-turnaround tool and mold operations, while modern laser and blue-and-white light scanning technologies could be added to CAD/CAM systems to reverse-engineer components that don’t have readily available drawings.

The most difficult aspect of producing simplified ventilators may be the electronics. Simple numeric digital displays would be preferred to LCD, software-driven screens. Switches and potentiometers would be simpler to implement than screen-driven menus, and these wouldn’t interrupt the exiting supply chain. This would put some pressure on manufacturers of connectors and wiring harnesses, and would likely result in much hand work on “peg board” jigs, but the auto industry’s tier ones could achieve this. It’s unlikely that robotic automation would be much help in this task; there isn’t time to set up and program the cells. However, volumes in the tens of thousands are still within the capability of manual operations over several weeks.

To make a program like this work, key manufacturing engineering and production personnel must move between supplier facilities in real time. Again, the military can move people quickly, anywhere. With the drastic reduction in leisure travel, housing assembly workers temporarily in hotels during the crisis is relatively simple. President Trump has the power to make this all happen, immediately. This is the “hottest job in the shop,” but days and even hours count now.

First published March 23, 2020, on the ENGINEERING.com blog.


About The Author

James Anderton’s picture

James Anderton

James Anderton is the Director of Content for engineering.com. Anderton was formerly editor of Canadian Metalworking Magazine and has contributed to a wide range of print and on-line publications, including Design Engineering, Canadian Plastics, Service Station and Garage Management, Autovision, and the National Post. He also brings prior industry experience in quality and part design for a Tier One automotive supplier.