{"id":9005,"date":"2021-09-05T15:07:00","date_gmt":"2021-09-05T19:07:00","guid":{"rendered":"https:\/\/desis.osu.edu\/seniorthesis\/?p=9005"},"modified":"2021-10-05T15:24:27","modified_gmt":"2021-10-05T19:24:27","slug":"the-united-states-and-other-countries-face-a-critical-shortage-of-the-lifesaving-machines-and-no-easy-way-to-lift-production","status":"publish","type":"post","link":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/2021\/09\/05\/the-united-states-and-other-countries-face-a-critical-shortage-of-the-lifesaving-machines-and-no-easy-way-to-lift-production\/","title":{"rendered":"The United States and other countries face a critical shortage of the lifesaving machines \u2014 and no easy way to lift production."},"content":{"rendered":"\n
\"An
An intensive care bed at University Hospital Dresden in Germany. To the right of the bed is a ventilator and infusion equipment.Credit…Ronald Bonss\/Picture Alliance<\/figcaption><\/figure>\n\n\n\n

By Sarah Kliff<\/a>, Adam Satariano<\/a>, Jessica Silver-Greenberg<\/a> and Nicholas Kulish<\/a>Published March 18, 2020Updated March 26, 2020<\/p>\n\n\n\n

As the United States braces for an onslaught of coronavirus cases<\/a>, hospitals and governments are confronting a grim reality: There are not nearly enough lifesaving ventilator machines to go around, and there is no way to solve the problem before the disease reaches full throttle.UpdateTrump administration pulls back on $1 billion coronavirus ventilators deal.<\/a><\/p>\n\n\n\n

Desperate hospitals say they can\u2019t find anywhere to buy the medical devices, which help patients breathe and can be the difference between life and death for those facing the most dire respiratory effects of the coronavirus.<\/p>\n\n\n\n

American and European manufacturers say they can\u2019t speed up production enough to meet soaring demand, at least not anytime soon.<\/p>\n\n\n\n

ADVERTISEMENTContinue reading the main story<\/a><\/p>\n\n\n\n

And while the acute shortages are global, not just in the United States, some European governments are deploying wartime-mobilization tactics to get factories churning out more ventilators \u2014 and to stop domestic companies from exporting them.<\/p>\n\n\n\n

The United States, by contrast, has been slow to develop a national strategy for accelerating the production of ventilators. That appears to reflect in part the federal government\u2019s sluggish reaction to the coronavirus, with President Trump and others initially playing down<\/a> the threat. This week, Mr. Trump urged governors to find ways to procure new ventilators. \u201cTry getting it yourselves,\u201d he said.<\/p>\n\n\n\n

That will be hard and in some cases impossible.<\/p>\n\n\n\n

\u201cThe reality is there is absolutely not enough,\u201d said Andreas Wieland, the chief executive of Hamilton Medical in Switzerland, one of the world\u2019s largest makers of ventilators. \u201cWe see that in Italy, we saw that in China, we see it in France and other countries. We could sell I don\u2019t know how many.\u201d<\/p>\n\n\n\n

Mr. Wieland\u2019s company is shipping machines as fast it can get them off the assembly line. He has moved office workers to the factory and hired more employees. Even so, he can\u2019t keep up with the crush of orders. \u201cItaly wanted to order 4,000, but there\u2019s not a chance,\u201d he said. \u201cWe sent them something like 400.\u201d<\/p>\n\n\n\n

The coronavirus attacks people\u2019s lungs, in some cases compromising their ability to breathe. Ventilators, which deliver air to the lungs through a tube placed in the windpipe, are a crucial tool to keep these patients alive. The computerized, bedside machines can cost as much as $50,000.<\/p>\n\n\n\n

Editors\u2019 Picks<\/h2>\n\n\n\n

Hospitals in the United States have roughly 160,000 ventilators. There are a further 12,700<\/a> in the National Strategic Stockpile, a cache of medical supplies maintained by the federal government to respond to national emergencies.Daily business updates  <\/strong>The latest coverage of business, markets and the economy, sent by email each weekday. Get it sent to your inbox.<\/p>\n\n\n\n

That probably won\u2019t be enough if the number of serious coronavirus cases keeps climbing.<\/p>\n\n\n\n

\u201cIn a worst-case scenario it would be very difficult to have a sufficient number,\u201d said Thomas R. Frieden, the director of the Centers for Disease Control and Prevention during the Obama administration.<\/p>\n\n\n\n

In the United States, roughly half of the intensive-care ventilators in use were made by foreign companies, including Dr\u00e4ger and Getinge, according to estimates by ECRI, an independent nonprofit group that evaluates medical technology. There are fewer than a dozen American companies \u2014 including giants like General Electric and Medtronic \u2014 that make ventilators, according to Greg Crist, a spokesman for AdvaMed, the trade group that represents American medical device makers. They are scrambling to accelerate production.<\/p>\n\n\n\n

But the machines are complicated, made up of hundreds of smaller parts produced by companies all over the world. There is no simple way to substantially increase the output.<\/p>\n\n\n\n

\u201cWe are in a global supply chain situation, like it or not, so everybody making ventilators here or elsewhere is going to be looking for parts, often coming from the same suppliers,\u201d said Marcus Schabacker, chief executive of ECRI. \u201cThere\u2019s a domino effect coming into play.\u201dMore on the coronavirus epidemic<\/p>\n\n\n\n

Earl Refsland, the chief executive of Allied Healthcare Products, a small ventilator manufacturer in St. Louis, said that ramping up production quickly was not possible. For his company, which makes about 1,000 ventilators a year, it will take at least eight months to sharply increase production.<\/p>\n\n\n\n

\u201cThese are ventilators to keep people alive,\u201d Mr. Refsland said. \u201cWe aren\u2019t making wagon wheels. It takes a while.\u201d<\/p>\n\n\n\n

Business & Economy: Latest Updates<\/a><\/h2>\n\n\n\n

Demand has spiked just as countries are forcing people to stay home to slow the coronavirus\u2019s spread. To bring more workers into factories, companies first need to buy protective gear for staff and spend money on cleaning services.<\/p>\n\n\n\n

Without an adequate supply, doctors may have to make life-or-death decisions about who needs the machines most.<\/p>\n\n\n\n

Johns Hopkins University\u2019s hospital system bought some new ventilators a few weeks ago, when the leadership saw the coronavirus spreading. But the Baltimore hospital network is struggling to find more to buy.<\/p>\n\n\n\n

\u201cWe\u2019re scrounging,\u201d said Gabe Kelen, director of Johns Hopkins\u2019 office of critical event preparedness. \u201cWe\u2019re looking at every possible place we might get one.\u201d<\/p>\n\n\n\n

The hospital system has considered whether it could work with the university\u2019s engineering department to build its own ventilators \u2014 an option that Dr. Kelen described as \u201cextreme,\u201d given that they\u2019ve never built the complex machines before \u2014 and has also convened a group of doctors and ethicists to figure out how to essentially ration the use of ventilators if there are more patients than machines.<\/p>\n\n\n\n

As the initial epicenter of the coronavirus outbreak, China snapped up whatever slack there was in the market for the assisted-breathing machines. When the disease spread to South Korea and Italy, hospitals in those countries put their orders in. Now manufacturers are getting inundated with orders from all over the world.<\/p>\n\n\n\n

ADVERTISEMENTContinue reading the main story<\/a><\/p>\n\n\n\n

The United States is toward the back of the queue, according to manufacturers.<\/p>\n\n\n\n

Ventec, a small ventilator company with headquarters near Seattle, recently filled an order to sell 150 ventilators to Japan, said Chris Kiple, its chief executive.<\/p>\n\n\n\n

Ventec is hustling to accelerate its production, adding employees and increasing their hours, he said. In an attempt to prevent the coronavirus from spreading among its staff, Ventec introduced mandatory temperature checks for everyone entering its factory. A janitorial staff works 24 hours a day to sanitize surfaces.<\/p>\n\n\n\n

But even with the increased production, the company won\u2019t be able to quickly satisfy the surging demand.<\/p>\n\n\n\n

For days, Mr. Kiple said, he has been getting nonstop phone calls from frantic hospital administrators, governor\u2019s offices and other government officials looking for more machines. He\u2019s even received inquiries from a number of wealthy individuals hoping to buy their own personal ventilators, a fallback plan in case the American hospital system buckles.<\/p>\n\n\n\n

\u201cI can tell you with a 100 percent confidence that every single manufacturer is facing a backlog right now,\u201d Mr. Kiple said.<\/p>\n\n\n\n

European countries \u2014 already reeling from tens of thousands of virus-infected patients \u2014 are responding forcefully. Some governments are restricting domestic medical supply companies from fulling international orders.<\/p>\n\n\n\n

In Germany, where about 25,000 ventilators are now available nationwide, the government ordered 10,000 from a domestic manufacturer, Dr\u00e4ger, to be made over the next year. The company, whose stock has risen more than 50 percent in the last week, said it was rushing to fulfill the orders, but faced constraints because of safety testing and the availability of components.<\/p>\n\n\n\n

Italy, which has nearly 30,000 confirmed coronavirus cases and more than 2,100 deaths, is perhaps facing the gravest shortage of ventilators. In the Northeast region of Veneto, officials are looking into whether ventilators designed for animals can be used on humans, local media reported.<\/p>\n\n\n\n

The government has sent about 25 engineers and other staff members from the ministry of defense to help with production of ventilators at Siare Engineering, a manufacturer near Bologna. The company has quadruped production to make up to 150 ventilators a week. It delayed deliveries to other countries like India to meet the need in Italy.<\/p>\n\n\n\n

\u201cIt\u2019s an urgent need for our country,\u201d said Enrico Tozzi, who leads Siare\u2019s export division. \u201cWe are completely in an emergency.\u201d<\/p>\n\n\n\n

And in Britain, where the country expects to need far more than the 5,000 ventilators now available, Prime Minister Boris Johnson on Monday called on carmakers and other manufacturers to immediately begin helping make ventilators, a move reminiscent of the country\u2019s mobilization to build Spitfire fighter planes during World War II. The government said it got more than 400 calls from businesses offering to help build ventilators.<\/p>\n\n\n\n

The American government has considered, to some extent, a similar option. A federal report<\/a>, obtained by The New York Times and dated March 13, noted that the president could invoke the Defense Production Act of 1950, which allows for the mandatory mobilization of manufacturing lines to produce key supplies. (Mr. Trump announced on Wednesday that he would do so.)<\/p>\n\n\n\n

So far, though, there have been no investments in technology to help manufacturers increase production, scant marshaling of federal resources and limited coordination to help distribute machines. Instead, it\u2019s essentially every state for itself, which leaves manufacturers having to decide which hospitals or governments need the machines the most \u2014 and, in theory, who is willing to pay a premium.<\/p>\n\n\n\n

Some industry officials said they recently had been discussing production issues with members of the White House\u2019s coronavirus task force and officials at the Department of Health and Human Services.<\/p>\n\n\n\n

Given the size of the United States, the problem is more complicated than raw numbers. An unused ventilator in Detroit, for example, does not help an overwhelmed hospital in Dallas.<\/p>\n\n\n\n

\u201cYou may have more than sufficient resources close by or even across the country but face clustered outbreaks that exceed the capacity locally,\u201d said Dr. Greg S. Martin, president-elect of the Society of Critical Care Medicine and professor of medicine at Emory University in Atlanta.<\/p>\n\n\n\n

There\u2019s also the question of finding enough trained personnel to staff the machines. Under normal circumstances, Dr. Martin said, physicians receive years of training before they are entrusted with operating ventilators in life-or-death situations.<\/p>\n\n\n\n

Rachel Abrams contributed reporting.<\/p>\n\n\n\n

Sarah Kliff is an investigative reporter for The New York Times. Her reporting focuses on the American health care system and how it works for patients. <\/p>\n","protected":false},"excerpt":{"rendered":"

By Sarah Kliff, Adam Satariano, Jessica Silver-Greenberg and Nicholas KulishPublished March 18, 2020Updated March 26, 2020 As the United States braces for an onslaught of coronavirus cases, hospitals and governments are confronting a grim reality: There are not nearly enough lifesaving ventilator machines to go around, and there is no way to solve the problem before the disease reaches full throttle.UpdateTrump administration pulls […]<\/p>\n","protected":false},"author":61,"featured_media":9007,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-9005","post","type-post","status-publish","format-standard","has-post-thumbnail","category-business"],"_links":{"self":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/9005","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/comments?post=9005"}],"version-history":[{"count":1,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/9005\/revisions"}],"predecessor-version":[{"id":9006,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/9005\/revisions\/9006"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/media\/9007"}],"wp:attachment":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/media?parent=9005"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/categories?post=9005"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/tags?post=9005"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}