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.
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.
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.
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.
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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Even 3D printing companies are responding with innovative new means to this challenge but will need support to internationalise such efforts to rapidly produce and deliver ventilators where they are needed.
The first 3D printed ventilators in Spain by Leitat Technology Centre are now moving into production after receiving certification from authorities in March, potentially bringing down the cost of production of a ventilator and overcoming the challenges of border closures impacting critical supply chains in this outbreak.
Companies in the 3D printing space are also exploring printing masks, goggles and gloves and no doubt will need help scaling up production.
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EYE OF THE STORM
When the coronavirus outbreak first begun, many countries wrongly assumed this would be a localised epidemic like SARS in 2003. Just mere months ago, some world leaders downplayed the severity and myopically refused to roll out preventive measures or shore up healthcare services.
Today, the world stands in the eye of the COVID-19 storm. The fatality rate has doubled over the last two months to 4.4 per cent by end-March, according to WHO data. Worse, total infections around the world doubled in one mere week when it surpassed the 1 million mark.
Healthcare workers and patients desperately need life-saving equipment but efforts to ensure they have what they need remains patchy around the world.
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Stories of middlemen outbidding each other just before consignments of medical supplies like masks leave airport tarmacs and countries imposing controls on ventilator exports suggest a brewing zero-sum race for coronavirus protection.
But a bright spark remains as companies develop novel ways and cooperate with each other to ramp up production.
The tide can still be turned. Whether these companies can deliver will determine how the pandemic plays out.
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Shahid Hussain is CEO of a consultancy company based in the United Arab Emirates and writes about matters which shape trade and business in Asian markets.