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Forbes: Ventilator Maker: We Can Ramp Up Production Five-Fold

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Could manufacturers of these devices boost output? Yes, but not overnight.

“We could increase production five-fold in a 90- to 120-day period,” says Chris Kiple, chief executive of Ventec Life Systems, a Bothell, Wash. firm that makes ventilators used in hospitals, homes and ambulances. He’d have to tool up production lines, train assemblers and testers and get parts. Accelerating the parts delivery might be the toughest task, he says.

The ventilator industry is getting a burst of desperate orders from China and Italy. The U.S. hasn’t seen that yet, although manufacturers are bracing for it. “The time for action by the government is now,” says Kiple. “[Covid] is most likely to get worse next fall.”

 

Quote

What would it cost to inject 50,000 machines into the U.S. hospital system? The average hospital-level machine might cost $25,000 in normal times, Branson says, although an ICU ventilator with all the latest features could run double that. So a few billion dollars would go a long way, even if every parts supplier had to be paid extra to expedite delivery. The suppliers might, after all, be adding employees and costly tooling that would become redundant when the crisis is over.

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Ventilator Maker: We Can Ramp Up Production Five-Fold
William Baldwin
William BaldwinSenior Contributor
Investing
The U.S. could be on a crash course of increasing ICU capacity—if it had the will.

Patient monitor
Ventilator screen in German hospital MARTIJAAN MURAT (GETTY IMAGES)
The German government just placed an order for 10,000 mechanical ventilators. What’s the U.S. government doing about a potential shortage here? Not much, it seems. President Trump alluded to the matter in a press conference but did not spell out any plans.

Ventilators pump oxygen into the lungs of a failing Covid-19 patient. U.S. hospitals have something like 62,000 up-to-date machines immediately available, plus another 99,000 obsolete units that could be pulled out of storage in an emergency, says the Society of Critical Care Medicine. If the pandemic in the U.S. veers off in the Italian direction, that entire collection may be inadequate.

Could manufacturers of these devices boost output? Yes, but not overnight.

Today In: Investing

“We could increase production five-fold in a 90- to 120-day period,” says Chris Kiple, chief executive of Ventec Life Systems, a Bothell, Wash. firm that makes ventilators used in hospitals, homes and ambulances. He’d have to tool up production lines, train assemblers and testers and get parts. Accelerating the parts delivery might be the toughest task, he says.

The ventilator industry is getting a burst of desperate orders from China and Italy. The U.S. hasn’t seen that yet, although manufacturers are bracing for it. “The time for action by the government is now,” says Kiple. “[Covid] is most likely to get worse next fall.”

The seven-year-old, 135-employee Ventec is a fairly small player in a market dominated by Medtronic (under the Puritan Bennett brand), GE Healthcare and Allied Healthcare in the U.S., and Hamilton Medical, Getinge, Drägerwerk and Philips Healthcare in Europe. Kiple estimates that worldwide production capacity is in the range of 40,000 to 50,000 units a year, but some of this output is of machines not suitable for intensive care units.

It is hard to predict the shape of the pandemic curve in the U.S., and thus what the peak demand for ICU capacity will be. But the vision of a grim outcome emerges from the chaos in Italian hospitals, and from a study of ventilator needs done in 2015 by a New York State task force. The study estimated that in a 1918-level pandemic, the state’s need for ventilators would peak at 18,600. There would be only 9,000 on hand, including those now in an emergency stockpile, and most of the machines would already be in use for other kinds of patients.

If there is a risk of a surge in need, and if it takes three months to boost part deliveries, somebody ought to be placing orders right now. But a hospital might well hesitate, given the perhaps equal risk that the extra machines will never be used. Who would eat the cost? That explains why the German order came from the government.

There’s one bright spot on the supply side. The manufacturers would not all be chasing after the same oxygen sensors, metering valves and compressors. “Every ventilator [maker] has individually engineered products,” says Richard Branson, a respiratory therapist and emeritus professor at the University of Cincinnati. “Philips is not going to be ordering the same parts as Medtronic.”

Kiple says the the typical supplier is producing custom parts for many different manufacturing clients. He’s hopeful that during an emergency those other clients could be put on hold.

What would it cost to inject 50,000 machines into the U.S. hospital system? The average hospital-level machine might cost $25,000 in normal times, Branson says, although an ICU ventilator with all the latest features could run double that. So a few billion dollars would go a long way, even if every parts supplier had to be paid extra to expedite delivery. The suppliers might, after all, be adding employees and costly tooling that would become redundant when the crisis is over.

There’s another element of treatment capacity, just as scary: staffing. A ventilator is not a plug and play machine. It needs to be meticulously calibrated to the patient, and if the calibration is not done right or is not updated, the patient is doomed. Pneumothorax, lung collapse, pneumonia from a hospital bug, oxygen toxicity and aspiration of vomit are among the complications. Will there be enough doctors and therapists?

In a crisis, the hospitals will have to get creative. Maybe they will relax some of their rules on credentials. A report yesterday by the critical-care society postulated an emergency staffing that has one ICU doctor overseeing 96 patients on ventilators. That doctor would command a staff of four non-ICU MDs brought in from other assignments, each of them looking after eight respiratory therapists, four ICU nurses and 12 non-ICU nurses (again, repurposed from other wards, like elective surgery). It would be a stretch.

Could there be a round of emergency training? That’s not easy. RT training is supposed to last four years. Perhaps fourth-year students could be drafted, Branson says. What about calling back retired doctors and nurses? Problematic. Those older workers, he notes, would be at high risk if infected.

But there would be a role for quick courses in how to set up a particular model of ventilator and help the MD get the desired output. In a test run of emergency preparedness several years ago, Branson says, instructions in machine operation were given to medically trained people who had never seen the machine before: nurses, physicians, physical therapists and veterinarians. After a two-day, 16-hour course, the veterinarians scored the best.

Sometimes government displays a sense of urgency. In 1942, a shipyard under Henry J. Kaiser laid the keel of a Liberty ship one Sunday and launched it four and a half days later.

Today?

William Baldwin
William Baldwin

 

 

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6 minutes ago, Patricio Swayze said:

Don’t social distance shame me bro...

Came into the office because the work from home thing is still voluntary. It’s me, a designer and a handful of mechanical engineers. Every other discipline is gone, including management.

I mean, I can definitely understand people with small kids coming in to the office on a very limited manner just to get some space to think. Damn near every one of my calls yesterday had a screaming kid in the background

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Sounds kinda perfect, so I'm reluctant to hate. Plus, I'm pretty sure you're married. 
A place with no management, lots of engineers and no wife.. um..
You're at a titter aren't you?


Haha I wish. And yes, married and being a pain in my ass lately. And no I am not a NowThis sock.

If I had the option to be the only person on my floor at work for the next few weeks....  I'd do it.


I’m being more productive. Reforecast 106 data sheets and still have time to read what y’all weirdos are up to.
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Boris Johnson is a dumbass, part 365468434684318438438

https://www.politico.eu/newsletter/london-playbook/politico-london-playbook-the-age-of-corona-rishi-leads-the-fightback-commons-rule-change/

Quote

Individuals privy to the call said that the aim was to have the ventilators “on stream” within two weeks. The government is leaning toward having manufacturing firm Unipart spearhead the national production drive.

Quote

Some participants came away from the conference call less than impressed with Johnson’s own performance. “He couldn’t help but act the clown, even though he was a on call with serious CEOs from goodness knows how many companies,” one participant told my POLITICO colleague Charlie Cooper. This individual said the PM “joked” that the enterprise to build more life-saving ventilators could be known as “Operation Last Gasp.”

 

Edited by NoName
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13 hours ago, Parliament said:

I know my 72 yo, diabetic, heart-attack father went nuts when he found out his favorite coffee shop was closed this am. Now he has nowhere to go to be coughed on by other old men.

I am sure there’s a trucker rest area somewhere nearby.

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Any tips on getting my 72 year old father to stay in the motherfucking house? My mom has respiratory issues already but he keeps going out to meet with his old man coffee club every morning.

Pro tip: if he has a will drafted right you can waive the probate bond requirement.

Demand he gets his last will shit together if he won’t stop meeting his buds.
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5 minutes ago, NoName said:

Forbes: Ventilator Maker: We Can Ramp Up Production Five-Fold

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  Reveal hidden contents

 

Ventilator Maker: We Can Ramp Up Production Five-Fold
William Baldwin
William BaldwinSenior Contributor
Investing
The U.S. could be on a crash course of increasing ICU capacity—if it had the will.

Patient monitor
Ventilator screen in German hospital MARTIJAAN MURAT (GETTY IMAGES)
The German government just placed an order for 10,000 mechanical ventilators. What’s the U.S. government doing about a potential shortage here? Not much, it seems. President Trump alluded to the matter in a press conference but did not spell out any plans.

Ventilators pump oxygen into the lungs of a failing Covid-19 patient. U.S. hospitals have something like 62,000 up-to-date machines immediately available, plus another 99,000 obsolete units that could be pulled out of storage in an emergency, says the Society of Critical Care Medicine. If the pandemic in the U.S. veers off in the Italian direction, that entire collection may be inadequate.

Could manufacturers of these devices boost output? Yes, but not overnight.

Today In: Investing

“We could increase production five-fold in a 90- to 120-day period,” says Chris Kiple, chief executive of Ventec Life Systems, a Bothell, Wash. firm that makes ventilators used in hospitals, homes and ambulances. He’d have to tool up production lines, train assemblers and testers and get parts. Accelerating the parts delivery might be the toughest task, he says.

The ventilator industry is getting a burst of desperate orders from China and Italy. The U.S. hasn’t seen that yet, although manufacturers are bracing for it. “The time for action by the government is now,” says Kiple. “[Covid] is most likely to get worse next fall.”

The seven-year-old, 135-employee Ventec is a fairly small player in a market dominated by Medtronic (under the Puritan Bennett brand), GE Healthcare and Allied Healthcare in the U.S., and Hamilton Medical, Getinge, Drägerwerk and Philips Healthcare in Europe. Kiple estimates that worldwide production capacity is in the range of 40,000 to 50,000 units a year, but some of this output is of machines not suitable for intensive care units.

It is hard to predict the shape of the pandemic curve in the U.S., and thus what the peak demand for ICU capacity will be. But the vision of a grim outcome emerges from the chaos in Italian hospitals, and from a study of ventilator needs done in 2015 by a New York State task force. The study estimated that in a 1918-level pandemic, the state’s need for ventilators would peak at 18,600. There would be only 9,000 on hand, including those now in an emergency stockpile, and most of the machines would already be in use for other kinds of patients.

If there is a risk of a surge in need, and if it takes three months to boost part deliveries, somebody ought to be placing orders right now. But a hospital might well hesitate, given the perhaps equal risk that the extra machines will never be used. Who would eat the cost? That explains why the German order came from the government.

There’s one bright spot on the supply side. The manufacturers would not all be chasing after the same oxygen sensors, metering valves and compressors. “Every ventilator [maker] has individually engineered products,” says Richard Branson, a respiratory therapist and emeritus professor at the University of Cincinnati. “Philips is not going to be ordering the same parts as Medtronic.”

Kiple says the the typical supplier is producing custom parts for many different manufacturing clients. He’s hopeful that during an emergency those other clients could be put on hold.

What would it cost to inject 50,000 machines into the U.S. hospital system? The average hospital-level machine might cost $25,000 in normal times, Branson says, although an ICU ventilator with all the latest features could run double that. So a few billion dollars would go a long way, even if every parts supplier had to be paid extra to expedite delivery. The suppliers might, after all, be adding employees and costly tooling that would become redundant when the crisis is over.

There’s another element of treatment capacity, just as scary: staffing. A ventilator is not a plug and play machine. It needs to be meticulously calibrated to the patient, and if the calibration is not done right or is not updated, the patient is doomed. Pneumothorax, lung collapse, pneumonia from a hospital bug, oxygen toxicity and aspiration of vomit are among the complications. Will there be enough doctors and therapists?

In a crisis, the hospitals will have to get creative. Maybe they will relax some of their rules on credentials. A report yesterday by the critical-care society postulated an emergency staffing that has one ICU doctor overseeing 96 patients on ventilators. That doctor would command a staff of four non-ICU MDs brought in from other assignments, each of them looking after eight respiratory therapists, four ICU nurses and 12 non-ICU nurses (again, repurposed from other wards, like elective surgery). It would be a stretch.

Could there be a round of emergency training? That’s not easy. RT training is supposed to last four years. Perhaps fourth-year students could be drafted, Branson says. What about calling back retired doctors and nurses? Problematic. Those older workers, he notes, would be at high risk if infected.

But there would be a role for quick courses in how to set up a particular model of ventilator and help the MD get the desired output. In a test run of emergency preparedness several years ago, Branson says, instructions in machine operation were given to medically trained people who had never seen the machine before: nurses, physicians, physical therapists and veterinarians. After a two-day, 16-hour course, the veterinarians scored the best.

Sometimes government displays a sense of urgency. In 1942, a shipyard under Henry J. Kaiser laid the keel of a Liberty ship one Sunday and launched it four and a half days later.

Today?

William Baldwin
William Baldwin

 

 

How the fuck was this not approved and done weeks ago? This is the shit that infuriated me CR style. This is obvious, basic shit. 

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14 minutes ago, Patricio Swayze said:

Don’t social distance shame me bro...

Came into the office because the work from home thing is still voluntary. It’s me, a designer and a handful of mechanical engineers. Every other discipline is gone, including management.

 

9 minutes ago, Macanudo said:

If I had the option to be the only person on my floor at work for the next few weeks....  I'd do it.

I am in the office for probably one last day today to set things up to work from home as much as possible for a while. I also talked to management about how I think I may come in on Fridays since they're considering officially closing the office on Fridays (hourly workers were cut back to 32 hours to try to spread hours out while this thing is going on). I need to print out lots of documents on 11x17 frequently for what I do and so will need to be in the office every once in a while. Coming on on days when nobody else is here seems like the play. If we stay open M-F then I'll just be bringing my ass up here on the weekend.

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1 hour ago, SydneyCarton said:

FWIW the biggest symptom of this virus is a dry cough. If you’re hacking shit up it might be a good sign. Also, I’m not a doctor, not even doctor adjacent, etc. but as other posters have said, don’t ignore that there are still hundreds of other strains of flu out there. Plus pollen. 

My biggest symptom of pollen is a dry cough.  I also get sinus infections quite easily.  FML.

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11 minutes ago, Gatorubet said:


Pro tip: if he has a will drafted right you can waive the probate bond requirement.

Demand he gets his last will shit together if he won’t stop meeting his buds.

A trust will avoid probate altogether.  Disclaimer: not an attorney. 

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How the fuck was this not approved and done weeks ago? This is the shit that infuriated me CR style. This is obvious, basic shit. 
The thing that worries me from his statement is that getting parts might be the trickiest.

They can ramp up production, but is he certain he can get the parts he needs to do that? Everything I've read is that those parts all come from China and are in high demand worldwide. It doesn't matter if you have production capacity without the parts.

Maybe it's the most cynical side of me, but I would worry about this being a situation where you take a billion dollar order and then have production delays and can't meet the urgent need. If you say you can ramp your production quickly in a time like this, you'd better be damn sure you can actually do it.
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1 hour ago, Casual Encounter said:

Based on the Spanish flu data, I’m going to predict we don’t have just one curve but more in line with this: 

* You can’t argue with this perspective.

spacer.png

 

1 hour ago, Incredulity said:

This might be the new version of the old woman/young lady drawing.

I can see this as birds eye view of boob or up the thigh view of panties.

A masterpiece really.

 

I stared at it kinda like a magic eye

 

hqdefault.jpg

 

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31 minutes ago, Patricio Swayze said:

Don’t social distance shame me bro...

Came into the office because the work from home thing is still voluntary. It’s me, a designer and a handful of mechanical engineers. Every other discipline is gone, including management.

Ahh mechanical engineers... no worries, they social distance regularly anyway.....in all situations.

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Just now, Cheeseweasel said:

We are like cockroaches and Keith Richards. We are going to outlive all of you fuckers.

Heheheheheheheh, Well, at least on paper...  you'll have all the numbers crunched for damn sure.  I hear pocket protectors are one of the best Coronavirus fighters.

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Thanks for your service, nerd.

06-FAB605-F8-DF-4-C78-BEC5-0-D74-AE70-F7

WASHINGTON (AP) — If Dr. Anthony Fauci says it, you’d be smart to listen. As the coronavirus has upended daily life across the globe, Fauci has become the trusted voice in separating fact and fiction.

Fauci’s political bosses — from Ronald Reagan to Donald Trump — have let him do the explaining because he’s frank and understandable, translating complex medical information into everyday language while neither exaggerating nor downplaying.

“I served six presidents and I have never done anything other than tell the exact scientific evidence and made policy recommendations based on the science and the evidence,” he said.

https://apnews.com/e9d289a802222800a6eeb56e6be28333

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1 minute ago, Onboard 2.0 said:

Heheheheheheheh, Well, at least on paper...  you'll have all the numbers crunched for damn sure.  I hear pocket protectors are one of the best Coronavirus fighters.

Never owned a pocket protector... but I do still have three or four slide rules, and a box of non-working calculators with more keys than a laptop.

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3 minutes ago, Goredho said:

Thanks for your service, nerd.

06-FAB605-F8-DF-4-C78-BEC5-0-D74-AE70-F7

WASHINGTON (AP) — If Dr. Anthony Fauci says it, you’d be smart to listen. As the coronavirus has upended daily life across the globe, Fauci has become the trusted voice in separating fact and fiction.

Fauci’s political bosses — from Ronald Reagan to Donald Trump — have let him do the explaining because he’s frank and understandable, translating complex medical information into everyday language while neither exaggerating nor downplaying.

“I served six presidents and I have never done anything other than tell the exact scientific evidence and made policy recommendations based on the science and the evidence,” he said.

https://apnews.com/e9d289a802222800a6eeb56e6be28333

That guy, I like that guy.

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1 minute ago, Tex Long said:

Never owned a pocket protector... but I do still have three or four slide rules, and a box of non-working calculators with more keys than a laptop.

Same effect  (SEE: Crucifix, mirrors, wooden stakes, holy water, sunlight for werewolves and vampires).  I have a pocket protector I break out whenever I meet with one of the engineers I work with, seems to put them at ease... they let you in their circle of trust...

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1 minute ago, Tex Long said:

Never owned a pocket protector... but I do still have three or four slide rules, and a box of non-working calculators with more keys than a laptop.

I keep my old TI solar scientific calculator around, just in case the power grid goes down and all battery production ceases-- I'll still be able to calculate Pi to 9 decimal places.

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47 minutes ago, SydneyCarton said:

How the fuck was this not approved and done weeks ago? This is the shit that infuriated me CR style. This is obvious, basic shit. 

How the fuck do they not have the common sense to 

A.) Watch the local news and have some foresight 

B.) Even without a direct US government order, and little detective work may tell you there is surging demand overseas. 
 

seems like a dumbass 

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24 minutes ago, Tex Long said:

Never owned a pocket protector... but I do still have three or four slide rules, and a box of non-working calculators with more keys than a laptop.

I had a pocket protector, still have two slide rules and a TI-1100 calculator. Was a physics major but wound up with a BA in history.

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10 hours ago, ChiTownDoc said:

That's your fear?  LOL, dumbasses will always be dumbasses.  You watch...even if this ends up really bad, those fucking people will still have some excuse for why they were actually right.  You can't think about the dumbasses when you're trying to save the masses...even though the masses are often dumbasses.  Got it? 

A fear, certainly not my primary fear. It is really more of a warning in the hope others will finally listen. I'd just hate for us to take learn the wrong lesson from all of this. 

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34 minutes ago, Bill Lumbergh said:

The thing that worries me from his statement is that getting parts might be the trickiest.

They can ramp up production, but is he certain he can get the parts he needs to do that? Everything I've read is that those parts all come from China and are in high demand worldwide. It doesn't matter if you have production capacity without the parts.

Maybe it's the most cynical side of me, but I would worry about this being a situation where you take a billion dollar order and then have production delays and can't meet the urgent need. If you say you can ramp your production quickly in a time like this, you'd better be damn sure you can actually do it.

Again, that's why you have this conversation with guys a month ago. 2 months ago. 

I realize the parts come from China, but as other posters have made allusions to NASA engineers building shit from scratch, or re-purposing CPAP machines, there has to be a way to manufacture some of the parts we typically get from China here. I don't fucking know. 3D Printers. New specs for similar parts that can be re-molded and created in the US. There has to be ways to do some of this stuff, and we should have been doing it a month ago. 

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2 minutes ago, Armybrat said:

I had a pocket protector, still have two slide rules and a TI-1100 calculator. Was a physics major but wound up with a BA in history.

A tale as old as time.  Young bright kid arrives on campus with dreams of getting a 4.0 in an in demand degree.  Discovers pussy and beer and says fuck it, liberal arts will do for now.

Source, graduated (eventually) with history major.

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40 minutes ago, Bill Lumbergh said:

The thing that worries me from his statement is that getting parts might be the trickiest.

They can ramp up production, but is he certain he can get the parts he needs to do that? Everything I've read is that those parts all come from China and are in high demand worldwide. It doesn't matter if you have production capacity without the parts.

Maybe it's the most cynical side of me, but I would worry about this being a situation where you take a billion dollar order and then have production delays and can't meet the urgent need. If you say you can ramp your production quickly in a time like this, you'd better be damn sure you can actually do it.

I know that 3d printing cant produce at scale like a factory in China, but if theres some critical widget thats holding things up, they should be able to keep the lines moving, albeit slower.  100 a week is better than 0.  

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56 minutes ago, Huckleberry said:

 

I am in the office for probably one last day today to set things up to work from home as much as possible for a while. I also talked to management about how I think I may come in on Fridays since they're considering officially closing the office on Fridays (hourly workers were cut back to 32 hours to try to spread hours out while this thing is going on). I need to print out lots of documents on 11x17 frequently for what I do and so will need to be in the office every once in a while. Coming on on days when nobody else is here seems like the play. If we stay open M-F then I'll just be bringing my ass up here on the weekend.

I do too. Get your home office one of these:

 

https://www.amazon.com/Wireless-Business-Printer-AirPrint-Compatible/dp/B00HM0IVDY

 

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3 minutes ago, Not a cat said:

A tale as old as time.  Young bright kid arrives on campus with dreams of getting a 4.0 in an in demand degree.  Discovers pussy and beer and says fuck it, liberal arts will do for now.

Source, graduated (eventually) with history major.

Example #3,444,567.001 of that American Can do spirit !!

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