Governments across Europe have intensified their search for ventilators as doctors and hospitals prepare for a continuing surge in patients infected with COVID-19

Medical ventilators are machines designed to put oxygen into the lungs of patients with acute respiratory difficulties. They are of critical importance for those in danger of lung failure, a typical cause of death for patients infected with the coronavirus

Public Health England’s guidance on infection prevention and control for COVID-19 outlines infection control for healthcare providers assessing possible cases of coronavirus. In the absence of effective drugs or a vaccine, control of this disease relies on the prompt identification, appropriate risk assessment, management and isolation of possible and confirmed cases, and the investigation and follow-up of close contacts to minimise potential onward transmission.

PPE shortages

However, as of late March there were already shortages not only of medical ventilators, but also of personal protective equipment (PPE) for UK healthcare providers.

Ventilators: challenges

Regarding the shortage of medical ventilators, the UK Government is reported to have sent a blueprint for making up to 20,000 ventilators as soon as possible to treat coronavirus patients, to more than 60 carmakers, aerospace manufacturers and engineering companies. Formula 1 teams have reacted positively to the Government’s request. A number of teams have applied-technologies divisions that could directly feed into the national production capacity of ventilators in the UK – particularly McLaren, Red Bull and Williams. All the teams have advanced manufacturing capability that could potentially be used to make these complicated devices, and as the Grand Prix season and all other such events have been cancelled, many will help if they can. However, there are serious challenges in designing, testing, manufacturing and distributing any medical device. They will have to go through the multiple ISO standards that specify general requirements for safety applicable to a specific characteristic of all medical electrical equipment. There have been other suggestions for increasing the availability of ventilators at short notice: refurbishment of all the old ones in hospital storage, adapting veterinary operating room machines to human use, and modifying the software in the fleet of bedside continuous positive airway pressure (CPAP) machines so that they can be used for a subset of patients.

Military support

Other measures being taken to support NHS staff include the recall of retired doctors and nurses in England and Wales to help tackle the coronavirus outbreak. A huge civilian army of volunteers has also been called up, with enormous response in late March. On 19 March, UK Defence Minister Ben Wallace announced that the UK Ministry of Defence (MoD) would put an additional 10,000 military personnel at a higher readiness and place Reserves on standby to support public services as part of a new COVID Support Force. These measures were part of contingency planning to respond in a timely way to any request from other governments departments or civil authorities for support during the COVID-19 pandemic. In addition to up to 20,000 personnel being placed at a high readiness to assist with supporting public services, 150 military personnel are being trained to drive oxygen tankers to support the NHS if required. Scientists from the Defence Science and Technology Laboratory (Dstl) are also supporting Public Health England’s effort to understand the virus and tackle the spread. Defence is fully engaged with other government departments, the devolved administrations, and local authorities to establish how best it can provide support over the coming weeks and months. The Standing Joint Command will be the Command and Control (C2) structure for the COVID Support Force, which represents the armed forces’ contribution to the government response. With authorities worldwide battling to contain the spread of the virus and many airlines suspending their flight schedules, the British government has stepped in to repatriate UK and EU citizens. Medical Personnel from the Royal Air Force Tactical Medical Wing have deployed to MOD Boscombe Down to support the repatriation of British holiday-makers who have been stranded abroad. Military medical staff have monitored the passengers in transit before they transit to a quarantine centre. As the virus spreads into spring and summer, no doubt further unprecedented measures and support systems will have to be put in place.

“COVID-19 has seen a worldwide increased demand for many health, safety and hygiene products that we stock – in particular, FFP3 respirators, goggles, disposable garments and sanitiser. COVID-19 is having an unprecedented effect on our supplies. We are doing all that we can to satisfy the demand, but it has reached a point where we cannot guarantee supplies. Certain countries are ring-fencing products manufactured in their own country for their own use. The German Federal Ministry for Economic Affairs has written to our supplier uvex restricting the export of PPE.”

– UK PPE SUPPLIER TOWER SUPPLIES, 10 MARCH 2020

Medical Personnel from the Royal Air Force Tactical Medical Wing are assisting the repatriation of UK tourists stranded abroad.

There is a shortage of personal protective equipment (PPE) for UK healthcare providers.