When COVID-19 gripped the UK in March 2020, the call went out for new ventilators for the NHS. Mark Bennett explains what happened next…
March and April 2020 is a period many of us are likely to remember for the rest of our lives. The tension was palpable - we all found ourselves gripped with concern about the spread of a new disease that was evidently both highly infectious and had a very high mortality rate.
As the country – and the world – faced up to the reality of the pandemic, a hive of activity was soon underway to source desperately needed ventilators for the National Health Service, as a precaution against a dreadful ‘worst case’ scenario. Data at that time showed that with unchecked exponential growth, the UK would be dealing with 10 million cases by the end of April. And in those pre lockdown days, we didn’t know what, if any, steps might be effective to check the spread.
On March 18 the government requested support from industry to produce what they called a “Rapidly Manufactured Ventilator System”. The task was stark: literally thousands of ventilators were needed by the end of April. A few hundred would have been useless as they would only have been a distraction to the NHS. Delivery later than May would also be useless as they would have been too late to help with the projected crisis in April and May.
We decided to get involved.
Getting down to work
Now, ventilator manufacturing is not exactly our normal business. But as one of the largest manufacturing companies in the UK we felt well placed to contribute to this national effort.
One of the first things I learned on this project is that when a patient is sick, it is apparently very easy to kill a patient with bad ventilation. This is because if someone’s lungs are unhealthy, the airways tend to be inflamed and more delicate than they would normally be; the lungs also produce a lot of mucus which sticks the internal air passages together and makes the lungs much more difficult to inflate. This all makes ventilation of sick lungs a difficult task.
Modern ventilators have a number of ways in which they operate, but one common way is through ‘pressure controlled ventilation’, and in this mode the ventilator accurately controls a set pressure into the lung – during both the inhale and exhale.
Within days of the call going out to industry we teamed up with Intersurgical, a company that became our major partner in this programme, and which makes the majority of the consumable items that are used for air breathing systems for patients in UK and European hospitals. By March 22 we had the outline of a viable plan – a useful machine we could build in the required numbers – and by the following Friday – March 27 – the project was up and running.
The ventilator we designed and constructed – christened “AirCare” – was a pressure controlled mandatory breathing system, doing all the breathing on behalf of the patient. A modern ICU ventilator has multiple other modes but ours provided the essential ‘mandatory breathing’ only, and it was designed using only readily available parts, so that it was simple and could be rapidly manufactured.
Before a ventilator can be used in a hospital it has to be approved by regulators and this is normally quite a drawn out process. So to speed this up, we made sure that the controller was hardware driven rather than dependent on safety critical software, as hardware is a lot easier to evaluate. The air path was all made out of already medically approved components and inherently fail safe in its design.
Why it worked
It’s important to note we didn’t set out to build a replacement for an ICU ventilator – we set out to build something that would be helpful in the crisis situation and that could be produced in large numbers in only six weeks. It was deliberately kept as simple as possible to enable rapid national deployment.
The partnership with Intersurgical proved ideal. Between the two companies we had everything we needed, and we were very complementary: BAE Systems could do the heavy lift on the engineering process and certification, and Intersurgical, which manufactures millions of consumable parts, had a wealth of experience on patients’ respiration. Between the two of us we covered all the bases.
We were able to get started really quickly. With support from the top of our business, within days we had a highly skilled technical team pulled together from across the BAE Systems Group. The fact that it was a relatively small project also made it easier for a big company to ‘crack on’ – a smaller company would have found it harder to commit to doing something like this so quickly. Plus, with the whole world chasing parts for ventilators, a company the size of BAE Systems had the necessary clout and trust to solve any supply chain challenges.
Thankfully, the much feared peak in April and May did not occur – the lockdown proved effective and the case load declined – and this meant that none of the AirCare ventilators were ever needed. Furthermore, the clinical treatment has changed – early ventilation is now seen as not such a good approach from a medical standpoint.
But for me, this doesn’t detract from what we achieved. Only a big, technical and high governance engineering company could have completed this sort of programme within this timeframe. And while the AirCare ventilator has not been used, we are proud that we succeeded in being able to make thousands of ventilators by the end of April, and thus played our part in responding to the call for help.
About the author
Mark Bennett is Strategy Director at BAE Systems Applied Intelligence
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