The number of confirmed coronavirus cases around the world past the one million mark earlier this week. The speedy spread of the virus, which first emerged in China late last year, has led to a scarcity of critical medical supplies worldwide, especially ventilators needed in an advanced stage of the disease. Ventilators, which automatically pump oxygen into a patient's lungs, have been instrumental in combating coronavirus and can be the difference between life and death for COVID-19 patients with acute respiratory difficulties. Only seven countries worldwide account for 70 per cent of total exports of ventilators, according to two World Bank economists who were quoted by CNN. Thus, many countries around the world — including the exporters of the bedside machine — are facing a daunting shortage of lifesaving ventilators to curb the outbreak. Italy's only domestic manufacturer of ventilators, Siare Engineering, was not only asked by the government to amplify its monthly production from 160 machines to 500 but ordered to reserve its production, 90 per cent of which was previously exported, for domestic use. To meet the rapid demand, Fiat Chrysler Automobiles, with the support of holding company Exor and Ferrari, have joined forces with Siare to provide additional resources and know-how to help scale-up its production. According to a report from Wuhan, the Chinese city where the coronavirus pandemic began, “mortality was 62 per cent among critically ill patients with COVID-19 and 81 per cent among those requiring mechanical ventilation.” Egypt, which passed 1,000 coronavirus cases early this week, has from 3,000 to 4,000 ventilators in its quarantine hospitals and 11,000 ICU beds nationwide, according to Cabinet Spokesman Nader Saad. Though only 5-10 per cent of the total number of infected cases in Egypt needs ventilators, according to the health minister, initiatives that aim to locally produce ventilators have emerged recently to cope with any larger outbreak. Tanafoss (Breathing) initiative has the most ambitious plan, aiming to locally produce 5,000 ventilators. “The idea was triggered following the announcement of the medical device-maker Medtronic that it would publicly share the design specifications for one of its ventilators,” Robert Boutros, spokesperson of Tanafoss, told Al-Ahram Weekly. In an attempt to allow other firms to help fill the gap caused by the new coronavirus, Medtronic posted in late March specs for its basic PB 560 ventilator model “to enable participants across industries to evaluate options for rapid ventilator manufacturing to help doctors and patients dealing with COVID-19.” Boutros said that after studying the Medtronic's device and making sure of the possibility of producing it in Egypt, currently “our work is divided into three specialisations: electronics, mechanical, and software. “The device is about 10 years old. This is in itself an advantage and a disadvantage,” Boutros said. “The advantage is that it has been tried and used for years and is known internationally and locally. “A large percentage of its components is available locally and there are factories that have already begun producing them, especially the hardware, such as boards, screens, valves and hoses,” he said. The disadvantage is that some of its components are not found in the market or their manufacturing has been discontinued, but have alternatives, he noted. “A large number of electronic engineers are working on the alternatives, as are software engineers, because the installation of an alternative to any of the components requires a modification of the device's software,” Boutros said. Another challenge, he adds, is that there are some components that depend on sophisticated technology which is not available in Egypt, or no party has yet manufactured them in Egypt “and we don't have time to experiment. We, however, may resort to importing a piece or two of these components, such as the embedded controller (EC), so that we can complete the prototype in order for us to speed up our production. “We are open to all kinds of cooperation with all concerned bodies, universities, research institutions, and university professors. We frequently publish the required specialisations in which we need volunteers on the official page of the initiative and we have been amazed by the number of volunteers applying,” Boutros said. On Saturday, the British University in Egypt (BUE) said that its Nanotechnology Centre will participate in Tanafoss. “Professors Amal Al-Kasri and Ehab Adli, representatives of BUE's Nanotechnology Centre, will act as the scientific advisers of the initiative,” the BUE said in a statement, adding that the move aims at boosting the capabilities of the health sector to fight the outbreak of the coronavirus. On Monday, Hani Dahi, head of the Egyptian Engineers Syndicate, called on the syndicate's electrical and mechanical divisions to support the initiative with all its human resources, according to Boutros. “Later on, after the prototype passes the quality and standard tests, we will negotiate with competent bodies that are capable of starting its mass production. Concerning the mass production of the prototype, only three entities can manufacture electronics in Egypt: the Military Factories, the Arab Organisation for Industrialisation, and the Al-Arabi Factory,” he said. Other initiatives have also drawn headlines recently with the same goal, including the Holding Company for Metallurgical Industries, Zewail City of Science and Technology and Cairo University. “Cooperation is currently underway between all the initiatives, but our working concept is different,” Boutros said. “We are working on producing a fourth generation ventilator [Medtronic's device], and they are working to produce second and third generation ventilators that need to be manually adjusted and need to be monitored,” Boutros said, referring to why the various initiatives were not being combined. “To simplify, they are more suitable for patients with mild coronavirus symptoms, while the one we're working on is for ICU.” Chairman of the state-run Holding Company for Metallurgical Industries Medhat Nafei proposed last week that the company, through its firms, host the first stage of production, which includes the production of a prototype ventilator. “There are working groups which say they can finish producing the prototype in one week. If we assume that the quality and standard tests will end in another week, we can say that after two weeks we can have the first prototype ready for mass manufacturing,” Nafei added on the CBC satellite channel. Under the Tanafoss initiative, the production of the prototype might take longer. Boutros would only say, “soon God willing”. “Parallel to the production, it was proposed to repair ventilators in Egypt that are not working which account for one-third of the total number in the country,” Boutros said, adding Tanafoss has sent a proposal in this regard to the Ministry of Health.
*A version of this article appears in print in the 9 April, 2020 edition of Al-Ahram Weekly
