- The federal government must coordinate a nationwide program that encourages states to exchange available ventilators based on their varied peaks in demand driven by the COVID-19 pandemic, according to a new research article in Health Affairs.
- The U.S. military has the expertise to direct a logistical operation for transferring ventilators across the country in real time as they are needed, according to author Daniel Adelman of the University of Chicago Booth School of Business. It would be a "moral failure" to allow resources to sit in states where cases have already peaked and they are not needed when the machines could be used in states with short supply that are approaching peak demand, Adelman contends.
- Separately, a trio of medical researchers called for a national data-sharing platform to maximize distribution of ventilators that relies in part on passive data collection using EHRs.
The Trump administration has vacillated in its approach on how to spur ventilator production and distribution, at first relying on private sector efforts alone and then prodding production via federal mandate powers. Lately, the feds have pushed more and more responsibility for securing supplies to the states themselves.
The unprecedented demand for the breathing assistance machines have prompted a massive ramp-up in production. But the uneven spread of the disease across the country could leave some areas stretched beyond capacity while equipment is underutilized elsewhere.
In the U.S., where some states and local governments are starting to reopen businesses seven weeks after the outbreak began, daily new cases have stuck well above 20,000 through most of April. Yet, as cases fall in states including New York, New Jersey and Massachusetts, rates of new infections are still rising in Illinois, Texas, Maryland and elsewhere, according to data compiled by the New York Times.
Projected ventilator shortages prompted the American Hospital Association to spearhead an effort among healthcare systems to create an online inventory of the devices and related supplies such as tubing and filters aimed at facilitating lending to providers facing increased need in their regions. The ventilator exchange program is being organized in cooperation with the Federal Emergency Management Agency, whose help in making allocation decisions was sought by AdvaMed.
The Health Affairs article contends that, while a good start, the plan is voluntary and may not be able to ensure that ventilators get to where they are needed most. What is needed are improvements to the nation’s pandemic response infrastructure, according to Adelman, who argues that the federal government must have "visibility into not only how many ventilators exist, but also where they are located in real-time." Currently, it does not.
In a similar vein, writing in the medical website Stat, data researchers from Harvard University and the Mayo Clinic Platform propose a national data sharing effort passively collecting data based on electronic health records.
"To maximize the lifesaving potential of equipment needed to care for patients with COVID-19, the U.S. urgently needs national-level visibility over supply and demand, ideally with a common platform that states and hospitals can use to share precise information about current ventilator availability and anticipated future need," the researchers wrote.
Last week, the CEO of respiratory device maker ResMed said the company had tripled output of ventilators, while Medtronic last month said it expected to produce more than 1,000 ventilators a week by the end of June, five times the volume it was manufacturing before the pandemic.
Also churning out ventilators are Philips, General Motors, GE, Hillrom and Vyaire Medical. AdvaMed last month said its members were gearing to manufacture 5,000 to 7,000 ventilators per week collectively, compared to just 700 a week for domestic distribution in 2019.
However, Adelman casts doubt on the ability of U.S. manufacturing to gear up sufficient capacity to produce enough to meet demand, noting the need for ICU beds, supplies and workers. Ultimately, the federal government must organize a massive logistical operation to overcome these daunting challenges, he concludes.