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'Things Can Be Done Much More Quickly': Vermontilator Designer On Lessons Learned

Images of the Vermontilator prototype
Jason Bates, courtesy
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The final production-ready prototype of the Vermontilator, a pared down ventilator developed to help COVID-19 patients in critical condition.

Back in March, during the early days of the pandemic, it seemed possible that the country may run out of mechanical ventilators for patients dealing with the severe respiratory effects of COVID-19.That prompted a group of scientists, doctors and engineers at the University of Vermont to quickly develop a prototype for a new kind of ventilator — one with a simple design that could be manufactured on the cheap. They called it "the Vermontilator" and pushed to get it approved for use by the Food and Drug Administration. What happened next?

VPR's Henry Epp spoke with  Jason Bates, a professor of medicine at UVM and the designer of the Vermontilator, about what's happened since this spring and the future of this new device. Their conversation has been edited and condensed for clarity.

Jason Bates: The Vermontilator implements a very simple poor man's version, if you like, of a particular mode of mechanical ventilation, which has features that are advantageous for avoiding the damage that can be caused to inflamed lungs by mechanical ventilation.

In the early days — and this is back in March — we, like just about everyone else who was thinking about it, had visions of thousands of patients lined up in hospital corridors gasping for breath and no ventilators to ventilate.

Henry Epp: Right, and that didn't exactly come about, although hospitals have had high numbers of COVID patients in various parts of the country. The last we heard, when you had put together this prototype in the spring, you were then seeking federal approval to manufacture the Vermontilator. Did you ever receive that approval?

We didn't. We've actually pulled back from that. We aimed for a very minimally functional, as basic as you can get, ventilator. And by the time it really came to addressing the issue of emergency use approval, the goalposts had shifted, if you like, because, as everybody knows, the federal government put a lot of effort into the manufacture of commercial grade ventilators.

So, there wasn't quite the acute need that there was at the point when you began working on this in March and April.

That's right. There wasn't the acute need. And that's not to say that hospitals may not be overwhelmed as we ramp up on the next wave, but my impression is it's not going to manifest as a shortage of mechanical ventilators. It's more likely to be [a] shortage of trained medical personnel.

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That was my next question. Do you anticipate any potential use for this, given that we are seeing another surge of COVID-19 that could continue in the coming months?

Well, if in the unlikely event — and I would have to say it's unlikely — we really do have a shortage of ventilators going forward, the Vermontilator's ready to be made. So, we could respond with a basic ventilator that I believe would keep people alive.

But at the same time, we also started realizing, by talking to colleagues who have a footprint in the developing world, that whereas there may not be an acute need for such a ventilator in the United States, in other parts of the world that are really short of medical supplies and medical facilities, there remains such a need.

But at the same time, we also realize that in order to attend to the developing world, we really need to extend the capabilities of the Vermontilator anyway, to make it a general purpose ventilator that could be used during surgery.

"We also realize that in order to attend to the developing world, we really need to extend the capabilities of the Vermontilator anyway to make it a general purpose ventilator that could be used during surgery." — Jason Bates, UVM professor and designer.

In terms of that need, is it in some sense going back to the drawing board to remodel what this device is so that it could serve those needs a more general need for a ventilator  — rather than this one specific use?

It does require a bit of redesign in how we achieve that because of the greater range of inspiratory and expiratory ratios, but the basic idea remains the same. That, I think, is the essential element of the Vermontilator.

So the point is, it then becomes cheap to make, and as I'm told repeatedly by people who work in the developing world, it becomes easy to repair.

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Finally, Jason, this whole project came together in the spring in a matter of weeks, as I understand it. So, even if it wasn't used in the way that you initially thought it might be, are there lessons that you'll take away from the experience of putting together this prototype in response to an emergency situation on the timeline that you did?

Taking something from basic idea to a final product is a huge distance. We managed to do it really very, very quickly, with the enthusiastic help of a lot of people who were committed to the idea of responding to the call, as was the case in many other areas of medicine related to COVID, like PPE, vaccinations and everything we've seen.

We've seen an unprecedented pace of progress from idea to what you actually need in all sorts of areas, and perhaps the most widely publicized one would be the vaccine. We've learned that things can be done much more quickly than had been the case before.

We've also learned how real progress can be made when people are not physically in the same place. What this COVID crisis forced us to do was to do everything that way, and I think we've demonstrated that it's, to a very large extent, distinctly possible.

Have questions, comments or tips? Send us a message or get in touch with reporter Henry Epp @TheHenryEpp.

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