Out of swabs, doctors mobilize an army of 3D printers
A month ago, Beth Israel Deaconess Medical Center in Boston was in trouble. The Italian supplier of swabs for coronavirus tests had been forced to halt shipments.
The hospital couldn’t reach a deal with another supplier, Puritan Medical Products in Maine, that was struggling with surging demand. Doctors had barely a week’s worth of supply left of the crucial swabs.
So Ramy Arnaout, a 43-year-old pathologist, put out calls for help. Among others, he contacted old classmates from MIT. Twenty-two frantic days later, four prototypes were clinically validated.
Now hundreds of thousands of these swabs — called nasopharyngeal swabs because they reach deep into nasal passages — are being churned out each day with the help of 3D printers. By next week, production should be up to more than a million swabs every day, Arnaout said.
The scarcity of swabs has helped to hobble coronavirus testing in the United States. But that gap in the supply chain is starting to be filled by private ad hoc efforts, 3D printing and do-it-yourself ingenuity.
Tech executives, start-up founders, factory owners and engineers have applied a hacker mentality to get testing and other vital parts of the national response working more smoothly.
More than 100 brewers and distillers began manufacturing alcohol-based hand sanitizer after consumers and businesses plowed through inventories. Tech workers have built online platforms to help hospitals vet the new gray market of Chinese test suppliers. And teenagers started turning out face shields for medical workers on 3D printers.
But few efforts have moved more swiftly, more collaboratively and — so far, it seems — more successfully than the quest to produce the nasopharyngeal swab, a sterile disposable medical device sometimes mistaken for its lowtech, cotton-topped cousin, the QTip.
“The big thing was, we were able to get from the identification of swab shortages to the first clinically validated high-quality 3D manufacturing in 22 days,” Arnaout said. “That wasn’t an accident.”
In some cases, each swab prototype underwent 20 design iterations — and all of them were posted online. “We ran a radically open and transparent process,” he said.
The breakthrough on the mundane-sounding swabs is critical. Three months into the COVID-19 crisis, bottlenecks in the supply chain have slowed down testing, limiting the identification of carriers of the disease and hampering the public health response. Perhaps no item has been in shorter supply than the specialized swabs.
“A nasopharyngeal swab not a joke. It goes about four inches into your head,” Arnaout said. “It has to be thin, long and flexible enough to get around the nasal anatomy but it has to be stiff enough that you can twirl it to pick up nasal secretions you’re going to do testing on. They tell us in medical school that if the patient isn’t complaining, then you’re not doing it right.”
EnvisionTEC, a maker of 3D printers in Dearborn, Mich., since 2002, is one of the four new manufacturers working with Beth Israel Deaconess. It began producing nasopharyngeal swabs for COVID-19 testing last week, after making 17 changes to its initial design.
The company is teaming up with a network of 500 affiliated medical labs that already use EnvisionTEC printers to make medical devices such as dentures and mouth guards. They now are making 200,000 testing swabs a day and have the capacity to make 1 million a day, said chief executive Al Siblani.
Siblani said those labs had largely sent home their employees during the pandemic because their work had been deemed “nonessential.” They gradually are returning, he said, to make testing swabs on 3D printers already designed to make safe, medical-grade products.
“All these dental labs, we are turning back on and bringing people back to work,” Siblani said.