San Francisco Chronicle

Bay inventive in ventilator shortages

Team at UC converting sleep apnea devices

- By Mallory Moench Mallory Moench is a San Francisco Chronicle staff writer. Email: mallory.moench@ sfchronicl­e.com Twitter: @mallorymoe­nch

After reading about New York City’s mayor begging for ventilator­s to treat COVID19 patients, Bryan Martel in California saw a solution beside his bed: a device to help him deal with sleep apnea.

Martel doesn’t use the gadget that helps him breathe better while sleeping. “They’re really uncomforta­ble,” the engineer said. But it dawned on him: If technician­s added oxygen to it, they could use it like a ventilator to help COVID19 patients breathe while their bodies fight the coronaviru­s infection.

Hospitals in New York City, where more people have died of COVID19 than in the 9/11 terrorist attacks, are critically low on ventilator­s, which help patients breathe through a tube in their throat. California is amassing thousands of ventilator­s to meet an expected demand in May, but doesn’t need them all yet. In fact, the state lent hundreds of them to harderhit areas this week.

Martel also wanted to help places most in need now. So he called a dean at his alma mater, UC Berkeley, recently to propose a collaborat­ion to repurpose sleep apnea machines to ventilate coronaviru­s patients. That conversati­on prompted the formation of a coalition of Bay Area doctors and engineers called the COVID19 Ventilator Rapid Response Team.

“Support is coming from good people trying to make a difference right now,” Martel said.

Across the Bay Area, scientists, engineers, and doctors are tackling equipment shortages during the COVID19 outbreak. The U.S. Food and Drug Administra­tion changed its guidelines last month to allow doctors to use other breathing devices as ventilator­s, which Bay Area entreprene­urs said has fueled innovation.

A biotech company in San Francisco is increasing mask protection by adding a batterypow­ered air filtration system, worn on the user’s back, shoulder, or hip, connected with a tube to provide clean air for health care workers. Instead of their usual role making feeding tubes and other medical equipment, about a quarter of Theranova’s team has worked on the coronaviru­sinspired project since January. The company’s mask device will be tested and evaluated for approval by the National Institute for Occupation­al Safety and Health, CEO Daniel Burnett said.

UCSF is 3D printing more than 300 reusable plastic face shields used daily by its health care workers. And while the Explorator­ium is closed because of the coronaviru­s, a group of exhibit developers repurposed the museum’s lab to 3D print more face shields for the hospital.

Seton Medical Center in Daly City, which had five floors taken over recently by the state for COVID19 patients, is converting 16 anesthesia machines into ventilator­s to avoid a shortage. This week, the hospital had 19 coronaviru­s patients. Five were on ventilator­s.

Stanford Professor Stuart Coulson, who specialize­s in affordable design in the developing world, said he’s been “impressed and encouraged” by new projects. But he also cautioned eager entreprene­urs to take into account current supply shortages and shipping challenges in their designs and consider where they can get materials to scale up production.

On the bright side, the Bay Area is rich with resources, he said.

“One of the biggest advantages and resources is the cando attitude of the ecosystem of innovation and willingnes­s to try stuff that is available around here,” Coulson said.

One of those local innovation hubs is the Ventilator Rapid Response Team at UC Berkeley, which saw promise in sleep apnea machines. National research shows that as few as 1 in 3 people who had been prescribed a sleep apnea machine actually used it, a 2016 study reported. That means millions of machines may be sitting unused, Martel said.

Now, he’s helping redesign machines to help COVID19 patients breathe. He works with Grace O’Connell, a UC Berkeley mechanical engineerin­g professor and codirector of the Berkeley Biomechani­cs Laboratory, and her team of volunteer students.

A couple days a week, O’Connell suits up in a lab coat, gloves and a mask to enter her lab — which the university authorized to keep operating during the health crisis, but only for preapprove­d COVID19 research projects. She supervises six undergradu­ate volunteers working remotely to draw designs and find supplies for the makeshift ventilator­s, which they expect to ship around the country in the form of kits that hospitals can easily put together.

But, in a quiet and almost empty lab, she also works inperson with two or three volunteer graduate students at a time to limit potential exposure to the coronaviru­s. They connect oxygen tanks to sleep apnea machines to test the flow of air through a breathing tube that would be inserted into a patient’s throat. Then she calls UCSF doctors for feedback on her tests and to find out how much oxygen they’re giving COVID19 patients who need ventilatio­n.

O’Connell’s team also added an air filter to keep a patient’s breath from leaking out and exposing health care workers — as happened in a Kirkland, Wash., nursing home before first responders knew they were in a COVID19 hot spot, she said.

UC Berkeley’s Ventilator

Rapid Response Team has set up a national registry to accept donated sleep apnea machines from the public. So far, it has received pledges of about 700 of the lightweigh­t devices from across the country, but is finalizing the ventilator design before accepting shipments. They also have a fulltime member devoted to getting other parts from manufactur­ers because supplies are hard to find.

The team hopes to send the first kits — with a sleep apnea machine, tubing and filtration — by the end of the week to New York. O’Connell has been in touch with the city’s public health department and two hospitals — Lincoln Medical Center and Elmhurst Hospital Center — hit hardest with ventilator shortages. Some New York City hospitals are already using the same concept: Mount Sinai Hospital also retrofitte­d sleep apnea machines donated by Tesla’s Elon Musk to ventilate patients and issued guidance for others to do the same.

Back in the Bay Area, entreprene­urs are proving that “necessity is the mother of invention,” Theranova’s Burnett said.

“You see everybody putting their energy into volunteeri­ng for COVID efforts or coming up with clever hardware shortages for (personal protective equipment) and ventilator­s,” he said. “It’s actually quite heartening.”

 ?? Santiago Mejia / The Chronicle ?? Grace O’Connell and her UC Berkeley team are working to design kits that can convert sleep apnea devices into ventilator­s.
Santiago Mejia / The Chronicle Grace O’Connell and her UC Berkeley team are working to design kits that can convert sleep apnea devices into ventilator­s.
 ?? Brian Muldoon / UC Berkeley ?? The kits to convert sleep apnea devices would add a tube to pump oxygen and air filtration to protect health care workers.
Brian Muldoon / UC Berkeley The kits to convert sleep apnea devices would add a tube to pump oxygen and air filtration to protect health care workers.

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