There are moments when Gui Cavalcanti feels like he woke up in a dystopian universe — a guy with no background in medical or disaster response, suddenly leading an international effort on Facebook to design medical equipment to fight the Covid-19 pandemic, the gravest public-health threat of our time.
“I have never worked so hard for a job I didn’t want in the first place,” Mr. Cavalcanti wrote in a text, as part of a recent interview.
Essential medical supplies, from exam gloves to ventilators, are in short supply. In response, and at Mr. Cavalcanti’s prompting, the world’s open-source enthusiasts have banded together to dig up and catalog blueprints of critical do-it-yourself gear and tools that can save lives.
Mr. Cavalcanti, 33, is the founder of the Open Source COVID19 Medical Supplies, a Facebook group that is crowdsourcing solutions to address the diminishing stock of medical equipment around the world. Mr. Cavalcanti, the founder and C.E.O. of MegaBots, a robotics company, initially intended to focus on ventilators. A front-line surgeon in the Bay Area convinced him to go after the low-hanging fruit: sanitizer, gloves, gowns and masks for medical professionals. Stacks of ventilators wouldn’t do the public any good if there were no health care workers to operate them.
The lack of supplies is already dire in many places. Nurses at Boston’s Brigham and Women’s Hospital turned to social media to collect donations of N95 masks. Workers at Providence St. Joseph Health, a network of 51 hospitals across several states, built face shields made with vinyl, industrial tape, foam and elastic purchased at Home Depot and other craft stores. Intensive care units, short of beds, are turning emergency departments into triage centers. Recent reporting by The Times reveals that the United States has only about 160,000 ventilators available — far fewer than what is needed to provide lifesaving treatments in the most critical cases.
While government officials scramble to find a solution, do-it-yourself makers are pressing ahead in what some corners of the internet are calling a medical hackathon.
When Mr. Cavalcanti started the group, he told his fellow moderators that it needed to “grow faster than the virus.”
“We have to reach literally everybody in the entire world, right?” he said in the interview. He laughed at the enormity of the thought.
In just over two weeks, the Facebook group has grown to nearly 50,000 people. Members share their designs or mock-ups for various pieces of equipment, and offer moral support and encouragement.
“You are all what the revolution looks like,” Angus Joseph, 42, in Durban, South Africa, wrote on March 18.
To keep things organized, Mr. Cavalcanti established a subgroup of 130 people who operate on Slack and filter through the information that amasses by the minute, building a catalog of open-source solutions for medical supplies as they go. (Version 1.1 of the guide was released on March 20.)
According to Mr. Cavalcanti, moderators flag designs that are posted in the main group. A team of medical professionals evaluates the flagged content. Then, a documentation group puts the approved information together in read-only Google documents, creating a virtual library that details equipment including exam gloves, face masks, negative pressure rooms and oxygen masks.
Rusty Oliver, an industrial artist in Seattle, was moved to act when he saw the city’s shelves being emptied of hand sanitizer. “The reaction to the coronavirus was like, ‘OK, so these things are in short supply, how do we make them?” Mr. Oliver, 49, said. “That’s, like, instinct.”
He browsed the Facebook group, and a conversation about producing hand sanitizer jumped out at him. People shared articles about distilleries in Oregon that were jumping in to meet the shortage. The World Health Organization has a formula to follow, which Mr. Cavalcanti’s team documents in its sanitizer page guide, making it easier to produce at home.
Mr. Oliver reached out to local distillers to follow Oregon’s lead and join forces. In the past week, several have stepped up, including OOLA Distillery, which quickly collected all the raw materials, from alcohol to storage bottles. The distillery is ramping up to churn out “thousands and thousands of liters of bottles” as early as next week, said Kirby Kallas-Lewis, the founder of OOLA. It will distribute the sanitizer to emergency medical workers, hospital staff and local community members; it also plans to sell it both to individuals and various businesses.
“The need is now,” Mr. Kallas-Lewis said.
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Coronavirus Has Hospitals in Desperate Need of Equipment. These Innovators Are Racing to Help.
Health care workers are facing a serious shortage of critical equipment needed to treat the coronavirus. We spoke to the makers who are building innovative protective gear and ventilators for them.
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Health care workers around the world are asking for help. “What do you want?” “PPE.” “When do you need it?” “Now.” They’re in desperate need of more PPE, also known as personal protective equipment. Stocks of the critical gear are disappearing during the coronavirus pandemic. Doctors say they are rationing gloves, reusing masks and raiding hardware stores. The C.D.C. has even said that scarves or bandannas can be used as protection as a last resort. “I’ve met the doctors, and talked with them every day. I think there’s an interesting challenge here in that, currently, there’s such a need that if they had anything, they would deploy it.” The cries for help are mobilizing a wide range of innovators, some of them even joining forces through online messaging platforms like Slack. These are engineers, doctors and even high school students from around the world. They come from all walks of life, but say their goal is the same. “It’s amazing because no one’s asking which country are you from? They’re just like, how can I help? What do you need?” They’re pitching in by crowdsourcing designs for masks, face shields and even ventilators that could be reproduced around the world. This is Nick Moser. He’s an active player in one of the maker groups. His day job is at a design studio. Now, he’s designing replicable face masks. “We’re focused on three products: a face shield, a cloth mask and an alternative to N95-rated respirators. The face shield is the first line of defense for medical workers. It protects against droplets. If a patient coughs, it’ll hit the face shield rather than them.” Some designs are produced using 3-D printers or laser cutters. “There you go.” Then, the prototypes are field-tested by health care workers. Even some university labs are experimenting with DIY techniques. A group at Georgia Tech is working with open-source designs from the internet to develop products. “My lab works in the area of frugal science, and we build low-cost tools for resource-limited areas. And now, we’ve realized that I don’t have to go that far. It’s in our backyard, right? We need it now. So this is a plastic sheet I have — not too different from what you would get out from a 2-liter Coke or a soda bottle. I actually bought this from an art store. It’s just sheets of PET, so we can cut these out. We are calling this an origami face shield, and it’s the Level 1 protection. This is one idea. There are multiple different prototypes.” “This headband can be reused, and a doctor or nurse could just basically tear this off and basically snap another one on. We’re hearing that, in some cases, that they go through close to 2,000 of these a day.” Because the need is growing so rapidly, the makers are also thinking about how to increase their production. “So how do we get from this one that someone made at home on a laser cutter or a 3-D printer, and then get it in the hands of thousands of doctors and front-line workers?” They’re working with mass manufacturers that can take their tested designs, and replicate them at a larger scale. “We’ve been on the phone talking to a number of suppliers, material suppliers. So I think one of the neat things that we’ve done is not only the design, proving that you can make it rapidly, but then also trying to secure the entire supply chains.” This is Dr. Susan Gunn, whose hospital system in New Orleans has even started its own initiative to 3-D print equipment. “So it starts with an idea. We put the idea into place. And then we make sure that it’s professional-grade first. Infection control is looking at it, and we’re making sure that we’re using the correct materials that would be approved by the C.D.C. and the World Health Organization.” Dr. Gunn says the gear is a safe alternative for those who might otherwise face a shortage. “We’re creating face shields and we’re creating these different PPEs, and we’re putting them in the hands where people felt like they needed them.” Another critical piece of equipment is the N95 mask, and the supply is dwindling fast. Nick and his team are designing a robust alternative for this mask that can hold any filter material, and be mass produced. “It is easily printable. This one is used in medical situations where there’s an actively infectious patient. So nursing homes or obviously I.C.U. units would be the target to receive these.” “These are really hard objects to manufacture because you’re going to give it to a nurse, and then I want to be really confident that it will not let a virus through, right?” This equipment is not approved by federal agencies, but the designers are testing their respirator prototypes for safety. “That was basically the first, almost the first question that was asked. Can we do anything that’s actually going to be safe and helpful?” Some makers are pursuing even more ambitious projects. An engineer named Stephen Robinson in New Haven, Conn., is working on designing ventilators to help patients breathe. Countries are facing a dire shortage of the lifesaving machines. Right now, these DIY ventilators are still prototypes. “So really, this should be thought of as the seed of an idea that could potentially be grown with, and absolutely requiring, the medical and the tech communities.” But they could become key if critical supplies run out. “We’re in very uncertain times, and I see explorations and projects as kind of an insurance policy that could potentially be leaned on if there was extreme circumstances.” Health care workers are hopeful that these efforts could prevent an even worse outcome. “We don’t want anybody — let’s be clear — to use a bandanna to protect themselves. I hope it never gets to the point where we have to wear a bandanna. And I don’t think, with this initiative that we will get there.” For innovators like Saad, the challenge is personal. “I just can’t stop. I have to do stuff. And then I’m currently at a hospital. That’s why I have this uplifting little flower portrait. We’re expecting a baby boy, and what do we tell him when he grows up about what we did when society needed us?”
Trevor Smale, an illustrator in Toronto, posted an early illustration of his ventilator design to the Facebook group. The responses prompted him to set up a GitHub page for his project, which he called OpenLung. He is now working with OpenSource Ventilator Ireland, a volunteer organization focused on developing low-cost and open-source ventilators.
Colin Keogh, a co-founder of OpenSource Ventilator Ireland, said that as thrilling as this challenge has been from an engineering and innovation standpoint, he hoped that hospitals would never have to use the equipment they were developing.
“It’s seen as an emergency intervention,” he said. “We hope we’ll be able to cope.”
Outside of the Facebook group, others are organizing efforts to find open-source solutions to the shortage. In Boston, a team of anesthesiology residents at Massachusetts General Hospital grew concerned that it might only be a matter of time before the United States ran out of ventilator machines.
Together, the residents founded the CoVent-19 Challenge, a virtual global contest to increase the capacity of hospitals to provide mechanical ventilation.
“We want people to come with great ideas, and we want to provide them the support that they need to develop something that is compatible with the physiology of the human body,” said Diana Barragan-Bradford, co-director of the challenge.
The CoVent-19 Challenge plans to work with the Food and Drug Administration to get approval on the prototypes submitted to the contest, which opens April 1 and runs through June 1.
For his part, Mr. Cavalcanti sees open-source solutions as a “backstop” for front-line workers who are rigging together personal protective gear. He stressed that it’s important for products and materials to be F.D.A. approved.
For now, homemade fixes are filling the gaps.
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