PARIS – With more than 10,000 people now infected, 3,626 hospitalized and 450 having died, France is in third place of European countries most affected by the coronavirus epidemic, after Italy (35,700 cases) and Spain (13,910 cases).

The exponential spread of COVID-19 has led to a surge in demand for respiratory therapy equipment in intensive care units. “The large-scale cancellation of non-urgent surgery in French hospitals has freed up capacity for resuscitation and intensive care beds, as well as a buffer stock of ventilators with which to face the epidemic,” Jérôme Salomon, who heads the French Department of Public Health at the Ministry of Health, told BioWorld. Salomon recognizes, however, that the situation is problematic for the six regions most affected in France: Ile de France, Grand Est, Corsica, Bourgogne Franche Comté, Hauts de France and Auvergne-Rhône Alpes.

Reallocation of beds to assist resuscitation departments during the epidemic

There are 931 severely ill patients currently undergoing treatment in intensive care units. “The number is growing exponentially. This has led us to establish lockdown policies throughout the nation,” said immunologist Jean-François Delfraissy, member of the 11-strong scientific committee that advises the President of the French Republic, Emmanuel Macron.

France has 5,000 hospital beds equipped with artificial ventilators. “We have one of the highest levels of resuscitation equipment in Europe. With increased flexibility capacity, due to potential reallocation of beds,” said Vincent Camus, director of sales and marketing, anesthesia & resuscitation at the French subsidiary of Chicago-based GE Healthcare Inc.

However, intensive care admissions for acute respiratory distress caused by the COVID-19 virus are doubling each week in France. And the average stay in intensive care for patients with coronavirus exceeds three weeks. The coming peak of the epidemic may need capacity of 65,000 beds, or a tenfold increase in beds and medical devices. Under these conditions, supply problems for artificial ventilators are starting to make themselves felt across the nation. The UniHA hospital procurement consortium ($5 billion in joint procurement for 52 French hospitals) has noted that orders for some consumables for extracorporeal membrane oxygenation systems are not being met in full.

The race for ventilators is intensifying

On a global scale, the manufacturers in this sector have been urgently reorganizing themselves for several weeks, particularly so as to improve supplies in France. The Swedish firm Getinge AB is temporarily increasing its output of ventilators, by 60% compared with 2019, at its production site in Solna, Sweden. “Since the outbreak of the COVID-19 pandemic, we’ve seen increased global demand for ventilators, extracorporeal life support equipment and advanced monitoring for intensive care units,” said Elin Frostehav, vice president for critical care at Getinge.

The Hamburg factory of Löwenstein Medical Innovation GmbH & Co. KG has “doubled its overall production of ventilators,” certainly to meet the increase in demand from France, but also from Italy and Iran. “Iran has placed 10,000 orders with us,” Christophe Hentze, managing director of Löwenstein’s French subsidiary, told BioWorld. GE Healthcare has also doubled its production levels for ventilators. “We are redeploying teams working on medical devices relating to anesthesia, to allocate them to those intended for resuscitation,” said Camus. However, GE Healthcare ventilators for French hospitals, made in the U.S., are not due to be delivered for several weeks.

France suffering from national priorities of overseas manufacturers

The whole point is that there are no French ventilator manufacturers. “France is not a priority in the order books of foreign manufacturers who favor their domestic markets, also hit by the coronavirus pandemic,” said businessman Loïc Le Floch-Prigent, former chief of staff at the Minister of Industry, former CEO of Rhône-Poulenc, Elf Aquitaine and then Gaz de France. One of the leading companies in this sector in Europe, Drägerwerk AG & Co. KGaA, based in Germany, has just received orders from the German federal authorities for 10,000 ventilators, to be delivered within three months. The equivalent of a whole year’s production. They have been banned from exporting to France.

France can still order its ventilators from American firm Resmed Inc., the Dutch firm Royal Philips NV or Swiss firm Hamilton Bonaduz AG – who can “sell 2,000 units a month by working day and night. including weekends,” said Andreas Wieland, CEO of Hamilton.

Confronted with the sharp rise in hospital demand for ventilators, the French association of home health care providers (FEDEPSAD) decided to ask its members to carry out an inventory of the ventilators in their ownership, in order to meet the demand from hospitals. “We will be sending this data to the Ministry of Health, which will be able to divert this equipment to hospitals who are in need,” said Charles-Henri des Villettes. Vice president, Home Healthcare France - Air Liquide Healthcare (a division of Air Liquide SA).

Some ventilator models being re-targeted

By the same logic, Löwenstein plans to re-target some of its ventilator models towards resuscitation departments. This is because the standard of high-end respiratory equipment is considerable in France, compared with other countries. “However, we manufacture products intended for home use, just as effective and less intricate to manufacture, which may be entirely suitable for patients suffering from respiratory failure. This crisis justifies re-targeting these products,” said Hentze.

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