BOGOTA, Colombia – The global shortage of ventilators caused by COVID-19 is not news to the Latin American region, an area already preparing for the tsunami of patients that could flood hospitals as it has done elsewhere. Latin America is closely following the development of the outbreak in Europe, mainly in Italy and Spain, two countries overwhelmed by the crisis. The region is trying to learn from the mistakes made by European countries before it is too late.

One of the projects which designers and researchers are working on is taking place in La Plata, Argentina, where Laureano Gallaratti, an industrial designer with experience in medical devices and holding a master’s degree in design from the Domus Academy from Milan, Italy, is based.

“Given the situation with COVID-19, I began to immerse myself in the design of these devices and to look for open source medical devices,” he told BioWorld.

“I started to look at what was happening in the world and I found some people in Barcelona, Spain, working on the OxyGEN device, a piece of open source hardware and they allowed me to collaborate with them from Argentina,” he said.

Protofy.xyz, from Barcelona, Spain is working on the development of a device capable of transforming manual bag valve masks (also known as ambu bags or manual resuscitators), into automated mechanical devices.

“This is not a medical device by itself. What it does is to free up medical staff in a collapse situation,” Gallaratti explained. “Medical staff can be doing something else, while this device helps patients to breathe,” he said, while stressing that this will not replace artificial vents that have alarms and are capable of mixing air with oxygen.

“We just don't have time for that,” he said. “This will be really useful under the extreme circumstances of a collapse, and to stabilize critical patients while they wait to be transferred to well-equipped hospitals, or when ventilators become available,” he explained.

Manual bag valves are not as hard to find as ventilators right now. The Spanish initiative is already working on the fifth version of the accessory for ambu bags and has created two models: One for mass production, and another one for DIY at workshops.

The latter is in the one that Gallaratti is focused on, and the challenge of finding motors for the device was solved by an unusual idea from the designer: windscreen wipers.

“Argentina is a large country and it can be hard to find the correct motors,” he explained. The country has been under mandatory confinement since March 20, and will stay so, until at least March 31. “The windscreen wiper motors have good torsion, and they are within the reach of anyone,” said Gallaratti.

At this time, when every possible assistance is needed to keep patients breathing in the midst of the COVID-19 outbreak, any workshop can easily become an improvised factory creating accessories for medical devices. And that is exactly what Gallaratti’s idea is about. He said that the production cost of the devices could be less than $100 each.

Gallaratti is waiting for the Spanish team to acquire certification and approval from EMA. Then, he says, he will get in touch with ANMAT, the Argentine health care surveillance agency, to try and put the necessary approvals on an emergency fast track process.

“The obstacle is certification by regulatory bodies,” said Gallaratti. “I´m waiting for the certification by Spain, but in an extreme situation, this will have to be used in any possible way,” he said.

Argentina already exceeded 500 confirmed cases of COVID-19, after the first case was reported on March 3 in the country. Most of the Latin American region is shutting down, closing borders and putting people in mandatory confinement, in an attempt to contain the outbreak.

North of Argentina, in Colombia, the first case was confirmed on March 6. The country has a similar number of cases to Argentina and different research groups are working around the clock to prepare for an avalanche of COVID-19 patients that could overflow the health care system’s emergency preparations.

In Colombia, Mauricio Toro, a mechanical engineer with experience in the design of orthopedic devices is leading a group designing mechanical ventilators that could cost between $500 and $1,000. The Colombian team supported by RutaN, from Medellin, Colombia, a publicly funded initiative to promote innovation and businesses in the second largest city of the country, along with the country's National Association of Entrepreneurs (ANDI for its acronym in Spanish), has spent about $37,000 on the project, and it aims to fund the project via a crowdfunding drive aimed at raising $1.5 million. More than 100 volunteers and 20 academic institutions are working on the project.

Their first goal is to manufacture 1,000 ventilators over the next month, and they are working together with INVIMA, Colombia´s health care regulator to get the required approvals.

As the Colombian team moves forward on the design of the devices, they say there's just no time for interviews, for now. “The teams need to be focused on working on the project and work as fast as possible,” Mauricio Toro told BioWorld. The project is intended to be able to be scalable to match any situation, anywhere. It is intending to achieve this by creating open source manuals for the construction of the mechanical ventilators, similar to the ones being developed by the Spanish team and adapted in Argentina.

The region is getting ready for a war against an almost invisible enemy. Open source med-tech that has easily scalable production methods could become a key weapon to save hundreds, if not thousands of lives in the Latin American region and elsewhere.

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