PARIS – Medical gases specialists Air Liquide SA, of Paris, along with Peugeot SA, Schneider Electric SE and Valeo SA have joined together in a consortium to manufacture ventilators in a time when there is a critical shortage. Intensive care units in France, overwhelmed by the influx of patients suffering from severe forms of coronavirus, need to be properly equipped.

“I have asked [the consortium] to produce 10,000 heavy- and light-duty ventilators by mid-May,” said French President Emmanuel Macron.

Looking to equip 14,000 resuscitation beds

According to latest figures from the Department of Health, there are 26,246 patients hospitalized in France currently, including 6,399 in intensive care in a serious condition. While France had only 5,000 beds before the COVID-19 crisis, it needs to reach a capacity of 14,000 intensive care beds in order to cope with the influx of patients.

French public authorities want to equip resuscitation departments with 8,500 Osiris ventilator models and 1,500 T60 ventilator models. These two ventilator models are manufactured by Air Liquide Medical Systems, the only French manufacturer of artificial ventilation equipment. They have sites in Antony (Hauts-de-Seine) and Pau (Pyrénées-Atlantiques).

“Three extra production lines will be set up at these two sites, leading to a 70-fold increase in output of certain ventilators,” said a spokesperson from Air Liquide. Whereas production of ventilators by the French manufacturer doubled in March, it is now a question of tripling this output in April and quadrupling it in May.

Air Liquide, leading the call to action

Air Liquide, leaders of the French consortium – along with Peugeot, Valeo and Schneider Electric – have set up a task force of some 30 procurement and manufacturing specialists to plan mass production of ventilators. These French manufacturers first secured the supply of the 300 components essential for the manufacture of ventilators, by calling on specialist input from 100 national partner companies.

Automotive parts supplier Valeo has put together a procurement team responsible for managing suppliers and supplying those parts required for the manufacture of ventilators. “We will also be providing technical support, with our R&D teams covering skills in plastic, mechanical and electronic technologies,” Valeo Chairman and CEO Jacques Aschenbroich told BioWorld.

For their part, 55 workers from vehicle manufacturer Peugeot will take care of mechanical pre-assembly for 8,500 ventilators at the Poissy plant in Yvelines, on behalf of Air Liquide. Lastly, French automation giant Schneider Electric will supply electronic and electrotechnical equipment, as well as workers. Their Lean Manufacturing specialists are helping improve Air Liquide’s existing production lines. “A hundred of our technicians will work at the Air Liquide site in Antony, 24 hours a day, seven days a week, for six weeks,” said the Air Liquide spokesperson.

Global effort amounting to $4.3B

The government is supporting the initiative to the tune of $38 million. More generally, a specific grant of $4.3 billion has been allocated to the national public health agency, to fund procurement of medicine, ventilators and masks needed to fight the COVID-19 pandemic in France. “We need to manufacture more right here in France, to re-establish our national and European sovereignty,” said Macron. At the start of the coronavirus crisis, production capacity in European Union member states could only meet 10% of the estimated demand for equipment outside of pharmaceuticals, according to the European Commission.

Other national initiatives, related for instance to R&D, are proliferating in France. A collective of four industrial designers based in Paris has just developed an emergency artificial ventilation device using 3D printing. The prototype is made up of physical control boxes, a pressure adapter, activated carbon filters, an electronics board to control the whole thing, and valves printed in 3D. “We have designed this minimal universal ventilator (MUV) using the fewest possible materials and favoring the use of components available everywhere,” said Christian Quest, part of the Parisian design collective.

The MUV prototype is currently in the test phase on a test bench in two Parisian Public Assistance hospitals, the Henri Mondor Hospital (Créteil) and the Pitié Salpêtrière Hospital in Paris. It is a matter of producing ventilator equipment, consisting of few components, easily reproducible, and which can be put into service swiftly while being inexpensive. The cost of the MUV is around $200, against $27,000 for more the high-tech ventilators currently on the market.

3D printing for manufacturing medical devices en masse, quickly

The 2D COVID project, another initiative from Paris University and the Necker-Enfants Malades Hospital in Paris, part of the Assistance Publique Hôpitaux de Paris (AP-HP), is being supported by French luxury goods group Kering SA, valued at $62 billion on the stock market. The Hôpital Cochin was thus able to procure a suite of 60 3D printers in order to produce medical devices quickly and in large quantities as of April 1, to meet demand for equipment during this COVID-19 pandemic. This is mainly valves for emergency artificial ventilators, intubation equipment, masks and protective face shields. “Thanks to this public-private partnership at a time of crisis, we will design, validate, produce and distribute 2D printable medical devices for all hospitals in the AP-HP,” said Roman Hossein Khonsari, maxillofacial surgeon at the Necker–Enfants Malades Hospital at the heart of the 2D COVID project.