Amid Global Shortage, Israel Races to Develop Ventilators

Defense Ministry leads drive for relatively crude devices that help in extreme situations, can be produced quickly

Sagi Cohen
Sagi Cohen
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Dr Karina Glick checks a medical ventilator control panel at a ward at Samson Assuta Ashdod University Hospital in the southern Israeli city of Ashdod, March 16, 2020.
Dr Karina Glick checks a medical ventilator control panel at a ward at Samson Assuta Ashdod University Hospital in the southern Israeli city of Ashdod, March 16, 2020.Credit: AFP
Sagi Cohen
Sagi Cohen

Like much of the world, Israel is in desperate need of ventilators for coronavirus patients. The Health Ministry estimates there are about 1,400 of the devices available for immediate use and another few hundred that can be made available. But if the scenario that sees 5,000 sufferers needing the devices at the epidemic’s peak comes to pass, there won’t be nearly enough.

Faced with that big gap between supply and possible demand, Israel is seeking to get ventilators from wherever possible. The Health Ministry says it has placed orders for 12,000 from overseas suppliers, but it will take time for them to come and the global competition over them is intense.

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Medtronic, one the world’s biggest makers of medical devices, has stepped up production and is cooperating with the automaker Tesla, among others, to convert production lines for solar panels to making ventilators.

“We’ve received hundreds of orders from the Health Ministry and we’ve succeeded in obtaining a few score ventilators that will be here by the end of April. Later, we’ll get more,” said Yaron Itzhari, country director for Medtronic Israel.

Meanwhile, the company is collecting ventilators that have been sitting in hospital and medical clinic storerooms because they have some kind of mechanical problem. “Our lab, which had 10 engineers and technicians, has stopped working on everything else and is working now exclusively to make these ventilators usable. So far, we’ve finished work on 15 and delivered them to hospitals,” said Itzhari.

Meanwhile, a collaboration between the Defense Ministry, state-owned Israel Aerospace Industries and medical device maker Inovytech has begun producing the devices on a converted missile production line, the Defense Ministry said Tuesday.

The retooling of the production line was completed in days and some 30 ventilators have been delivered to the Health Ministry, the statement said. It did not say how many machines it planned to produce daily.

Meanwhile, a group of Israeli startups and independent developers are competing in a race against time to develop and produce ventilators. Sources say that all kinds of engineers, researchers and investors are coming forward with ideas for improved ventilation machines that can be produced quickly and at low cost.

Some of these efforts are being done in coordination with the Defense Ministry. On Twitter, Defense Minister Naftali Bennett said the ministry had purchased 3,000 of the devices, a third of which will be delivered within a month.

Two devices that have been developed over the last few weeks are now being examined by the Health Ministry. Their developers have met with ministry experts and senior doctors, who have examined the prototypes and recommended improvements.

How quickly these ventilators can be put into use is unclear. Even after development has been completed, they will have to undergo trials with human patients and a fast-track regulatory approval process for medical devices.

One of these ventilators is being developed by the Nazareth-based startup Guide In Medical, which developed its Lifescan Medical respirator together with ImpactLabs, a Tel Aviv-based facility that helps inventors to take an idea from concept to production-ready product.

The simplified ventilator is an automatic device based on a manual resuscitator from the Danish company Ambu. The device is designed to provide medical teams with a device they can get to patients as a first step. “Within a week we succeeded in producing five working units through a massive effort and by sourcing parts from all over the country. The device is now being evaluated at Sheba Medical Center [at Tel Hashomer] and we’re working to bring it into production. We’re working with [arms manufacturers] Elbit Systems and IAI,” said ImpactLabs CEO Sefi Attias.

Assuming it gets regulatory approval from the Health Ministry, ImpactLabs says it hopes to start manufacturing 150 units within the first 10 days and then ramp up to scores of devices daily.

Meanwhile, MDSG Innovation, a startup based in Rehovot and backed by investor Marius Nacht’s aMoon venture capital fund, has halted all its ordinary activities and is dedicating itself to developing a ventilator. CEO Dr. Benny Rousso divided his 10 engineers into two development teams to work on different concepts using only locally sourced components.

Sources say the undertaking has elicited an unusual level of volunteerism. One engineer posted a Facebook call for components that could be made by 3D printing. Within an hour he received 80 responses offering help. Today the company is producing prototypes and within 2-3 weeks, subject to regulatory clearance, defense companies could be manufacturing them.

Another undertaking had its origins in the Israel Air Force’s electronics and computing unit: a simplified device, also using an Ambu manual resuscitator, operated by a motor. Anyone can manufacture it because the instructions for making it are open to the public. The device was developed by the First Robotics League, with help from Microsoft Israel’s research and development center, Ichilov Hospital and Magen David Adom.

These projects have received wide television coverage, but none of these devices can substitute for the kind of ventilator used in intensive care units. They are simple devices for use in extreme situations, which it is hoped will not emerge.

“They’ll only be used in an apocalyptic kind of situation when the choice is for a patient to continue to breathe with it or not to breathe at all,” said one source involved in the undertaking.

“Nice ideas are popping up, maybe one of them will surprise us,” said a source in the biomedical industry, who asked not to be identified. “An Ambu-based system can keep a patient alive in the early stages, but it’s not an advanced respirator capable of keeping a patient alive for long.”

Another source was more critical: “It’s all nonsense. Such devices could be suitable for soldiers with strong lungs, but they can’t serve an 84-year-old that requires two weeks of ventilation.”

A hospital ventilator doesn’t just pump air into a patient’s lungs, but is a sophisticated medical device that regulates the respiratory rate, filters the air, has a battery backup in case of a power failure, and is designed to gradually release a person from dependency on it.

Developers of these other, simple devices are aware of the complexity of ventilators and acknowledge that accelerated development might turn out to be dangerous in the end.

“You have to worry about not blowing up someone’s lungs and adjust the level to the patient’s breathing rate and intake. There are a lot of things that make a device reliable,” Attias of ImpactLabs explained. “Rapid development can be risky, but it’s all a matter of risk management. In an emergency situation, there are expedited approval processes, and something that has only passed certain tests and not all of them is the lesser of two evils.”

Reuters contributed to this report.

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