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Covid-19: Meeting the challenges through Engineering
I was president of the IET for 2016-17, and have been asked by government to gather practical and innovative ideas from our Engineering communities. So, please enter any ideas you might have in this thread that might help address and mitigate the Covid-19 crisis. Ideas might include digital tracking / monitoring through therapy equipment and beyond. Even ideas outside your usual expertise domain will be welcome. Now’s the time for Engineering to show we can change the world!
70 Replies
A group of data experts are offering their help over on LinkedIn.
https://www.linkedin.com/posts/marc-hilbert-engineering_community-covid19-coronavirus-activity-6646031162336690177-Uq-r/

Is there anyway of unlocking this thread so it's visible without an IET login? Would help it gain more traction,
Andy Millar
1730 Posts
If the PEIs and EC could facilitate links between suppliers of medical equipment who are unable to meet demand, and manufacturers with strong experience in safety critical / mission critical equipment who could subcontract supply them then that would be a great service.

This will be challenging for manufacturers of medical equipment who are not set up to manage third party manufacturing in terms of regulatory compliance, again the PEIs and EC could facilitate linking such manufacturers with appropriate training / consultancy organisations.

In the railway signalling industry I know of cases where we've used manufacturers of medical equipment as sub suppliers, on the basis that they have experience in the control of manufacture of life critical equipment. So it ought to be able to work the other way around given some determination to make it work. The challenge is helping the right people find each other.

Thanks,

Andy
i think Andy's hit the nail on the head here.


Andy Millar:
If the PEIs and EC could facilitate links between suppliers of medical equipment who are unable to meet demand, and manufacturers with strong experience in safety critical / mission critical equipment who could subcontract supply them then that would be a great service.

.... The challenge is helping the right people find each other

I had the same thought earlier after seeing this update from KTN: https://ktn-uk.co.uk/news/covid-19-response-from-ktn stating

...we’ll be working with Innovate UK and other organisations to try and connect those of The government is looking for businesses who can support in the supply of ventilators and ventilator components across the UKyou able to respond or adapt to the UK’s new challenges. From rapid scaling up of the manufacture of ventilators (if you can help, click here for details of how to apply) and other medical supplies, to supporting the wider population and economy to adapt to face challenging new situations.

The linked government web page states:

The government is looking for businesses who can support in the supply of ventilators and ventilator components across the UK...

but there's no information to indicate what constitutes "ventilator components". I can see two problems with this: 1/ companies won't know if they have something useful, 2/ it will lead to unsuitable companies offering help, thus wasting time triaging applications.
The Manufacturer also has a blog page claiming to have "all the information you need", but it merely restates what's on the government's page.
The IET, other professional institutions and their respective publication channels could play an important role via our expert panels and wider networks collating and reviewing information to make sure it is useful from a technical perspective and keeping it up to date.
Moshe W
505 Posts
https://www.yahoo.com/news/coronavirus-immunity-test-090033681.html
 

UK ‘very close to breakthrough coronavirus immunity test’

The UK is “very close” to developing an antibodies test that will determine whether someone has had coronavirus and is now immune, according to a former government adviser.

Professor Sir Mark Walport said that the test, that would show whether someone has already had the virus and is able to safely interact with those who are infected, “has been validated’.

Speaking on ITV’s Peston show on Wednesday, Prof Walport said: “This may seem slow now but compared to the rate at which you have been able to develop a test like this for a few years, this is going at the speed at light.



 
Manufacturing companies with rapid prototyping and 3D printing capabilities will be able to make parts for ventilators. All they will need is a compatible 3D cad file of the components needed. The key to releasing the manufacturing potential to to release the design data electronically.

The next step is to coordinate suppliers and the supply chain to assembly facilities. As I am also a member of the Chartered Institute of Logistics and Transport, I know they are directly coordinating help for critical supply chains by way of volunteers, including retired members, so they could be enlisted to do that part.

The final step is to identify the assembly facilities, these will be companies making low to medium volume small products (similar size, with agile production facilities - so not the likes of JCB
In the short term, focusing on the Ventilators challenge, the common thread among most of the responses so far is about making the right information available to the widest range of relevant, supply-chain audiences in an intelligent way, in order to promote valuable action rather than sustain uncertainty.  This feels right, and something which intelligent digitalisation might accelerate.  For example:
  • A managed, open-source styled, design authority.
  • Coordinated information on manufacture, logistics, assembly, testing, shipping, support, recycling?
  • Is blockchain technology too challenging in the required timeframes, or can it build confidence rapidly (for this and future manufacturing effort)?
In other words, make it smarter?
 
Longer term, it is presumably too early to predict what the impact of COVID-19 will be, which will only become clearer once we can gauge steady state responses across the population as we strive to return to 'normal' economic activity.  In this context, engineering seems well placed to contribute to mapping out how the systems and enterprise architecture of modern life can or will need to adjust if responding to infections needs to be sustained far into the future, with containment permanently in mind.  Relevant topics might include:
  • Transportation
  • Testing
  • Localised community response equipment and procedures
  • Social distancing 'monitoring' - at a simple level perhaps around occupancy density in buildings.
And maybe COVID-19 is the required nudge for transformation of our built environment / urban areas / high streets in the 21st Century:
  • A proportion of office and retail space migrating to environmentally-aware 'living' space.
  • Cleaner, lower-cost transportation solutions that capitalise on the reduced demand for commute journeys that the current encouraged / enforced remote working might signpost.
  • The often touted, widespread, data connectivity.

Ian MacGillivray:
... focusing on the Ventilators challenge...

  • A managed, open-source styled, design authority.
There are a number of open source initiatives, all with worthy aims, but I'm not sure how you would recognise one or the other as a design authority?
https://opensourceventilator.ie
https://opensource.com/article/20/3/open-hardware-covid19

Ian MacGillivray:

...
  • Coordinated information on manufacture, logistics, assembly, testing, shipping, support, recycling
I think this is what's missing, certainly I can't find it easily using Google searches. Even a simple list of components required mapped to the skills/facilities required and the companies authorised to assemble them would be a good start.
I am interested in the measurement / sensing/ testing challenges in this area. It is important that we ensure that the data produced by new measurement systems of all kinds can be used with confidence in decision making and will be reliably available. This is not easy, especially when working under pressure.  I chair the UK Sensing Innovation Leadership Council which is championing collaboration between five UK Centres with specialist expertise in sensing to facilitate the sensing innovation lifecycle to deliver just this confidence and security of supply.  We were discussing this week how best to gather the requirements and engage positively without getting in the way of the teams working hard on this issue.  If you could facilitate that Jeremy, it would be much appreciated.

ps. We also have the IET hosted International Measurement Community to provide a greater reach in the search for solutions if needed.
https://www.hcpc-uk.org/covid-19/covid-19-our-approach-to-temporary-registration/
i wonder if the front line biomedical engineering and clinical engineering could use non*-registered help in preparing or  simply returning equipment through  standard existing system of work back to clinical itu ? 

maybe hospital physics and engineering could help? If not urgently needed in their registered disciplines. 
 
Orangepeel
2 Posts
How can we harness the power of mobile phone technology. One suggestion is placing a mobile phone on the lower chest/stomach to measure breathing rate. I know that mobile phones can be used as a spirit level so they should be able to detect the rise and fall. This might be useful for when doctors are doing remote appointments with patients. If anyone has the skill set to build such an application I would be interested to see it. Also collectively I would ask if anyone has seen anything online where mobile phones have been used for medical diagnostic.
 
KSharpe
8 Posts
Hi All,

We are being slightly hampered by a power outage at MFH today meaning the server is down for everyone working remotely - but I have been making headway into collating a list of individuals who are willing to offer their time and expertise on this subject. Along with RAEng we are putting out the message below and coordinating where best to direct people to. The text below is being designed into a flyer as we speak so as soon as I have access to it I will circulate. In the meantime if you would like to be included on the list could you please let me know on this forum, along with your area of expertise?

Many thanks,

Kate-Zillah

Kate-Zillah Sharpe
Devolved Nations Lead
----------------

Can You Help to Engineer a Solution to COVID-19?

An increased demand for medical supplies and equipment provides an opportunity for the engineering profession and manufacturing sector to contribute to the fight against COVID-19.
More than 60 companies have already responded to the Prime Minister’s call for 3D-printing capabilities to tackle the shortage of ventilators, but the engineering community is ideally placed to do more.
If your company has the capability to divert production to components that could be used in ventilators or has the following skills of design/specification; rapid prototyping; contract/product assembly; certification/regulation/testing; logistics or medical training please register via the Government website at: https://ventilator.herokuapp.com/

If you are an Engineer wondering how you can support the fight against COVID-19 on an individual basis - we can help! Please email your contact details and area of expertise to SEP@theiet.org and we will ensure that your interest is passed on to the relevant organisation.
 
BEIS has published a minimum specification for ventilators today. It still doesn't say what components are required and by whom, but it is certainly valuable if considering starting manufacture:

https://www.gov.uk/government/publications/coronavirus-covid-19-ventilator-supply-specification/rapidly-manufactured-ventilator-system-specification
(Current chair of the IET healthcare technologies network here.) It seems to me there are 3 broad themes here:
  1. On ventilator design/manufacturing, and 3D printing of parts and equipment. Clearly lots can, and is, being done here but the regulatory challenges are very significant and (personally I think there is a long way to go on the regulatory side). Clearly there is also a need for leadership in this space, and coordinating projects. We don't need 100 different open source ventilator designs, that effort could be better spent on refining and testing a few. (>1 is needed for redundancy and to have separate supply chains.)
  2. Mobile phone based tracking of people, movement and cases; easier reporting and similar. To my understanding this has worked very well in some Asian countries, but raises significant questions on privacy and what people will accept. (AI modelling of the spread and likely infection routes, prediction of infection risk on a per-person/site basis, likely comes in here too, although is likely well covered by the epidemiologists.)
  3. Support for Medical Physics. The shortage of engineers in the NHS is known already (~10,000 IIRC but don't quote me), and the IET/IPEM/IMechE already had on the radar from before this a campaign to highlight this shortage. It's only ever the shortage of nurses that is mentioned in the media. To me, this is both the least mentioned in the media and elsewhere (it is in the thread already) and is likely the easiest to actually do. In principle honorary contracts and emergency basic training on 1/2 tasks can be done very quickly. Engineers on the ground are going to be critical in terms of actually keeping the infrastructure going. 
Susan Jones
14 Posts
Concept - Portable respiratory support for emergency situations – Can SCUBA diving kit be easily adapted to provide it?
This is an idea we've been looking at with and Engineer / Scuba Diver. I appreciate that it may not be the first port of call but we see it is as a possible solution should care and mass recovery be moved to non-hospital situations, possibly without impacting existing supply chains.

Dear Colleague,

I am looking to see if you, or someone you know may have any ideas, feedback, or support on the attached idea for emergency respiratory support systems.
Covid-19 is causing unprecedented need for ventilation, even with increased manufacture will demand be met?  If hospitals are at capacity improvised sites may need to be used, without plumbed oxygen. While we may not be at the point to need to think quite this laterally –we may yet reach it. There are 3 levels of respiratory support solution discussed, and while they may not currently be suitable for a hospital, they may be ideas which could prove useful in extreme or mass recovery situations (e.g. use of Stadiums to house patients). It should also not impact existing supply lines. If not for this virus - then the next where solutions that could call in civilian equipment & hold a library of designs for manufacture could prove vital.
Please take a moment to review the attached summary and supporting information, and respond with your thoughts. Please feel free to share it, as the aim here is to think of possible solutions, and work out if they could feasibly work, then develop them - which is why it’s being shared at such an early thought stage. In the hope that it may be useful to develop – or may trigger some ideas in others which it can help.
Thank you for your time, and please stay safe.

Kind Regards,
Susan Jones MEng CEng MIET MWES

Jeremy Watson:
I was president of the IET for 2016-17, and have been asked by government to gather practical and innovative ideas from our Engineering communities. So, please enter any ideas you might have in this thread that might help address and mitigate the Covid-19 crisis. Ideas might include digital tracking / monitoring through therapy equipment and beyond. Even ideas outside your usual expertise domain will be welcome. Now’s the time for Engineering to show we can change the world!

Can IET offer a mechanism to match companies looking for additional engineering people at this time - i.e. companies stretched making /servicing ventilators and other medical kit? Appreciate the special skills / training required for medical standards; nonetheless I bet there could be loads of retired / displaced engineers who could prettry quickly come up the learning curve - for design, testing, manufacturing, documentation, sourcing, etc.
Hello,
 Within the last week I saw a news item where the person being interviewed said that ways had to be found to source the electronics for ventilators. I presume he was referring to control systems. The thought  that crossed my mind was that there must be a large stock of retired or superseded mobile phones in drawers around the country. After all people are forever being encouraged to upgrade. Working on the belief that a smart phone is really a computer with a fairly powerful processor. If a call is put out for retired mobile phones to be donated to be used a control systems for ventilators, would this solve the problem? I have not thought about whether the android or IOS operating systems should be retained and the control system for the ventilator should be a single app on the smart phone.
Hep
2 Posts
I have no medical expertise, but according to several news articles Covid-19 starts off as an upper respiratory infection, before later becoming a lower respiratory infection, which is when it requires ventilators and ICU care.

Other lower respiratory infections are caused by "inhalation of aerosolised material", "aspiration of upper airway flora" or by "hematogenous seeding".

So would it be possible to prevent the upper respiratory infection from becoming the more dangerous lower respiratory infection, by sealing recently diagnosed peoples Tracheas shut?
This would use an expanding seal, which has a tube through the middle to allow air flow to the lungs from a clean air source, bypassing the upper respiratory system.

The expanding seal and tube would be similar, in concept, to the plastic lid and straw that you get with a McDonalds cup.

If this works then it should reduce the number of Covid-19 cases that become the dangerous version, which requires ventilator support.
No need to seal, you would simply intubate the patient. Pass a plastic tube into the lung and pump oxygen in, this is standard practice  
Hep
2 Posts
Forgive me, I'm new to this subject.

Can a patient be intubated early on, before they need to be placed on a ventilator? i.e. with the patient breathing manually through the tube, not using a ventilator.

It seems the tubes have expanding cuffs, which would act as a seal to block the upper respiratory virus from reaching the lower respiratory system. (I'm assuming that would work, to keep the virus in the upper respiratory system only)
Jeremy,

Thank you for opening up this forum topic.  I'm a VC investor with a number of companies that want to make a difference.

One company delivers data visualizations that marry with predictive analytics.  It helps users to drill down into data better to gain hindsight, insight and foresight into what happened and what might happen.

I'm not advertising their name here, but I'd be delighted to effect an introduction.   They are very keen to make a difference in whatever way they can.

We believe it may be helpful if the government or local authorities want to set up war rooms to better understand and manage a range of public health initiatives - including distribution of the disease, antibody results, medical equipment, vaccines etc - over the course of the pandemic.

Here is a simple example visualisation but the software is of course very flexible and interactive.

ecc77ab7fdd16fb557448c1e5716a4db-huge-im
 
MarkN
3 Posts
Many of us who have manufacturing and design capability are working outside the medical industry, to vastly different EU Directives and standards. If we have some cross-over capability, how do we quickly get to find out what needs adapting in practise to safely meet the standards required?
To go through a new set of audits etc with a different Notified Body would likely take too long, even if practical right now.
The Institute of Physics and Engineering in Medicine (IPEM) posted a link (23 March 2020) to the UK Government's Requirement Specification for Ventilators
https://twitter.com/ipemnews/status/1242029088266690568 

"Guidance

Specification for ventilators to be used in UK hospitals during the coronavirus (COVID-19) outbreak"

https://www.gov.uk/government/publications/specification-for-ventilators-to-be-used-in-uk-hospitals-during-the-coronavirus-covid-19-outbreak
This specification is a crucial starting point.
 

Susan Jones:
Concept - Portable respiratory support for emergency situations – Can SCUBA diving kit be easily adapted to provide it?
...

They have been trialling something along these lines successfully in Italy. See https://www.isinnova.it/easy-covid19-eng/
Susan Jones
14 Posts
Thank you a few people have sent me this link about using dive kit - the example in teh link is more about the mask, while we're looking at the oxygen and its container. Nothing saying they couldn';t be combined. There are interesting points which included
* Open to a different approach
* Their approach to recognising it's not approved and who can use
* Their approach to making it available and the design of the parts.
* Recognising that emergency calls for change of protocols.

Thanks for the feedback please keep sharing and discussing.
 

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