U.S. hot spots in the coronavirus pandemic are facing a shortage of ventilators, and it's not clear how or even if the need can be met.
Manufacturers are scrambling to ramp up their production as states, the federal government and countries all over the world clamor for the machines, which are needed to allow seriously ill coronavirus patients to breathe.
Without enough ventilators, health care workers are forced into agonizing decisions when rationing life-saving machines.
Illustrating the dire need, New York Gov. Andrew Cuomo (D) said Wednesday his state needs 30,000 ventilators in as soon as 14 days when the peak of the epidemic is expected to hit, yet it only has 11,000.
Louisiana Gov. John Bel Edwards (D) said Wednesday that New Orleans could run out of ventilators as soon as next week, and that he needs several thousand more.
“It’s a pretty daunting and unprecedented challenge,” said Rob Clark, chief communications officer for Medtronic, a major medical device company that makes ventilators. “We’ve got a demand that far outstrips supply.”
He said the company has increased production from the 100 ventilators a week it produces in normal times to 225 a week for ventilators used for the most seriously ill patients. It is hoping to eventually get to 500 a week.
The numbers are daunting given the potential scope of the pandemic. There are about 160,000 ventilators in the United States, according to the Society of Critical Care Medicine (SCCM), and about 60,000 of those are the most advanced kind used for the most seriously ill patients.
While there is significant uncertainty about how many will be needed, SCCM cited one estimate from an American Hospital Association presentation that found as many as 960,000 people could need ventilators, far higher than the number available.
Experts say that made it imperative to slow the spread of the virus so that infections are spaced out over time and do not spike over the capacity.
Officials are also exploring a number of ways to stretch the capacity of ventilators, such as sending them around the country from hot spot to hot spot.
Cuomo said the state is exploring ways to split ventilators to sometimes be used on two patients at once if need be.
“The number of ventilators we need is so astronomical, it’s not like they have them sitting in the warehouse,” Cuomo said at a news conference on Thursday.
Cuomo, as well as the American Hospital Association, is urging President TrumpDonald TrumpPredictions of disaster for Democrats aren't guarantees of midterm failure A review of President Biden's first year on border policy Hannity after Jan. 6 texted McEnany 'no more stolen election talk' in five-point plan for Trump MORE to use his powers under the Defense Production Act to direct companies to ramp up production. Trump has so far declined to do so, instead saying he is relying on voluntary actions from companies.
Major car companies, including Ford, General Motors and Tesla, are also stepping up to start making ventilators or help supply parts.
But the machines are complex, and the timeline for starting up production is not immediate.
Ford CEO Jim Hackett told CBS this week that the ventilators his company is making will not be available until “early June.”
“The problem is the lines that have been in place produce hundreds or thousands; we're talking about needing hundreds of thousands,” he said.
GM is working with the health care company Ventec and exploring using a GM plant in Indiana, saying it is “planning exponentially higher ventilator production as fast as possible.”
The company did not provide a timeline or a number of ventilators it could make, though.
Medtronic is also in talks with Tesla about ramping up production, though there is no timeline for when it can start the additional manufacturing.
Asked about the shortage of ventilators, Vice President Pence on Wednesday pointed to efforts to convert anesthesia machines used in surgeries to be used as ventilators.
“I actually spoke to Governor Cuomo about that today,” Pence said. “He’s in the process of surveying all of his surgical centers, as governors around the country are doing. We literally believe there’s tens of thousands of ventilators that can be converted now that the FDA (Food and Drug Administration) has given guidance.”
The administration has also sent 4,000 ventilators to New York this week. There are 16,600 ventilators in the national stockpile, the Center for Public Integrity reported Tuesday.
Dr. Jeffrey Feldman, a member of the American Society of Anesthesiologists Committee on Equipment and Facilities, said there are about 40,000 anesthesia machines in hospital operating rooms in the United States that could potentially be moved to intensive care units.
But Feldman warned those machines are not enough on their own to address the need, particularly given that they are spaced out all across the country. Cuomo said New York has a “couple of thousand” of the machines it is looking to convert.
“The short answer is it will not solve the problem," Feldman said. "It will, however, save lives,”
The strains are already starting to show.
A survey of hospitals from the health care company Premier found that 20 percent of hospitals said they are in need of more ventilators.
Illustrating the challenge of ramping up production, though, Clark, the Medtronic spokesman, said each ventilator has more than 1,700 parts and more than 100 suppliers around the globe.
He called on the federal government to play a larger role in allocating ventilators once they are made to make sure they are going to the highest need areas amid the crush in demand from all over.
Governors are also urging the Trump administration to play a larger role.
“We would really like some help, because, otherwise, you're left to just beg, borrow and steal from wherever you can get these things,” Edwards, the Louisiana governor, said on PBS Wednesday night. He said the state has requested 5,000 ventilators from the federal stockpile but has not heard back yet on the request.
“And so we are asking the federal government to have a bigger role in this,” he added. “Because I don't know that it gets sorted out in the short term any other way.”