In two weeks’ time the National Ventilator Project will distribute the first batch of non-invasive ventilators to hospitals in the country. This much cheaper technology is built locally, stimulating the local economy and creating jobs.
Professor Justin Jonas, the chief technologist at the South African Radio Astronomy Observatory (Sarao), said the first 1 000 of 20 000 machines will be rolled out on July 16.
This comes in time for the rapid rise in Covid-19 cases — on Monday there were more than 200 000. Over 10 800 cases were confirmed in one day this past week, the highest daily increase. It surpassed that of Mexico, Russia and Argentina. Those countries with a greater daily increase were the United States, Brazil and India, which have higher population sizes than South Africa.
The number of deaths also escalated, with Sunday marking the deadliest day when 175 were lives lost. More than 3 300 people in South Africa have died so far.
Jonas said: “We have been watching the [Covid19] models and it looks like that we are on track to meet the expected demand that will be coming in the next month or two. We planned our production numbers according to the epidemic models and our production timescales are almost on track. We are hoping that we are in time.”
He said that a few months ago, there were two ways of getting oxygen. “You would either be put onto a low flow, oxygen cannula, which is a low dose of oxygen, but you’re lying there and you’re awake and you know you’re all okay. And then there is the other extreme, which was full ventilation. Those are the million rand devices, which need to be operated by a specialist, and, in most cases, if you’re having invasive ventilation, you need to be sedated.”
Based on the experience in the United Kingdom, Italy and other places where Covid-19 has hit hard, “we have realised that, actually, what’s needed is an intermediate therapy; the so-called non-invasive ventilation”, Jonas said.
Two types of non-invasive ventilators being manufactured locally are the Continuous Positive Airway Pressure (CPAP) and High-Flow Nasal Oxygen (HFNO) devices.
The CPAP has a mask or hood and a patient is provided with a small “overpressure” of air to ensure that air sacs in the lungs remain inflated and oxygen is transferred efficiently to the blood. The hood or mask prevents the virus-laden air exhaled by the patient from infecting hospital staff and other patients. The HFNO provides the required slight overpressure and raised oxygen concentration, and the air is supplied to the patient through a high-flow cannula inserted in the nostrils. The use of the non-invasive ventilators are being ramped up to be the first port of call when Covid-19 patients are battling to breathe.
Jonas said these machines, at R10 000 a unit, are much cheaper than the current ventilators and because the machines are being manufactured locally, hundreds of jobs will be created.
With the production line now in full gear after the Solidarity Fund confirmed about R150-million for the manufacturing of the non-invasive ventilators, 1 000 units will be produced every week.
Out of the 95 companies that responded to the call for requests for information, Sarao chose six that provided prototypes. The companies are not ventilator manufacturers and range from car and diving manufacturers to the Council for Scientific and Industrial Research.
Once the rollout begins in less than two weeks, Jonas said that the department of health’s hospital readiness team will identify the hospitals where these devices will be sent, based on where there is a need, the hotspots and in the provinces hardest hit by the virus.
But ensuring that the life-saving machines are ready for the peak in cases has not been a simple process. The experience of Sarao, which is best known for its world-renowned work in developing complex systems for the MeerKAT radio telescope — a precursor to the Square Kilometre Array — has been vital.
Jonas said the key to running such a technical procurement process for a project such as the National Ventilator Project was in blocking out the noise that comes with thousands of different opinions published every day.
“Just about every university had ideas about how to build ventilators. Something which was quite common to both the radio astronomy and the ventilator side is having the ability to get rid of noise in the system.
“So when we started building Meerkat, there were a lot of opinions. Everybody in the world had their opinion about what we needed to do and a very important reason for our success with Meerkat is that we sifted through those opinions to find the ones that were appropriate. It turns out it was the same thing in the ventilator project with the advent of Covid.”