These institutions are a crucial part of the research and development process that underpins South Africa’s life-and-death fight against the Covid-19 outbreak that, by May 7, has killed 153 people in the country and 251 446 worldwide. Athandiwe Saba looks at the research and the inventions that will assist our hospitals and medical professionals, particularly when the number of cases peak
The ventilator prototype
Ventilators have become one of the most sought after health items during this Covid-19 pandemic. Essentially this is the machine that helps patients with severe lung infections to keep breathing.
As the number of positive cases increase around the world so the need for these machines has grown. Last month the department of health told Parliament the country has 3216 ventilators. It is estimated that the country will need about 7000 ventilators when the number of cases peaks and more people with serious symptoms are admitted to hospital.
But work is afoot at higher education institutions, such as the University of the Western Cape, which is working on a ventilator prototype.
Professor Bernard Bladergroen said the team tasked with designs was asked to present a prototype by May 19. But there have been some difficulties.
“One of the main challenges is not just about designing and producing a functional prototype, but also to ensure that the entire supply chain for all 48 system components is ready for manufacturing and assembly of the first 10000 units envisaged by the end of July 2020,” he said.
Manufacturing the prototypes forms part of the National Ventilator Project led by the government, but also feeds into the need to begin developing and producing medical goods locally.
This project will not only mean the difference between life and death for patients with severe lung infections, but will also start forging strong academic-industry partnerships with both large companies and Small Medium and Micro Enterprises.
Bladergroen said: “When our students get exposed to such a partnership environment they develop a critical understanding of what is required in real life and how their theoretical knowledge can be transferred into something that society needs.”
When people get sick their immune system produces antibodies to help fight the infections. There are different kinds of antibodies. Some develop quickly as the body’s immediate response to an infection, while others are generated more slowly and in some cases can last long after the infection has cleared up. This provides the body with a measure of protection in the event that the infection returns.
Professor Landon Myer, the head of the School of Public Health and Family Medicine at the University of Cape Town, said antibodies are different for each illness and scientists are working on understanding antibody responses to the SARS-CoV-2 virus to understand how the body can successfully fight off this infection for a few reasons.
“First, one of the big questions in the fight against the Covid-19 pandemic is whether recovering from the infection leads to an antibody response that confers immunity against re-infection in the future.
“If it does, then people who have recovered from SARS-CoV-2 are not susceptible to become infected again. This is the basis of the ‘immunity passport’ concept that has been discussed in some countries, and also the ‘herd immunity’ concept that is widely discussed. But right now the data on this question are unclear, and we need to know more,” he said.
This kind of research will also assist scientists in developing vaccines.
“This is how most vaccines work — tricking the body’s immune system into generating an antibody response to a specific pathogen, without the vaccinated person truly having the infection or disease; then when the actual pathogen comes around [such as SARS-CoV-2], the body is well prepared for it,” said Myer.
But no one knows whether people who have had SARS-CoV-2 become immune to reinfection.
Understanding the antibody response to SARS-CoV-2 is vital for epidemiologists, because they will be able to assess how many individuals in the population have had the infection, and thus they can better understand the spread of the disease.
The mechanical ventilator
The ventilator system is expensive, its availability is limited and it cannot be easily moved to remote locations. Attempting to solve this problem spurred the mechanical engineering faculty at Walter Sisulu University to develop a non-invasive mechanical ventilator.
Though the project is in its early stages, Dr Sunir Hassan, the lead researcher, said his team is exploring the options of designing a mechanism to automate the working of a bag valve mask (BVM) system or a manual resuscitator.
“Subject to the availability of necessary resources and support, the automation of the BVM is possible in a matter of a couple of weeks,” said Hassan.
The BVM system that is available takes effort to manually compress the self-inflating bag and give oxygen to a patient. This project wants to automate that process to achieve mechanically assisted breathing support. This kind of ventilator is not a replacement for those used in intensive care units. Rather, it will be a lifesaver where no ventilator is available.
Hassan explains that the idea is for the bag compression to be controlled by the oscillation of an arm powered by an electric motor.
“Some of the subjects affected by the Covid-19 pandemic exhibit breathing difficulty as one of the symptoms. It may be necessary that such cases be assisted with breathing support at the discretion of a qualified medical practitioner. This system needs to be rapidly mass produced and deployed in remote areas,” he said.
Hassan added that manual resuscitators were developed many years ago, but the advancement of technology had led to the highly complicated ventilator systems that are now available in the market.
“However, the affordability of such complex systems is a matter of concern when such a system is expected to be mass deployed in remote locations.”
The Christmas Tree
Two patients, one supply of oxygen. This is closer than we thought thanks to the work of engineers from The Product Development Technology Station at the Central University of Technology in the Free State.
This team has produced an oxygen connector, commonly referred to in the hospitals as a “Christmas tree connector”, and a two-way splitter, with an added safety feature to ensure that the pipe does not dislodge from an oxygen machine.
Though South Africa has not reached its peak of infections it is known that patients who are admitted to hospital often need to be supplied with additional oxygen. When the number of infections increase, especially during the fast approaching winter season, more hospitals will not have enough oxygen points to accommodate all the patients requiring oxygen.
The connector provides oxygen from the main supply and the splitter takes the oxygen from one wall point to two patients.
The parts can be manufactured using 3D technology.
The project has been completed and they are waiting for production to begin, according to the university’s spokesperson, Daniel Maritz.
“Through these initiatives, we intend to assist government and local hospitals; with the transfer of social and technological innovations that will, in turn, help solve the current challenges the world is facing for the benefit of this region,” he said.
“The current shortage of these medical devices in our hospitals is a wake-up call for us to develop the capacity to manufacture them, which will be a huge contribution to our manufacturing capability in the Free State.”
• Evaluation of coronavirus treatment options in partnership with 45 other countries and the World Health Organisation;
• Advanced research into the consequences of HIV and tuberculosis co-infection on Covid-19 disease dynamics;
• 3-D printing of ventilator parts, protective visors and face masks;
• Students working on bed design and manufacturing;
• Advising the president on the competencies of traditional healers to help deal with the Covid-19 outbreak;
• Development of the N95 face mask; and
• Development of a cellphone application for doctors to manage Covid-19 cases in the hospital setting.