In March 2020, as Covid-19 infection rates were rising dramatically in Europe, the number of infections in many low- and medium-income countries remained low. However, it was predicted that towards the summer these rates would start to increase. This was especially worrying due to the low number of ventilators available in the developing world.
Engineering contribution
An engineering team led by Dr Tashiv Ramsander at Cambridge Aerothermal Ltd was quickly assembled at the Whittle Laboratory, and comprised people from several departments at the University of Cambridge and a range of local companies including Cambridge Aerothermal, Beko R&D, Cambridge Instrumentation and Interneuron.
Together, this multidisciplinary team was able to solve problems such as the design of a pressure relief valve, inspired by the mixing nozzles on the Rolls-Royce Trent 1000 aircraft engine. The design removed flow instabilities, resulting in a more stable operation than any commercially available valve.
The clinically driven design was developed with the help of two senior intensive care clinicians with experience of treating COVID-19. They argued that a design for developing countries needed to be more versatile than the UK government specification and the final design can operate in non-invasive, mandatory or patient-triggered ventilation modes.
For more than eight years the Whittle Laboratory has been developing a rapid technology development process for the aerospace and power generation sectors. During the pandemic this process was switched to develop a clinical grade ventilator within a week and allowing a rapid response to design changes driven by the pandemic, cost reduction and clinical demand.
The final Open Ventilator design can be manufactured mostly from standard parts, anywhere in the world that it is needed.
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Impact
The reach and impact of COVID-19 in developing countries is not yet known, but this new design - the first intensive care quality ventilator to be manufactured in Africa - could prove to be a gamechanger when it comes to a host of conditions including pneumonia, as well as COVID-19. Childhood pneumonia killed 162,000 children in Nigeria alone in 2018.
There are very few ventilators in Africa, due to their high cost, inability to operate in harsh environments and a lack of local maintenance expertise. The team realised these problems could be solved by manufacturing the equipment in Africa. The Cambridge engineering team assembled a wider manufacturing team that includes Defy and Denel Land Systems in South Africa, Beko R&D and Prodrive in the UK and Arçelik in Turkey. This team delivered the first 20 preproduction ventilators in South Africa in June.
Professor Richard Prager FREng, head of the Department of Engineering at the University of Cambridge, says: “The result is a design that will save countless lives in the developing world where ventilators are scarce and many that exist cannot achieve the quality of performance that the Open Ventilator offers. It is a scalable solution. The high-performance open-source design will enable companies across the world to make systems wherever they are needed, and at a price that is compatible with the local healthcare systems,”
Evren Albaş, CEO of Defy Appliances Ltd in South Africa, says: “With global supply chains facing unprecedented demand, South Africa's National Ventilator Project wanted to build locally, using parts and materials that are readily available in large quantities on the commercial market or can be manufactured locally in South Africa. This led to a number of significant challenges and the Defy global supply chain and the Cambridge engineering team worked together to redesign the ventilator multiple times to ensure that it only used cheap, readily available components but retained its overall flexibility of operation.”