New York wants the nation's breathing machines, but supply is low
New York's scramble to find enough breathing machines to treat its rapidly expanding legion of coronavirus patients illustrates a problem vexing hospitals and governments worldwide.
In his nationally televised briefings this week, New York Gov. Andrew Cuomo has made desperate pleas to other states and the federal government to send breathing machines that the state will return when demand slows down.
Cuomo's plea has proven to be a tough sell. For one, the devices are already in short supply nationally. And medical professionals and officials in other states are expecting to be inundated with coronavirus cases themselves relatively soon. They aren't easy to quickly manufacture either, despite efforts underway by several major companies.
The machines also known as ventilators are necessary for severely ill patients, and there aren't enough to meet the projected needs as the virus spreads.
Compounding the problem is the fact that doctors say coronavirus patients often need ventilators for weeks, if not longer — slowing the hand-off from one patient to the next. It's the same problem that China and Italy have also faced with no easy solution.
Cuomo said this week his state has 4,000 ventilators and has purchased another 7,000. The U.S. government has pledged to send New York another 4,400 ventilators. That's still far short of the 30,000 ventilators that Cuomo said the state will need if the crisis reaches its expected breaking point in New York, which has emerged as a virus hotspot.
In the meantime, New York is converting a couple thousand anesthesia machines they have into makeshift ventilators and adding a second set of tubes to some ventilators so each one can be used for a two patients.
“It's not ideal, but we believe it's workable,” Cuomo said.
The American Society of Anesthesiologists disagreed, saying in a statement that sharing a breathing machine for two people is dangerous and could prevent both patients from benefiting because “ventilation needs to be individually tailored and monitored continuously.” The group did back New York's use of anesthesia machines.
At present, U.S. hospitals have roughly 65,000 ventilators that are fully capable of treating severe coronavirus patients. But they could cobble together about 170,000, including some simpler versions that won't work in all cases, said Dr. Lewis Rubinson, chief medical officer at Morristown Medical Center in New Jersey and lead author of a 2010 medical journal article on the matter.
In a February presentation for other medical professionals, Dr. James Lawler, an associate professor and infectious disease specialist at the University of Nebraska Medical Center, estimated that 960,000 people in the U.S. will need to be on ventilators.
Rubinson said it’s unlikely the U.S. would need that many ventilators at the same time, estimating it will need more like 300,000 fairly quickly. If social distancing works, people will catch the virus at different times, allowing hospitals to use ventilators multiple times.
“This is the whole reason why everyone talks about flattening the curve,” he said.
He estimates there are seven or eight ventilator makers in the world, and together they can crank out several thousand per month, far short of global demand.
In the most severe cases, the coronavirus damages healthy tissue in the lungs, making it hard for them to deliver oxygen to the blood. Pneumonia can develop, along with a more severe and potentially deadly condition called acute respiratory distress syndrome, which can damage other organs.