The flip-side of globalization is there are unlikely to be any more large-scale conventional or NBC wars (only proxy, cyber and economic wars) because of extreme economic interdependency.
- For products containing electronics: short of the electrical components themselves, there is a healthy amount of US electronics+mechanical manufacturing, but it's more geared for lower-volume higher-margin type stuff (think for energy / agriculture / etc.)
- IIRC having spoken to someone at Jabil a few years ago, vague recollection of being told that the US is the largest manufacturer of high volume plastic goods (as well as other products using automated processes). Not so much enclosures for consumer electronics, but rather stuff like shampoo bottles, and that sort of tooling is done here in the US.
- Just keep in mind that manufacturing has a broader scope than what it seems you're implying. Not all manufactured goods involve electronics or injection molding.
And lots of the tooling for this high volume plastic bottles, lids, etc is made in Germany. Consensus is Germans make best tools for this volume (100’s of millions of parts per year)
Yeah, here's one: protectionist tariffs. I once looked into what it would cost to make a pair of pants in the US instead of China. The difference isn't that large; something like an extra dollar goes to shareholders instead of workers. You can see it in the actual list prices of jeans made in China versus USA. They're .... about the same. This same calculation is done in lots of different places: MBA types want that extra dollar to go to shareholders. Well, if they're not allowed to do so, everything works just fine.
So basically work smarter than harder or cheaper. The way to compete with the Chinese is through better ideas.
The idea that automation means people can't or don't work is a fallicy.
When Woodrow Wilson talked about making the world safe for democracy, the flip side of that is that democracy requires safety and security. We liberal democratic nations are capable of playing nice with one another. We will have normal rivalries. But China cannot play nice.
We need to transition away from trade with China, under MFN status.
After this pandemics is over I think we'll know better what "no other solutions that wouldn't sink the US economy" actually means. I suspect that behind the typical talk about sinking "the US economy" is not what it appears to be, especially if one talks about "capitalism" versus others.
Namely, since a some decades ago both China and Russia are technically capitalistic societies. Therefore I interpret the statements only as "will our empire continue to be the empire." The empire is kept primarily with the arms, and they aren't going away, whatever changes.
Why are we trying to reinvent the wheel. We should be finding simple, battle proven designs and throwing the manufacturing efficiency machine at them. Developing new products on this timeline is exceedingly naive.
But they inccessantly write about 3D printing for more buzzword invoked clicks.
I don't know enough about the manufacturing process to say if it's faster to spin up a new simpler design from scratch, or expand existing lines. But it's worth evaluating.
Half the world's population lives on an income of less than $300 usd/month. Who will make ventilators for them?
Consider Egypt, 100m people living on a thin strip of land by the Nile, the Philippines, rural Ukraine, India. A yearly salary may not cover a Chinese ventilator."
We are testing our centrifugal compressor for pressure/flow tomorrow, driven by $5 quadcopter motor.
Any turbomachinary engineers in the house? :-)
The goal is to design a low-cost, simple, easy-to-use and easy-to-build ventilator that can serve the COVID patients, in an emergency timeframe. It should be easy to build locally, its functionality must be easy to verify, and must meet the design requirements.
Manufacturers have the world by the balls in a crisis like this, and throwing money at them as they increase their costs is not something a government can do forever.
I'm glad scientists are taking over the means of production here.
I am appalled to see tv news showing people making home 3d printed masks for use in local hospitals out of PLA and cut up HEPA filters. This is as effective as holding a tissue paper to your face, plus your breath the glass fibers from the HEPA filter you cut up and the bacteria that is trapped in the PLA layers.
There is no shortage of toilet paper, there's warehouses full of them (https://youtu.be/wA4KS546rZo), it's just a matter of getting them to the shops. Nobody's out there making a better version of toilet paper.
However, in this particular case we have a paper with 26 authors, mostly physicists and engineers, humbly asking for feedback from the scientific and medical community. Not a group of people arrogantly thinking they have The Solution to our problems.
So reevaluating the design might be out of necessity to work with what is available in terms of materials, skills and equipment.
That’s just my theory, I’ve no evidence to support that.
The researchers believe that these could be quickly slapped together in substantial quantities in many parts of the world.
Perhaps both paths will prove necessary and valued?
GP's point was why do we need new designs when company X already has a proven design. Well I can't access that design; it isn't published. My factory has cleanrooms, CNC tools, presses, waterjet cutters, testing equipment, and more, and a lot of flexibility and is presently running well below capacity. But I can't even assess whether that tooling is sufficient to make that design.
The open source designs do at least solve this problem.
Do you have injection molding tools and mold making expertise?
The point is that we have thousands of these 3d printing machines distributed around the world, with a good amount of source material. At this point, we can afford to brute-force our way to producing hundreds of thousands of items, don't we?
This is not going to solve all our manufacturing needs, not even by a long shot, but it seems it could fill very specific critical and unexpected needs.
By all means, use 3D printing at hospital level to get things made that's needed. A parts of the face shield (such as the head band) can be locally manufacturered using 3d printers.
But it is boggling to me that the media keeps wanting to get 3D printing buzzword clicks than actually asking manufacturing engineers.
If every household or building
had one, the parts could be crowdsourced from every machine that could make them.
The difference between where 3D printing and injection molding technology is right now is that 3D printers have scaled down in size and cost to the point of consumers being regular folks.
As for right now, 3D printing can help but it won’t be the savior of mankind.
Apparently thats not true:
"I really don't get this DIY respirator hype.
I get the idea, but why does everyone seem to reinvent the wheel using their "fancy" 3D printers and arduinos?!
This is 70s 80s tec, all patents expired. There are literally pages of exploded view drawings: http://www.frankshospitalworkshop.com/equipment/ventilators_...
A whole lot of people are going to get a simple introduction into why some things are expensive.
Patents and service manuals are most of what you need to start reinventing the wheel. They're what you hand your R&D staff as you start reverse-engineering something, learning along the way all the little tricks that make it harder than it looks. They're not what you hand your machine shop and start producing.
because a cheaper, ubiquitous, and open design could have lead to us having more than enough ventilators at this point in time had we been considering the need earlier. An open design that was prevalent now could allow manufacturers to spin up production without the fear of IP legal repercussions.
Why are people interested in designing such things now? Because the problem has been elucidated and maybe the shortage can be prevented next time.
Something majorly bad for fast production : capitalism-oriented-design(read: profit) high tech machines with heavily unique firmwares and lots of high-cost IP in use inside the mechanism.
It uses fluid dynamics rather than a sensor system, simplifying manufacture at scale.
- Consider the failure-modes of the device. (If inspiration pressure set screw is not mechanically fixed and fails open, you will irrevocably damage the individuals lungs and likely kill them. Similarly, exhalation pressure drop could collapse alveoli and suffocate them). Could also put pressure relief/vacuum break valves on the device, but hard to do accurately and cheaply at small pressure ranges.
- Fail indication. Need indicators in the field to understand whether device is functioning as designed or not. Particularly with high PEEP settings, visual indications of respiration are pretty much non-existent and no way to tell if pressures are causing barotrauma.
- You may want to include guidelines for proper air supply intended for this device as well. Modern ventilation systems have fail-over and redundancy for all critical aspects (electricity, oxygen source, pressure regulation, etc) for respiration. This may be done at the device (taking feeds from multiple continuous supplies) or in the oxygen supply system (multiple compressors connected to a header system, high volume compressed oxygen tank etc).
Seems like a worthwhile risk to take on a patient that is going to die within minutes of going off a ventilator that is needed for a patient with a better chance of survival.
Unfortunately, that's a common scenario playing out in Italy right now.
Is PIP adjustable?
Is PEEP adjustable?
Is Tidal Volume adjustable?
What sort of pressure regulation is required at the input?
Asking because a friend at one of the Uni's here in Melbourne, Australia is part of the team that looks after the Uni CNC machines (5 axis) and their 3D printers.
The design in the twitter above looks like pretty much exactly what their 5-axis CNC machines can do. And they were already discussing potentially doing something with the 3d printers.
So, might be a good fit to put them in contact with you? :)
I can say for sure, the solenoid valves specified here in this paper are too small to work well enough. This problem has slowed our progress down by a week.
If anyone has questions please ask them here.
We chose parts you can get from Home Depot and Amazon/Ebay only, except for the PCB, which you will be able to make with hand-soldered components.
Also: make sure you choose a design where it is not possible to over-pressure the lungs. Even so much as 1.5PSI can damage them permanently. As well, the design must never allow the pressure to drop below about 300 pascals (above STP), or the patient will eventually suffocate due to alveoli collapsing.
It sounds like this one is using an ESP32 microcontroller (described as 32 bit, arduino-compatible, WiFi+Bluetooth ). What microcontroller are you using?
Is your design open source?
Can you expand on the solenoid difficulties you experienced?
We will be using an Arduino uno because they are so easily available, no wifi or bluetooth, last thing I'd want people to deal with is bluetooth bugs in a situation like this...
The solenoids I have tried (many) are too restrictive for air flow, and after some minutes I felt suffocated when using them. Most solenoid valves don't have orfices greater than 2.5mm, and we found even 4mm was not enough.
It will be open source, yes.
It might not be enough to bother you or I, but if someone is respiratory compromised to the point they are on a vent, they really need medical grade oxygen.
I have tested our design with supplemental air from a Phillips EverFlo and it still works well.
although there are others MCU's with even better availability (e.g. the SAMD21, which also has plenty of dev boards and it seems like Microchip has extensive stock on hand, for example https://www.microchipdirect.com/product/ATSAMD21J17A-MUT?pro... ). One can take any of the devboards a a reference design.
With variations on it (but same problem) with each page load.
Capture fail, or joke website?
Edit: After clicking "Block notifications" about 10 times, and being redirected to a different "redfundchicken" address each time, I finally end on skyprize22.live, an obvious scam site.
I believe adammunich.com redirects to a scam site.
We can reprogram our lines to make any type of PCBs and assemble them (we have inventory of most standard components).
All: if you see a banned user that shouldn't be banned, please let us know at email@example.com. We try not to get this wrong, but we (and/or software) sometimes do. It's a big contribution to your fellow users to let us know so we can fix it.
But I'd guess that 99% of the effort required to create a ventilator is not the design of the mechanism pumping air into lungs but guaranteeing it is reliable, maintainable, easy to use, is hygienic and can be cleaned safely, obeys regulations and manufactured.
It doesn't matter if there's a crisis on or not - hospitals will get sued if your Heath Robinson style ventilator breaks and kills a person, however sick that person is.
In light of ventilator shortages, I encourage you to look up non invasive airway clearance methods. These are medically recommended for people with serious, chronic lung issues. They've been around a long time. I'm not seeing them get much attention compared to the ventilators.
I applaud the initiative, but even for something macgyvered together in a hurry, I think a more rigorous approach is needed before deploying something like this en-mass.
Those shelves, I'm afraid, are going to be empty. Manufacturing is optimized for "just-in-time" production, not "just-in-case" stockpiling. Perhaps I'm the wrong person to consult, but I wouldn't know how to procure ample amounts of "Medical Care Flow Meters" or "Spirometers".
Somebody figure out a way to solve the problem with plastic bags, PET bottles, outdated smartphones and old PC fans. I've got a strategic stockpile of those to give away, just like every other nerd on the planet.
No electronics - huge plus for scalability
1-to-N - one ventilator can serve a hundred or more intubated patients - again a massive boon to scalability and dovetails nicely with the armies approach to retrofit empty hotel rooms with negative pressure kit.
PEEP and moisture control - this was in the version 2 model
Love the groundswell of new ideas here. Traditional designs were made for individual patients with and a broken procurement process - these new versions can address a large volume of patients in a distressed supply chain.
That's... scary. I seem to remember that each ventilator needs to be tuned to a patient's pulmonary capacity. Otherwise, you risk either not providing enough air or exploding the lungs.
Right I'm making an effort to acquire DIY to build a ventilator that squeezes an AMBU bag. I found it incredible easy to make and scale, total cost around 300 euros/324 USD.
But this design is missing some fundamental things which makes me wonder if they've really understood the requirement.
The first is that there is no flow monitoring so no way to adjust tidal volume. Since this is the most important parameter to adjust and control in treating ARDS, that lack is worrying.
Their taxonomy of ventilatory modes is wrong.
All the diagrams and text refer to a non-invasive ventilation using a mask but that is not where the greatest shortage is. There are a lot of BIPAP and CPAP machines which can be used for that sort of thing.
There is a consistent reference to a PEEP of 5cm which is too low for the desired use case. I know the design is adjustable but the fact that this is not acknowledged is again a sign that they may not have understood what is needed.
There is no blending arrangement for running on an O2/air mix. I don't understand why they did not add that.
I don't object to this stuff, it's all a bit of fun, but the ventilator shortage is going to be fixed if it is by combining the resources of idled factories with mass production capabilities with the knowledge of ventilator manufacturers.
When we did this in WWII, we did not ask Ford and GM, "Could you build us a bomber, please?". They collaborated with plane manufacturers to convert their factories to produce existing designs.
If I was in charge of this effort, here is what I would do:
First, in the near terms, make sure that existing manufacturers have what they need to boost their own production.
-People who work in aerospace (or F1 racing, of a few other things) for instance have experience in hand assembly of critical components following procedures precisely. This is a better resource to draw on than other manufacturing workers such as auto workers. You could bulk out the assembly teams in existing manufacturers with these people.
-What parts will they soon run out of? If their supply chain can't deliver, what alternatives can be rapidly qualified for use? Valves and sensors could be sourced from non-medical-grade manufacturers, preferably aviation or other safety critical because again - they live in a similar world as far as traceability and quality goes.
In parallel you work on a basic design that meets the requirements of treating ARDS. You do that using the engineers who design ventilators anyway, together with supply chain and manufacturing experts from your other industries so that you design something that the supply chain can either produce or more likely they can produce sub-assemblies and/or parts.
These are life critical systems designed with serious fault tolerance in mind. Home Depot parts, randomly sourced solenoids, valves and fucking Arduino's? Has everyone gone insane?
Here, go read the Wikipedia page on ventilators:
Let me highlight a few sections. Like this one:
"Because failure may result in death, mechanical ventilation systems are classified as life-critical systems, and precautions must be taken to ensure that they are highly reliable, including their power-supply."
"Mechanical ventilators are therefore carefully designed so that no single point of failure can endanger the patient. They may have manual backup mechanisms to enable hand-driven respiration in the absence of power (such as the mechanical ventilator integrated into an anaesthetic machine). They may also have safety valves, which open to atmosphere in the absence of power to act as an anti-suffocation valve for spontaneous breathing of the patient. Some systems are also equipped with compressed-gas tanks, air compressors or backup batteries to provide ventilation in case of power failure or defective gas supplies, and methods to operate or call for help if their mechanisms or software fail."
I mean, seriously, read that again right now. If you have zero experience in fault-tolerant design of electronics, mechanics, pneumatic, hydraulic and software systems, please recognize the dangers of the Dunning-Kruger effect and stop.
If that wasn't enough, there's this:
"In Canada and the United States, respiratory therapists are responsible for tuning these settings, while biomedical technologists are responsible for the maintenance. In the United Kingdom and Europe the management of the patient's interaction with the ventilator is done by critical care nurses."
In case the point isn't obvious, what this means is that certified professionals have to operate these devices. They are not going to get anywhere close to a pile of parts from Home Depot and the local auto repair shop. They are trained to operate reasonably standardized equipment and expect form, function and reliability that comes with time-tested, certified and well proven professionally manufactured equipment.
Want to build something to help? Maybe figure out how to make hospital beds. My guess is there's far less likelihood of killing people with a frame and a matress than with a pile of Home Depot parts and an Arduino pretending to be a ventilator.
Why are these posts even permitted on HN? This is unproductive dangerous quackery. Nobody is going to invent anything useful. Go help existing companies stamp out more units of their designs. I'm sure they can use the help.
Let me give you an idea of just how stupid it is for a bunch of guys pulling parts out of Home Depot to decide they are going to make a ventilator for mass manufacturing:
Elon Musk decided to make ventilators at SpaceX. I've done work there. I know exactly what capabilities exist at Hawthorne. Let's just say that, compared to Home Depot, it's a universe apart.
Did he go off to invent them from scratch? No, they had high level engineering meetings with Medtronic. His opinion is summarized in one comment and one action. First, among other things, he said, "Impressive team". Next, he bought 1,200 ventilators from China and brought them into the US.
He also recognized you can't Superman ventilators. Not that simple. Not if you want to keep people alive. Not if you want to get them to market when needed.
There are consequences for allowing our industrial base (I include Europe) to erode to such an extent that we depend on China for just about everything. Here's the perfect storm that is going to show us just how stupid our political class has been for the last 50 years. And somehow everyone is angry at Trump. Medtronic can't scale their ventilator manufacturing because the imbeciles going back decades before him were incompetent political actors who only cared about their own careers and political goals rather than the interests and needs of a nation. Now we get to pay for it.
Superman does not exist. We might just have to face a reality that will be cruel punishment for our failings. I hope we learn something by the time this is over.
Complaining about globalization is certainly not likely to help. Anyway, I'm not sure the location of Medtronic's factories is that important. Most likely mass-manufacturability and high-availability of components was not a important design driver if it was intended as a high-value low-volume device.
I can find the blueprints for the engine in a 1967 Ford Mustang and machine one from scratch and probably make it work. From there to making tens of thousands of copies of that same engine it's a different matter. It's a million times harder if I have to ensure a certain level of reliability, smoothness, wear rate and longevity. And we are not even talking about a critical life support device.
Regarding globalization and the supply chain. Believe it or not, we almost can't build anything in the US or Europe without Chinese components. This spans almost anything you can think of, from wires to chips and displays.
The displays are a good example. On a good day lead times for displays and related components range from, depending on what you are buying, 8 to 20 weeks. This is for stock product. If, on the other hand, you are using a custom display in your product, perhaps one with custom indicators, lead times can easily double. We don't make ANY of that stuff in the US or Europe. And most displays are sole source.
So, if you, all of a sudden, need to make 100,000 more units of something immediately --within two to four weeks-- it is about as close to impossible as you can get and truly impossible without supernatural intervention.
Having a local supply chain may not necessarily modify that, yet it would provide you with far more control.
Extend that concept to almost every single component in a machine and the problem we have should become very evident.
All the eggs were in one basket.
The real issue here is probably not where the factories are located, but the for-profit medical device industry where flexibility and excess capacity are liabilities. The same model that is good at reducing the price of consumer crap is probably not the the right model for things we may actually need. DOD supply chains are much more nationalized but I doubt they are substantially more flexible because there is not much incentive for a for-profit company to do that.
Doubtful. Once all this blows over the older patterns will resume.