Comment by arbuge | Hacker News Reader

Comment by arbuge | Hacker News Reader

> The seven-year-old, 135-employee Ventec is a fairly small player in a market dominated by Medtronic (under the Puritan Bennett brand), GE Healthcare and Allied Healthcare in the U.S., and Hamilton Medical, Getinge, Drägerwerk and Philips Healthcare in Europe. Kiple estimates that worldwide production capacity is in the range of 40,000 to 50,000 units a year, but some of this output is of machines not suitable for intensive care units.

Forget about start ups and tiny companies now. The government needs to call on the big players here - those mentioned in the quote above look like a good start. Not just for ventilators but for everything else like masks and gowns that will be needed. And field hospitals capable of handling massive numbers of people. Something will need to be done about training and deploying large numbers of medical staff quickly too.

In WW2 Roosevelt commandeered the car factories to build planes and tanks. It didn't hurt the car factories as far as I know - the government paid them in full. We sorely need a leader of that caliber at this time with the vision and capacity to make bold moves like that.

The wrinkle being that, in Roosevelt's era, the car factories were right here in the United States. It's much harder for the U.S. government to commandeer a factory in China.

It'd be interesting to see how much of the actual production of Medtronic, GE Healthcare, Allied Healthcare, etc. takes place within the United States.

> Roosevelt commandeered the car factories...

Roosevelt also commandeered Americans with Japanese ancestry to live in concentration camps.

These sorts of powers are dangerous, an I doubt and edict that extreme would be very effective, it's just this feeling of we have to do something. What the government needed to do two months ago was place very large orders with all the manufacturers and pay enough so they're being made 24/7. The ramp-up time for much more is probably too long, and the peak need will be April-June, hopefully less after that. I doubt you could retool and train a random factory fast enough for that.

I would bet a lot that the production lines weren't running 24x7 or anywhere near it for ventilators. They're probably batch builds. i.e. 1-4 weeks of production every X weeks.

Scaling production != building new lines/factories, just reprioritizing, for significant uptick in units shipped.

But you have to hope that those production lines aren't also providing mission critical goods.

The cost to doing this seems like a rounding error, even if it's not useful, isn't it? And if we can't use them, we can send them elsewhere to places that end up peaking later.

Taking over a factory and putting people in concentration camps aren’t even close to the same thing.

>The government needs to call on the big players here

Call on them to do what, stand behind the President in a press conference and give short speeches? They manufacture ventilators for hospitals, and it's the hospitals who pay for them.

War time measures like taking over private factories to produce armaments is a significant ask, especially when factoring in timelines of a few months turn around (at best). It’s a fair question.

I personally don’t see how filling up small companies orderbooks with a giant federal order makes sense when other countries like Italy and Germany have a real and active shortage today, while the US still has capacity. Ramping up production as we face a second wave is going to be happening regardless. There’s more than enough demand globally and from the various hospitals already. Adding more orders on top of it doesn’t exactly make things run more smoothly, there should be plenty of capital readily available for them to expand.

Supporting the hospitals/industry in their purchasing and production efforts and clearing red tape is something that could help now. Which I believe is what the giant stimulus and relief packages include already?

I guess people won’t be happy unless they buy it all up themselves first then donate it to the most needy, or hoard it more efficiently than others?

>I personally don’t see how filling up small companies orderbooks with a giant federal order makes sense when other countries like Italy and Germany have a real and active shortage today

But, the federal government doesn't order ventilators. That's not how the US system works, we don't have an NHS like the UK.

There’s a giant emergency stockpile in the US which includes ventilators and other material managed by the federal government. They already talked about distributing them if they become needed, during different press conferences.

But otherwise I’m agreeing with you that there are better ways than flooding orderbooks for federal stockpiles. Like subsidies, capitalization, and removing red tape for both hospitals and manufacturers.

Not only does the federal government order ventilators, it is specifically mandated to stockpile them for a public health emergency.

The President also has emergency powers under the Stafford Act to (1) put government orders at the "head of the line" for any manufacturer, and (2) to pre-fund production of materials or products necessary to protect the public or national interest in an emergency.

FDR issued Executive Order 9024. Which established the War Production Board.

https://en.wikipedia.org/wiki/War_Production_Board

> The WPB directed conversion of industries from peacetime work to war needs, allocated scarce materials, established priorities in the distribution of materials and services, and prohibited nonessential production.[3] It rationed such commodities as gasoline, heating oil, metals, rubber, paper[4] and plastics. It was dissolved shortly after the defeat of Japan in 1945, and was replaced by the Civilian Production Administration in late 1945.

> In 1942-45, WPB supervised the production of $183 billion worth of weapons and supplies, about 40% of the world output of munitions. Britain, the USSR and other allies produced an additional 30%, while the Axis produced only 30%. One fourth of the US output was warplanes; one fourth was warships. Meanwhile, the civilian standard of living was about level.

It was the WPB that coördinated all contracting and procurement through 12 regional offices and 120 field offices... At a time when the very basic tenets of information theory, and subsequent digital communications, had just begun to gestate in the heads of Claude Shannon.

Joseph Stalin said in 1943 at the Tehran Conference:

> Without American production the Allies could never have won the war.

Basically, it's been done before. You don't need to look far for inspiration: the historical record basically hands us a blueprint.

Of course they are going to stand behind your president and give short speeches... if literally everybody is just accepting that as a given without actually pushing back on the whole thing, holding people accountable now and demanding proper statesmanship.

The government should pay for them. It can print or borrow money if it needs to, inflation be d-ed, but it should but them.

> Call on them to do what

If the problem is lack of ventilator production capacity, the "Tool up like WW2" proposal would be to take Vortran's designs and expertise making things like the go2vent [1], and get them made in Lego's factories.

And if to make that happen the government has to hand out a few solid gold cadillacs, medals or eminent domain orders then so be it.

(Obviously, Vortran and Lego are just examples; the point is in WW2, what the war effort wants the war effort gets)

[1] https://www.vortran.com/go2vent

>> In WW2 Roosevelt commandeered the car factories to build planes and tanks.

They also built things like machine guns.

The problem now, is the car factories have so much automation. The lines are specifically built to build one thing, the robots are designed to do one thing. You can't run a tank down a Ford Focus paint line.

Well they are also built to be modular and support changes in cars over the years. So I don't think it would be that bad.

Won’t be strong enough to move a tank though if designed for a focus...

The parts needed are mostly in the engine: mass air flow sensor, oxygen sensor, electric turbo assist

Hello! Please take a moment check out opensourceventilator.org and get in touch if you can contribute to this initiative.

We know how to make ventilators. What we need to do is make them at scale.

True. And finding a way to do that is part of our initiative. If you would like to contribute to it please get in touch :)

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