As the “Startup Nation,” it comes as no surprise that Israeli organizations, medical centers, hospitals and even the country’s Ministry of Defense are acquiring and producing vital medical equipment to treat, prevent and slow the spread of COVID-19. Equally noteworthy are the various partnerships within Israeli entities, as well with other centers and organizations worldwide, in the name of fighting the global coronavirus pandemic.

Likely to be the most important product needed to face a potential tidal wave of hospitalized patients are ventilators, with many countries already facing a shortage.

“Many of the most severe COVID-19 infections witnessed in patients have led to severe lung inflammation, where the patient’s status may deteriorate to Acute Respiratory Distress Syndrome (ARDS); a situation that requires assisted ventilation and oxygenation in the intensive-care unit (ICU),” explained Technion- Israel Institute of Technology associate professor Josué Sznitman.

“With a complete lack of existing therapies to tackle ARDS, this disorder has a notoriously high mortality rate, and thus many of the severe coronavirus related deaths are the outcome of ARDS. These mortality rates are expected to rise with a growing number of COVID-19 patients as ICUs run out of beds and ventilators,” he told JNS.

Working to address the potential shortage of ventilators and respirators in Israel and beyond, Israel’s Air Force is managing a multi-partner project with Magen David Adom, Sherman Medical Devices, FIRST Israel robotics competitions, Israel Aerospace Industries, Microsoft Israel R&D, Ichilov Medical Center and other partners, which have already begun manufacturing ventilator prototypes to be used in Israel and beyond.

According to MDA paramedic and medical engineering student Yuval Eran, who previously participated in the FIRST robotics competition and brought the organizations together, the new prototype represents a faster and significantly more cost-effective way to produce the vitally in-demand medical equipment compared to existing options.

The new prototype, Eran told JNS, should cost between $200 and $500 to manufacture—“thousands of dollars cheaper than the normal solutions, which can cost up to $70,000 for the ventilator machine.”

Though the prototype is very basic compared to regularly produced ventilator machines—and therefore should only be used as a last result on the least complicated intubated patients and where no other options are available—Eran explained that “we are preparing for a situation like in Italy or Spain, where too many patients are in critical condition and need mechanical ventilation, but there are not enough machines.”

The prototype has already been shared online as an open-source design and can be made within two days to a week, though Eran noted that it has not yet been approved for clinical use and will require FDA-like approval in every country that manufactures it.

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Companies around the world that have the ability to manufacture such machines in large quantities are taking note, said Eran, with their prototype likely to be seen soon in Israel and abroad, as more than 30 countries have reached out to MDA, interested in its solution.

Collaborating with ‘a variety of partners’

In another promising advancement that hopes to produce cheaper ventilators that can be mass produced quickly, Sheba Medical Center is working to transform BiPAP and CPAP machines, which provide breathing support for those who suffer from sleep apnea, into functioning ventilators for the center’s ICUs in the coming days.

According to Yoel Har-Even, director of the International Division & Resource Development at Sheba Medical Center, the center is now primarily focused on these efforts, which he says “will have huge implications for not only Sheba and for Israel, but also for the world.”

After completing successful tests on animals this week, Har-Even told JNS that because the existing machines are easy to purchase, finding a solution that modifies existing technology could be a “game-changer for communities without funding for traditional ventilators.”

BiPAP and CPAP machines are “much more prevalent, less complicated and significantly cheaper than traditional ventilators,” said Har-Even. “There are hundreds of thousands of BiPAP and CPAP machines across the globe, so if this works, the shortage of ventilators will be able to be overcome much more easily.”

Sheba, added Har-Even, is collaborating with “a variety of partners on this endeavor” with testing is taking place there right now.

As ventilators remain vitally important to saving lives of those who need critical care, Israeli organizations, as well as Israel’s Defense Ministry, has been working on various fronts to manufacture and bring vital medical supplies to Israel that can prevent the spread of the coronavirus.

Israeli nonprofit and volunteer organization Yad Sarah, which offers free loans of medical equipment in Israel, recently brought 5,000 oxygen generators, 220 respirators, 10,000 oxygen balloons and 20,000 protective kits with disposable gowns, masks and gloves to Israel from China.

“Yad Sarah’s mission is to bring help and hope to the people of Israel—period,” Adele Goldberg, executive director of Friends of Yad Sarah, told JNS. “Right now, that means raising funds and sourcing equipment to address the country’s life-threatening shortages.”

On April 5, the Defense Ministry announced that it will bring 20 tons of medical equipment, including ventilators, 900,000 surgical masks and 500,000 protective suits, to Israel.

In coordination with Israel’s Foreign Ministry, El Al and Israel Chemicals, the first of the 11 El Al planes touched down in Israel on Monday morning with two flights per day planned until all the equipment arrives to Israel.

Reconfiguring machinery to treat severe respiratory arrest

At the same time that Israel works to acquire medical equipment from abroad, projects have also begun to manufacture medical supplies within Israel.

At the Technion, expert researchers and professors are focusing their work on combating COVID-19 through interdisciplinary collaborations, including Sznitman’s team, which is working on a potentially life-saving technology for the targeted delivery of drugs to the lungs to treat severe respiratory arrest.

The technology uses a smart inhaler that “delivers short-pulsed boluses of specifically sized magnetically loaded therapeutic aerosols, coupled with a computer-controlled ventilation machine.”

According to Sznitman, director of the Technion Biofluids Laboratory in the Faculty of Biomedical Engineering, his team has been developing Liquid Foam Therapy (LIFT) for pulmonary drug delivery of potentially life-saving treatments of currently untreatable lung disorders, including COVID-19.

On the governmental level, at the Israeli Defense Ministry’s Rehabilitation and Maintenance Center at Tel Hashomer, the Israel Defense Forces converted its armored vehicle assembly lines to make 1,400 pairs of protective goggles per day.

According to the center’s commander, within 12 hours, the center changed its entire work plan.

“Similar to the rest of Israel, we understood we are in a war right now against an invisible enemy, and therefore we decided to pitch in to help fight the coronavirus pandemic,” said Col. Udi Amira, in Israel Hayom.

As the Rehabilitation and Maintenance Center continues to receive requests “on a number of urgent matters,” including the manufacturing of Hazmat suits to protect against the spread of the deadly virus, several other IDF centers are being repurposed around the country in the continued effort to win the war against the coronavirus.

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