Meet The Italian Engineers 3D-Printing Respirator Parts For Free To Help Keep Coronavirus Patients Alive

Christian Fracassi, founder and CEO of Isinnova, an Italian engineering startup, heard the call for help last Friday. The hospital in Chiari, in the Brescia area of northern Italy where the coronavirus pandemic has hit hard, urgently needed valves for its respirators in order to keep patients who required oxygen alive. The manufacturer couldn’t provide them quickly enough and the hospital was desperate.

Fracassi immediately started tinkering with his engineers to reverse-engineer a 3D-printed version of the official part. Called a venturi valve, it connects to a patient’s face mask to deliver oxygen at a fixed concentration. The valves need to be replaced for each patient.

By Saturday evening, Fracassi had a prototype, and, the next day, he brought it to the Chiari hospital for testing. “They told us, ‘It’s good. It works. We need 100,’” says Fracassi, who is 36 and holds a Ph.d. in materials science with a focus on polymers. “We printed 100 of them on Sunday, and we gave all the pieces to the hospital. They are working very well.”

As the coronavirus spreads globally, shortages of medical supplies have become a major problem. Manufacturers simply can’t crank up their production of life-saving medical devices fast enough. The biggest supply crunch is with ventilators, but respirator parts like the ones in Italy and even simple nasopharyngeal swabs for testing are all in short supply. Meanwhile, the technology of 3D printing, which allows digital design of parts and the “printing” of them off a machine that creates them layer by layer, is ideally suited to emergency manufacturing because it is fast, cheap and can be done without a big factory.

But it raises issues, ranging from the quality of the products in a medical situation to the patents held by the original device’s manufacturers. Typically, new 3D-printed parts have to be certified. In Italy, Fracassi says, emergency rules during the coronavirus pandemic allowed that requirement to be waived. “They said, ‘We know the product you will bring will never be the same,’” says Alessandro Romaioli, Isinnova’s engineer, who designed the 3D-printed valves. Isinnova offered the hospital in Chiari the valves for free; Fracassi says the cost to print them is two or three Euros (or $2-3) apiece. Isinnova now has the capacity to produce around 100 parts per day, and is talking with a second hospital in Italy about sending the valves there, too.

Yet potential legal and medical issues have stopped Fracassi from distributing the digital design file more widely, despite receiving hundreds of requests for the 3D-printed valves. There are complexities because hospitals use a wide variety of respirators, each of which has slightly different technical specs and would require slightly different valves. Then, too, there’s the threat of potential patent litigation, as first raised by Techdirt. “We don’t know if something is patented. We just hope the factory can close its eyes because they cannot produce it in time,” Fracassi says. “It’s only for emergencies.”

Still, in the face of the coronavirus pandemic, 3D printing offers a smart stop-gap solution at least. Davide Sher, the 3D printing analyst who wrote the original story about Isinnova for trade publication 3D Printing Media Network, subsequently created an online Emergency AM Forum to help hospitals, 3D printing companies and inventors share ideas in the fight against COVID-19. As he writes there: “While there are both copyright issues and medical issues that need to be taken into account when 3D printing any medical product, and a critical one such as a venturi valve, in particular, this case has shown that a life-and-death situation could warrant using a 3D-printable replica.”

Fracassi says that Isinnova is now working to design other medical products that hospitals need during the coronavirus pandemic. The first is a mask. The startup created a prototype earlier this week, and sent it to the hospital for testing, he says. “We are waiting for a response, and if it works, we are ready,” Fracassi says. “Then every hospital can make their own masks.”

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I’m a senior editor at Forbes, where I cover manufacturing, industrial innovation and consumer products. I previously spent two years on the Forbes’ Entrepreneurs team. It’s my second stint here: I learned the ropes of business journalism under Forbes legendary editor Jim Michaels in the 1990s. Before rejoining, I was a senior writer or staff writer at BusinessWeek, Money and the New York Daily News. My work has also appeared in Barron’s, Inc., the New York Times and numerous other publications. I’m based in New York, but my family is from Pittsburgh—and I love stories that get me out into the industrial heartland. Ping me with ideas, or follow me on Twitter @amyfeldman.

Source: Meet The Italian Engineers 3D-Printing Respirator Parts For Free To Help Keep Coronavirus Patients Alive

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U.S. Hospitals Increasingly Worried About Surge in COVID-19 Cases

(TOLEDO, Ohio) — Government and hospital leaders are increasingly sounding the alarm about the health care system in the U.S. and its readiness to absorb waves of patients in the worst-case scenario involving the new coronavirus outbreak.

Authorities nationwide already are taking major steps to expand capacity with each passing day, building tents and outfitting unused spaces to house patients. They also are urging people to postpone elective surgeries, dental work and even veterinarian care. New York’s governor called for using military bases or college dorms as makeshift care centers.

Among the biggest concerns is whether there will be enough beds, equipment and staff to handle several large outbreaks simultaneously in multiple cities.

Dr. Anthony Fauci, the National Institutes of Health’s infectious diseases chief, said it’s critical that steps be taken now to prevent the virus from spreading quickly.

“The job is to put a full-court press on not allowing the worst-case scenario to occur,” said Fauci, who appeared Sunday on several network news shows.

While he does not expect massive outbreaks in the U.S. like those in Italy, he said there is the possibility if it reaches that point that an overwhelming influx of patients could lead to a lack of supplies, including ventilators.

“And that’s when you’re going to have to make some very tough decisions,” Fauci said.

In Washington state, which leads the nation in the number of positive COVID-19 cases with more than 600 illnesses and 40 deaths, the increase in people visiting clinics with respiratory symptoms is straining the state’s supply of personal protective gear worn by health care workers.

The federal government has sent the state tens of thousands of respirators, gowns, gloves and other protective gear for health care providers. But those shipments aren’t enough, said Clark Halvorson, Assistant Secretary of Health for Public Health Emergency Preparedness and Response.

The disease has infected over 162,000 people worldwide, and more than 6,000 people have died so far.

Most people who have tested positive for the virus experience only mild or moderate symptoms. Yet there’s a greater danger and longer recovery period for older adults and people with existing health problems.

The nation’s hospitals collectively have about a million beds, with 100,000 for critical care patients, but often those beds for the sickest patients are mostly filled, Scott Gottlieb, a former FDA commissioner, told CBS’ “Face the Nation.”

“If we do have multiple epidemics in multiple large U.S. cities, the system will become overwhelmed,” he said.

New York Gov. Andrew Cuomo has suggested mobilizing the Army Corps of Engineers to turn facilities such as military bases or college dorms into temporary medical centers.

“States cannot build more hospitals, acquire ventilators or modify facilities quickly enough,” Cuomo wrote in an opinion piece published Sunday in The New York Times.

Officials in the Seattle area have been setting up temporary housing — and even bought a motel and leased another — to add space for patients who might be homeless or whose living conditions might not allow for self-isolation, such as students in college dorms. King County also is setting up modular housing and is using the arrivals hall at a county-owned airport as a shelter to reduce overcrowding — and meet social-distancing requirements — in existing homeless shelters.

Hospital executives say they’re always planning for disasters and have been concentrating on coronavirus preparations for the past two months.

“If you go past our emergency department now, you’ll see tents erected in the parking lot that allow us to increase emergency department capacity,” Johnese Spisso, president of UCLA Health, said Sunday on NBC’s “Meet the Press.”

The system’s network of clinics throughout Los Angeles and Southern California have additional capacity and doctor’s are encouraging telemedicine, he said.

Dr. Peter Slavin, the president of Massachusetts General Hospital, said the next two weeks will be critical as the medical community expects a dramatic increase in the number of cases.

Ohio Gov. Mike DeWine recommended on Saturday that elective surgeries be postponed, including dental and veterinary procedures, so that health care workers won’t be stretched thin and surgical masks can be saved for health care workers dealing with the virus.

ProMedica, which operates 13 hospitals in Ohio and Michigan, is ready to call in help from staffing agencies if needed and is looking at ways to provide child care for employees whose children are off school, said Deana Sievert, chief nursing . Doctors also have voluntarily canceled their vacations.

The community “can flatten off the curve of this,” by avoiding large events, staying at home, washing their hands and practicing social distancing to help U.S. hospitals avoid an onslaught of cases, said Dr. Penny Wheeler, CEO of Minneapolis-based Allina Health, which has 12 hospitals and more than 90 clinics in Minnesota and Wisconsin.

Allina also has been canceling conferences, meetings and anything else that does not directly impact patient care.

By JOHN SEEWER / AP March 15, 2020

Source: U.S. Hospitals Increasingly Worried About Surge in COVID-19 Cases

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Will The Stock Market Drop By Half?

In 2008 the S&P fell half off its peak and nothing physical happened to the economy. Now we have two very physical things — supply and demand shocks. The strategy of no strategy means these two physical problems will continue until a vaccine is produced, i.e. likely not for a year or more.


On February 25th, I predicted a massive drop in the stock market due to the coronavirus. At that point it had already fallen 8% from its peak. Today, it’s 20% below its peak. I think it will fall 50% below peak.

That may be conservative. In the Great Recession, the S&P fell half from its peak and nothing physical happened to the economy. Now we have two very physical things — what economists call supply and demand shocks — happening. A growing share of the labor force is not going to work and a growing share of consumers are shunning retail outlets and all other manner of service establishments for fear of getting infected.

Let me give you my partial list of the businesses that I think will go under. I think restaurants will fail. I think coffee shops will fail. I think dry cleaners will fail. I think airlines will fail. I think cruise boat companies will fail. I think hotels will fail. I think department and boutique clothing and other retail stores will fail. I think travel agencies will fail. I think movie theaters will fail. I think universities and colleges will fail. I think theaters will fail. I think theme parks will fail. I think spas will fail. I think resorts will fail. I think convention centers will fail. I think malls will fail. I think gyms will fail. I think orchestras will fail. I think hair salons will fail. I think nail salons will fail. I think barber shops will fail. I think bars will fail. I think every business that’s not online and involves customers will fail.

What share will fail?

Ten percent is optimistic.

Let me justify my view. Containing the coronavirus requires two months at a minimum. Why two months? This is the time it’s taken China to bring new infections down to single digits. Even so, China has not lifted the lockdown of Hubei Province. Indeed, every city you enter in China is now requiring a two-week period of quarantine. China is enforcing this with technology and people. You enter into Shanghai and you’re asked where you are staying. Once you get there, the neighborhood officials, who have been electronically notified of your arrival, check on you daily to make sure you are staying inside.

What happens when China’s new infection rate goes to zero? Will it lift its restrictions? Hard to say. If I’m President Xi and have gone to such lengths to eliminate the problem, I don’t want to run the risk that someone has a four-week incubation period or has slipped across the border carrying the virus and all hell breaks out again. In short, it may be a long time before China returns to something close to normal. Even then, foreigners arriving in China will surely need to spend two weeks in confinement before being let loose on the streets.

We don’t know China’s end game. But we’re pretty sure it has one. The US has no end game. Yes, the president has finally gotten serious about bringing testing on line. But it can take two weeks for infected people to show symptoms. Indeed, 1% will first show symptoms after two weeks. Suppose Joe Blow contracts the virus today. Say ten days later he starts feeling symptoms but he waits another five days to get tested. Then it takes two days to get results at which point he self quarantines or heads to the hospital. Now he’s had 17 days to infect a motherload of people either directly or indirectly. Maybe Joe works in a nursing home. We’ve seen the damage one person with coronavirus can do to a nursing home. The Life Care Center in Kirkland, Washington had 120 residents. In recent weeks, 26 have died. Another 24 are definitely infected. And many of the Center’s staff have symptoms, but, as of two days ago, have yet to be tested.

Okay, back to Joe. He gets tested on day 15. But on day 14 he infects Jane Doe who also takes 15 days before going into quarantine, but infects Jack, Jill, and Sandy on day 14. You see where I’m going. Our voluntary (we or our docs decide) testing system does nothing to keep the coronavirus infection from rolling along for months if not years.

Here’s a policy that would actually save lives and the economy. Quarantine the entire country for two weeks. Italy is doing this, although no one knows its duration. At the end of two weeks, test everyone — all 327.2 million people plus any visitors and continue testing everyone once a week for months. Anyone who tested positive would, of course, be quarantined or hospitalized. We would also reopen the borders, but test everyone coming into the country. This is a policy that would a) stop the spread of the infection in its tracks and b) limit the renewed spread of the infection once the quarantine is lifted.

Could we produce hundreds of millions of tests? Yes. During WWII, we built cargo ships in four days. Can we put everyone under quarantine for two weeks? Yes, the president has this authority. Can we require weekly testing. Again, the answer is yes.

Will our president do this? Clearly not. According to him, the “foreign” virus is going to disappear on its own and in short order. President Trump is, himself, possibly infected by way of an aide to Brazil’s president. But, thus far, he has chosen not to get tested. In the meantime, he may have infected or be infecting his top aides as well as his family. And members of his administration may have infected or be infecting much, if not most of Congress. Beyond jeopardizing so many people, the president is setting the worst possible example.

The strategy of no strategy means the two physical problems hammering the economy will continue until a vaccine is produced, i.e. likely not for a year or more. How many retail and service establishments can survive that long without customers, while retaining their employees? Not many. Hence, we can expect a massive wave of layoffs and bankruptcies starting next week.

There are two other reasons to expect a 50% from peak decline in the stock market. First, the market was perceived by many to be overpriced to begin with. Second, corporate America is dramatically over leveraged. To quote the Fed, “The ratio of debt to assets for all publicly traded non-financial companies has hit its highest level in two decades, and the leverage ratio among debt-heavy firms is near a historical high.” The higher the leverage ratio, the larger the percentage decline in stock values for a given percentage reduction in profits.

Moreover, over half of corporate debt is rated BBB compared to roughly 25% in 2008. This means that a large share of corporate America faces solvency risk. Here’s the BBB rating description: “A BBB rating reflects an opinion that the issuer has the current capacity to meet its debt obligations but faces more solvency risk.”

There’s more, but you get the picture. I hope I’m wrong, but I fear an even bigger drop in the market is coming.

Follow me on Twitter or LinkedIn. Check out my website.

I am a professor of economics at Boston University, a Fellow of the American Academy, a Research Associate of the NBER, and President of Economic Security Planning, Inc. — a company that markets personal financial planning tools at maxifi.com, maximizemysocialsecurity.com, analyzemydivorccesettlement.com, and economicsecurityplanning.com. Recent books: Get What’s Yours – The Secrets to Maxing Out Your Social Security Benefits (a NY Times Best Seller with Phil Moeller and Paul Solman), The Economic Consequences of the Vickers Commission, The Clash of Generations (with Scott Burns), Jimmy Stewart Is Dead, and Spend ‘Til the End. Follow me on twitter @kotlikoff, Circle me on Google , check out my website, kotlikoff.net, and ask me Social Security questions by clicking Ask Larry at the bottom of http://www.maximizemysocialsecurity.com.

Source: Will The Stock Market Drop By Half?

 

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Coronavirus Live Updates: As Lockdowns Expand, Global Markets Plummet

Markets in Asia and the Middle East opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets. Shares in Saudi Aramco, the state oil giant, dropped 10 percent leading to a halt in trading on the Riyadh stock market.

Asian markets opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets.Tokyo was down 4.7 percent at midmorning on Monday, while Hong Kong was down 4.1 percent. Futures markets showed investors predicting sharp drops in Wall Street and Europe as well.

The coronavirus has unnerved investors as it spreads, clouding the prospects for global growth. Italy on Sunday put a broad swath of its industrial northern region under lockdown as the virus has spread, making it one of the biggest sources of confirmed infections outside China. France, Saudi Arabia, Iran and other countries also took further steps to stop the spread.

In the United States, the number of confirmed infections exceeded 500 cases. A top American expert said on Sunday that regional lockdowns could be necessary.A clash over oil between Russia and Saudi Arabia, two major producers, further unnerved investors. As the coronavirus hits demand for fuel, Saudi Arabia slashed its export oil prices over the weekend, starting an apparent price war aimed at Russia.

Lower oil prices could help consumers, but it could unsettle countries that depend on oil revenue to prop up their economies. In futures markets, the benchmark price for American and Europe oil supplies tumbled $10, or about one-quarter.Investors fled to the safety of the bond market, driving yields lower. In the market for U.S. Treasury bonds, yields broadly fell below the 1 percent level for both short term and long term holdings. The 10-year Treasury bond, which is closely watched, was yielding about 0.5 percent.

In other Asian markets, South Korea was down 3.6 percent. Shanghai was down 1.5 percent.

Italy reported a huge jump in deaths from the coronavirus on Sunday, a surge of more than 50 percent from the day before, as it ordered an unprecedented peacetime lockdown of its wealthiest region in a sweeping effort to fight the epidemic. The extraordinary measure restricted movement for a quarter of the country’s population.“We are facing an emergency, a national emergency,” Prime Minister Giuseppe Conte said in announcing the government decree in a news conference after 2 a.m.

The move is tantamount to sacrificing the Italian economy in the short term to save it from the ravages of the virus in the long term. The measures will turn stretches of Italy’s wealthy north — including the economic and cultural capital of Milan and landmark tourist destinations such as Venice — into quarantined red zones until at least April 3.

They will prevent the free movement of roughly 16 million people. Funerals and cultural events are banned. The decree requires that people keep a distance of at least one meter from one another at sporting events, bars, churches and supermarkets. The Italian outbreak — the worst outside Asia — has inflicted serious damage on one of Europe’s most fragile economies and prompted the closing of Italy’s schools. The country’s cases nearly tripled from about 2,500 infections on Wednesday to more than 7,375 on Sunday. Deaths rose to 366.

More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks. More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks.

On Sunday, Saudi Arabia cut off access to Shiite Muslim towns and villages in the east of the kingdom, cordoning off an area in Qatif Governorate where all 11 of the country’s confirmed coronavirus cases have been identified. And local Saudi media reported that the country would temporarily close down all educational institutions and block travel to and from a number of countries in the region. The kingdom had already suspended pilgrimages to the Muslim holy cities of Mecca and Medina.

In Iran, which has been hit the hardest in the Middle East, state media reported that all flights to Europe would be suspended indefinitely. The health minister in France, one of Europe’s bigger trouble spots, announced a ban on gatherings of more than 1,000 people. The U.S. has counted at least 539 cases across 34 states — Connecticut reported its first case and Washington announced another patient being treated for coronavirus had died on Sunday — and the District of Columbia, and logged 22 deaths. Washington State, New York, California, Maryland and Oregon have declared emergencies.

A growing number of schools are shutting down across the country, raising concerns about the closings will affect learning, burden families and upend communities. The U.S. Army suspended travel to and from Italy and South Korea, now the world’s third largest hot spot, until May 6, an order that affects 4,500 soldiers and family members. And the Finnish armed forces announced that troop exercises planned for March 9-19 with Norway would be scrapped.

On Sunday, the leading U.S. expert on infectious diseases, Dr. Anthony S. Fauci, said that it was possible that regional lockdowns could become necessary and recommended that those at greatest risk — the elderly and those with underlying health conditions — abstain from travel. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the Trump administration was prepared to “take whatever action is appropriate” to contain the outbreak, including travel restrictions in areas with a high number of cases.

“I don’t think it would be as draconian as ‘nobody in and nobody out,’” Dr. Fauci said on “Fox News Sunday.” “But there’ll be, if we continue to get cases like this, particularly at the community level, there will be what we call mitigation.”

Even as the rate of new infections appeared to taper in China, the number of cases around the world continued to rise on Sunday, with some of the biggest clusters emerging in Europe. Besides the sharp rise in Italy, Germany reported more than 930 cases; Switzerland’s total reached 281; and Britain’s health department said that three people with the virus had died and that the number of cases in the country had jumped to 273 by Sunday. The smallest E.U. nation, Malta, reported its first confirmed case on Saturday: a 12-year-old girl recently returned from a vacation in northern Italy. Her condition was described as good.

The Spanish authorities announced on Sunday that three more people diagnosed with coronavirus had died in Madrid, raising the number of coronavirus fatalities in the country to 13. There are now over 500 cases, the authorities said. Salvador Illa, Spain’s health minister, said at a news conference in Madrid that several cases in Spain were linked to people who recently traveled to Italy.

Source: Coronavirus Live Updates: As Lockdowns Expand, Global Markets Plummet

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