Name:   Talullahhound - Subject:   Thoughts on Stockpiling ventilators Date:   4/4/2020 1:01:31 PM

And the question of availability of ventilators in general.  A friend who participated in a study of medical equipment tells me that the normal lead time from order to delivery of ventilators is 30-60 days, depending on the time of year and how they run their production. A normal year would see an order for 5-10 a year from a hospital.  So we know that the national stockpile of ventilators was created for one major incident.  Manufacturers are having to ramp up their production to surge capacilities.  You do not do this over night.  And right now the virus is moving faster than the production line.  Hence, the near term shortage.  I have no idea what their surge capacity looks like, but by all accounts, it is not easy to manufacture these and you have to keep your quality assurance up in the high 90s.  During a war time scenerio, you would have months to ramp up to surge capacity, but not in this case.  

So everyone seems to think that the answer to the longer term issue is to stockpile more ventilators.  But there is a problem associated with that - they likely need detailed maintenance to keep them in optimal condition.  Maintenance costs money.  A possible solution would be to rotate ventilators in and out of storage, to make sure you have useable material in times of the crisis.  But the stick is that hospitals buy ventilators and own and maintain them.  And I'm thinking that they probably buy from the same company to ensure that the users don't have to relearn how to use each one.  So hospitals that were willing to send their ventilators to the stock pile on a rotational basis would probably want the same ones back.  We know the the government no longer maintains anything itself but relies on companies to maintain it's equipment.  I have a feeling that ventilators are pretty sensitive pieces of equipment.  

I think back to the stockpiles of military equipment we had in Europe and drew down in the 90s.  This was pretty hardy equipment, but it had not been maintained and most of it was in too bad shape to repair it and ship it back, and the best of it was sold off to foreign countries, on an as is/where is basis.  

What we are witnessing and governors are crying about is that companies are in the ramp up to surge capacity and there is a lag time in what they can produce at this point, while still maintaining that quality assurance.  No one is going to be happy to get a bad ventilator.  So governors and the Democrats need to stop blaming the President for having no strategy and for failing them on the ventilator front.  I don't know what the President knew or when he knew it.  It's likely he didn't expect it to go as it has.  If these governors were as brilliant as they claim (and we know hindsight is 20/20) they could have taken actions to start ordering ventilators before the feds got involved.  But then it was a question of money and whose money will be spent to replenish their stocks.  And what will they do with all those ventilators, once the crisis is over?  How will they maintain them for the next crisis.