UCL-Ventura CPAP in Africa
In mid-March 2020, the growth of COVID-19 in the UK stimulated the formation of a unique, interdisciplinary consortium of engineers, critical care consultants and manufacturers with the aim of delivering non-invasive ventilation devices to the NHS, at a pace to match the COVID-19 surge.
The UCL-Ventura team brings together engineers at UCL Institute of Healthcare Engineering, UCL Mechanical Engineering and Mercedes-AMG High Performance Powertrains (Formula 1) with critical care consultants at University College London Hospital (UCLH).
The consortium developed a life-saving device, known as the UCL-Ventura CPAP (Continuous Positive Airway Pressure device), which delivers pressurised oxygen to the lungs of COVID-19 patients. Reverse-engineering an existing, off-patent CPAP device, allowed them to innovate and manufacture at a rapid pace. A Mark II device was developed to minimise oxygen usage, given the unprecedented demand for therapeutic oxygen. From initial meeting to regulatory approval took just 10 days, with the Mark II approved just a few days later.
The UK government ordered 10,000 devices for use in the UK which were manufactured by Mercedes HPP within one month. These are now being used in over 130 NHS hospitals. UCLH data shows using CPAP reduces a patient's chances of needing invasive ventilation by 50-60%. This is beneficial not only for the patient, but also for optimising healthcare resources such as hospital beds, mechanical ventilators and trained healthcare workers, which are already in short supply. Although other factors may be contributory, mortality rates in UK intensive care unit patients fell by 21% over the course of the first COVID-19 surge, coinciding with a 26% reduction in ventilator use despite equivalent severity of illness.
To contribute to the global humanitarian effort, the consortium released full details of the CPAP designs and manufacturing instructions at no cost to governments, industry manufacturers, academics and health experts across the globe. These blueprints have been downloaded by more than 1,950 teams from 105 countries around the world.
The UCL-Ventura team have worked with in-country teams, particularly through the Foreign, Commonwealth & Development Office, to support local manufacture through technical and manufacturing support, local supply chains, regulation support working with the MHRA (in the UK), and clinical guidance. They have delivered a programme of webinars, training resources, and connected regional manufacturers through a peer-to-peer Facebook support group, as well as establishing a hub for component supply internationally.
Great progress has been made so far with over 30 teams successfully beginning manufacture and hospital testing of devices in countries across the world, including Australia, Bulgaria, Canada, Colombia, Ecuador, Germany, India, Iran, Mexico, Peru, Pakistan, Paraguay, Philippines, Russia, South Africa, Ukraine and the US. A deeper look at some of the progress internationally can be found through these country spotlights.
The UCL-Ventura team have also worked with charities and governments to supply the devices directly to countries where there is urgent need, including Palestine, Peru and Uganda.
Significantly, there have been fewer downloads of designs in Africa and less progress with in-country CPAP manufacture in African countries (although it is in use in hospitals in Uganda following work with the International Medical Education Trust 2000, and also in use in South Africa). Through Innovation Action, we will be exploring what the barriers are in different countries and regions, in particular access to supply chains and manufacturing capabilities, funding, and oxygen availability within hospitals. For each region and African country that we focus on, we will begin by mapping out the specific challenges and barriers to adoption faced there to understand the role that CPAP could play locally in treating COVID-19 patients.