BOTHELL, Wash. — Seven years ago, Chris Kiple helped start a company called Ventec Life Systems that makes ventilators, the machines that help critically ill patients breathe, here in this Seattle suburb. At the time, the team was trying to re-imagine home health care, not solve a global pandemic, he says.
Now the young med-tech company finds itself on the front lines of the worldwide COVID-19 outbreak. The calls just keep coming. Would-be buyers from 65 different countries, several "high net worth individuals" and federal, state and local authorities have all reached out, says Kiple, now the company's CEO. He says the company has decided not to fill individual orders, but is moving through the requests as fast as it can.
The callers are all worried about the same thing: ventilator supply. These medical devices are critical to the survival of some patients with extreme COVID-19 cases — lifeboats for drowning lungs.
There are about a dozen manufacturers of the lifesaving device in the world, and only around five in the U.S. So Ventec Life Systems intends to do what it can to help cope with the worldwide shortage by ramping up production. Within the next 90 days, Kiple says, his company will move from its typical production of 150 machines a month to 1,000 per month. Kiple hopes to hit 2,000 per month later in the year.
When asked whether the company's supply chain can withstand such a massive increase, Kiple says that so far he's confident it will, noting that many of the parts are made here in the U.S. But the strains on the company and its employees will be real.
"It's going to be hard to increase manufacturing." Kiple said. "But we have it a lot easier than the medical professionals who are in the hospitals right now trying to triage COVID-19 patients. And we know that. We're not going to take a break because we know that the medical professionals aren't getting a break treating COVID-19. Sleep is optional right now."
Around 960,000 people infected with COVID-19 in the U.S. might need ventilators in a worst-case scenario, according to an estimate from the American Hospital Association and the National Ebola Training and Education Center. But U.S. hospitals collectively have only about 160,000 ventilators available, according to a2010 study by the Society for Disaster Medicine and Public Health.
There is a federal stockpile of ventilators — part of the $8 billion Strategic National Stockpile of medical supplies housed in secret warehouse locations around the country. The number of ventilators in that stockpile is classified, but Vice President Mike Pence said Wednesday it is over 10,000.
These may sound like large numbers, but it is believed the need may far exceed the resources. If the crisis escalates in a catastrophic way, NBC News projects that based on available estimates of the total supply the ventilator shortfall could be at least 790,000.
"In a worst case scenario, ventilators would be one of the choke points, if you will, for effective response," said Thomas Frieden, former director of the Centers for Disease Control and Prevention. "And it's not clear that we would have enough."
Meanwhile, back in Washington state, Ventec Life Systems gave NBC News an exclusive look inside its manufacturing facility. The company makes 18 different life-support ventilators, and the COVID-19 outbreak has brought extra attention to the VOCSN Multi-Function Ventilator. It looks like a small suitcase topped with a thick gray touch-screen monitor and a bright blue plastic breathing tube. With this machine, the work of five hospital therapies — cough assist, nebulizer, ventilator, oxygen and suction — is combined into one.
These therapies can be crucial for hospitalized COVID-19 patients, according to a recent Journal of American Medicine Association study of 138 hospitalized COVID-19 patients. Eighty-nine percent of patients in the ICU required a ventilator. Seventy-seven percent of patients required supplemental oxygen.
A nationwide shortage of ventilators is exacerbated by the potential shortage of hospital beds. If hospitals fill up, patients may have to receive lifesaving treatment anywhere from school gymnasiums to makeshift tents. This presents a whole new host of challenges, experts say.
"It's not just about ventilators," said Frieden. "Who's going to operate them? Where will they be done? What if someone is infectious there? And that's what every hospital needs to plan for. Could you defer elective surgery? Could you use operating rooms as intensive care units? Could you involve anesthesiologists and others? Could you train nurses to do respiratory therapy?"
In that scenario, said Kiple, the VOCSN machine, approved by the FDA two years ago, could prove especially useful. It is transportable, with advanced data monitoring, a nine-hour battery life and internal controls to make the most of each oxygen tank. The five-in-one technology compresses 55 pounds of equipment into 18 pounds, according to the Ventec website, reducing the amount of workers necessary to man the equipment.
"You've got situations right now with hospitals around the world who have overflow capacity," Kiple said." It's difficult to set that equipment up. It takes up a lot of space. And it takes up a lot of power outlets. Not every room has five, six, seven, eight power outlets."
Before Ventec Life Systems can help, it has a tough manufacturing stretch ahead. Ventec Life Systems has only about 130 employees.
Kiple says the factory is running "around the clock." For Ventec employees in overdrive, the gravity of the situation hits close to home. The first major COVID-19 outbreak began right outside their doors, and the state of Washington continues to have among the highest case numbers in the U.S., totaling 1,016 cases and 55 deaths as of Wednesday.
But the need is nationwide, especially as cases outside of Washington have brought the U.S. total to 6,200 cases. New York hit 1,650 cases as of Wednesday, the highest in the nation, and Gov. Andrew Cuomo said Tuesday that the state needs federal help, particularly for hospital capacity issues. Other, less-affected areas are also looking to buy ventilators to get ahead of the shortage.
"Everyone is calling to say that they have an urgent need for ventilators," Kiple said. "And some may be truly urgent, where their hospitals are at capacity and they truly need ventilators. Others are very concerned about the current supply that they have of ventilators and may be faced with challenges of getting ventilators in their communities. And others are just really scared for what's coming and want to start to prepare. It's a mix of different scenarios out there. But it's top of mind for everybody right now, 'How do I get access to more ventilators for my community?'"
On Monday, President Donald Trump said that the federal government was ordering "tremendous numbers" of ventilators, respirators and masks.
"We have quite a few, but it may not be enough," he added later. "And if it's not enough, we will have it by the time we need it."
There are also some backup options to address the national ventilator shortfall, like turning to anesthesia machines and older hospital ventilators. But many of these machines may not be capable of adequately supporting patients with failing lungs, a report from the Society of Critical Care Medicine notes.
Kiple says he's aware of the responsibility his company is shouldering.
"We know every single VOCSN we get out there can save a life," Kiple said. "And that's what we're trying to do."