Author: vermontnews

Over the last three weeks, a team of scientists, engineers and doctors at the University of Vermont have developed a new design—and built a working model—for a simple, inexpensive ventilator.

“We think these could be rolled out very quickly and be effective on an emergency basis,” says University of Vermont lung expert Jason Bates who is leading the new effort in response to the burgeoning global coronavirus epidemic—and the huge shortage of ventilators that may be needed to treat people.

Affectionately called the “Vermontilator,” preliminary calculations suggest the UVM Ventilator “can be produced quickly and in large numbers for a few hundred dollars per unit in parts and materials,” Bates says.

Alternative approach

Unlike other improvised emergency ventilator designs, now being worked on around the world, the UVM team’s approach uses an alternative mode of helping critically ill patients breathe. It’s called “airway pressure release ventilation” or APRV.

This APRV approach may be particularly useful for patients suffering with the new virus. “One of the main complications from COVID-19 is called acute respiratory distress syndrome, a disease where the lungs fill up with an inflammatory fluid,” explains Dr. Anne Dixon, director of pulmonary disease and critical care medicine at the University of Vermont Medical Center and Larner College of Medicine. “Many of these patients end up being dependent on a ventilator for fairly prolonged periods.”

The new ventilator could help these patients by inflating their lungs using long inspirations of air, which are held inflated at a constant and relatively high pressure, Bates explains. Then “at regular intervals, short expirations are allowed during which the lungs expel carbon dioxide,” he says.

This APRV approach is the opposite of a normal breathing pattern—and may allow patients with COVID-19 to avoid, or reduce, the lung damage associated with the disease and with extended periods on a ventilator.

For more than fifteen years, Jason Bates— a professor in both UVM’s Larner College of Medicine and College of Engineering and Mathematical Sciences—has been researching the kind of lung damage that occurs during illnesses like doctors are now seeing in COVID-19 patients. A traditional fear is that a ventilator can cause injury from overinflation of the lungs. But Bates’ research is part of a growing body of evidence showing nearly the opposite: that the major risk to many patients comes when regions of the lung collapse. Then, the damaged and delicate lining of the lung comes together, sticks, and then is peeled apart—over and over.

“This peeling apart process is extremely injurious to the lining itself and can damage it to the point of allowing fluid to leak into the lungs from the capillaries that course through it,” Bates says. “Once this starts happening, the damage from peeling becomes worse, causing ventilator-induced lung injury to progress in a way that is difficult to reverse.”

APRV may avoid this trouble. “This mode of ventilation is thought to be particularly safe and non-injurious for patients with acute respiratory distress,” says Dr. Dixon who has been supporting the project.

A peak approaches

The APRV approach is also helpful to the engineers designing the new ventilator. Using this simpler breathing pattern allowed the team at UVM’s IMF Labs to build the prototype Vermontilator with a simple mechanism. Unlike a traditional ventilator—a very complex piece of equipment that can cost more that $25,000—the Vermont-built machine was quickly assembled out of a commercially available motor that drives a rotating disk, conventional medical hoses, and other relatively simple parts. The team’s prototype was built using a 3-D printer and machining equipment, with pieces that could be easily milled or cast, and assembled.  Bates credits the extraordinary skill of UVM engineers Jake Kittel, Mike Lane, Carl Silver and Guy Kennedy as being critical to the project’s rapid progress.

“We’ve diverted resources from our other projects to work on this and the guys are working all weekend,” says Lane, the director of UVM’s IMF Labs. “We know we have a very limited window to be successful, maybe just weeks before this [epidemic] peaks in Vermont.”

Dr. Dixon agrees. “They’re facing a catastrophic shortage of ventilators in New York. We’re hearing from our colleagues there that they’re trying to use machines we use for patients with obstructive sleep apnea and trying to ventilate people by hooking two patients up to one ventilator. Just crazy stuff that I’ve never heard of in my lifetime,” she says. “This new ventilator has amazing potential to help quickly. It’s not just simple—it’s innovative and elegant.”

The design is about to be submitted to the FDA for emergency review, and the team is working with the Vermont Manufacturing Extension Center, UVM Health Network, UVM Foundation, the state of Vermont, and other partners to secure funding, and engage qualified manufacturers. They’re also collaborating with UVM Innovations to develop an intellectual property strategy and business model to produce a large number of the devices.

Source: UVM News

For as quickly as coronavirus spread across the globe, so too did claims of snake oil “cures” and home remedies to the virus. While we can’t attest to the effectiveness of some makeshift treatments circulating around the internet, we can say with confidence that the emergence of a true medical solution “does not happen in a short amount of time; sometimes it can take three to five years,” says Estee Dilli ’15, a senior associate scientist at Pfizer. 

Right now, Dilli and a team of scientists in New York and Mains, Germany, are scrambling to develop a potential vaccine for COVID-19. But the admittedly long process is “on a very expedited track—things are able to progress at a much faster rate than I’ve ever seen anything move along,” she says. 

When it comes to creating a vaccine, Dilli explains that there are generally two sides from which it needs to be approached: “One side is dealing with the live virus, which has to be done in special labs. The other side — my side — is the blood side or serology side of things. That part isn’t dealing with live virus, it’s looking more at the body’s natural immune response.”

As an assay developer at Pfizer’s vaccine research development site, she is currently working with blood samples, plasma and sera at her benchtop to establish the specific controls that will be used during clinical trials to measure the body’s immune response to COVID-19 or a future vaccine.

“If you’re working on a meningitis study, for example, you can’t expose somebody to meningitis,” Dilli says. “With this, you can’t expose somebody to COVID-19. Once a vaccine is developed, you need a way to measure that it’s doing what it’s supposed to be doing. You want the vaccine to illicit the same immune response from the body as if it were fighting an infection. You want to be able to measure that your body’s responding the way it should.”

In the global dash to a vaccine, Dilli says it’s not uncommon for timelines and priorities to shift by the hour as they progress with their partners in Germany, as well as partners around the world. “It’s not just Pfizer; everyone is sharing what they know to work toward the same goal. Everybody is working on this as a compassion project in response to this global crisis. It’s an exciting time to be involved in this, but it’s a different way to work when there’s pressure behind it like that.”

Source: UVM News

As new COVID-19 cases multiply and the death tolls mount daily, uncertainties trigged by the pandemic ripple outward. A new online speaker series, developed by the College of Arts and Sciences and the Center for Research on Vermont, addresses some of these implications, such as health policy, economics, human relationships, politics and international relations.  

“All of us have been deeply affected by this crisis,” says Richard Watts, director of the Center for Research on Vermont and organizer of the ExpertsLive series. “Arts and Sciences faculty have valuable perspectives about the human and social dimensions of COVID-19, so we’ve put together a series that draws on their expertise from a wide range of disciplines.”

The series kicked off the first week of April with the program “Pandemics in an Age of Resurgent Nationalism,” presented by Pablo Bose, director of UVM’s Global and Regional Studies program and a professor of geography. 

Bose spoke about the re-emergence of figurative and literal boundaries between nations in the wake of a virus that doesn’t respect barriers. He said the promise of a borderless world where people, goods and services could move easily between nations has been made obsolete by the pandemic.

“There were claims that the Brexit movement in Britain would create a cascading domino effect–that other member of the EU would simply seek to leave,” Bose said. “In the face of this pandemic there are many in Europe who have questioned what this project of European common identity really means when Italy and Spain find themselves going it alone…where they reach out to other members for assistance and are essentially rebuffed.” 

Other live talks are scheduled on upcoming Thursdays at noon. Review the schedule and past programs on the ExpertsLive website. Each session lasts for about 20 minutes, followed by an online question-and-answer period.

Thursday, April 9: The Stimulus: Who Benefits
Stephanie Seguino, Professor of Economics

Thursday, April 16: Government Power in Times of Crisis
Lisa Homes, Professor of Political Science

Thursday, April 23: Impacts of Stay-at-Home Policies on Children and their Families

Betsy Hoza, Bishop Joyce Chair of Human Development, Professor of Psychology

Thursday, April 30: Latin America, the Mexico-US Border and COVID-19
Caroline Beer, Professor of Political Science

Thursday May 7: Weather, Climate and COVID-19:
Lesley-Ann Dupigny-Giroux, Professor of Geography (Fellow of the American Meteorological Society and President-elect of the American Association of State Climatologists)

Source: UVM News

As the coronavirus pandemic loomed, shuttering his employer, Generator, along with countless other Burlington businesses, Jake Blend had an idea. What if the Burlington makerspace, which was full of high-end tools, could do what small manufacturers around the country were doing: help out during the crisis by suppling healthcare organizations with the personal protection equipment, or PPE, they so desperately needed? As one of Generator’s resident industrial designers, he could fabricate and produce the equipment himself.

Using an open-source design he found online, Blend began work on a prototype face shield, the clear plastic covering healthcare workers wear to protect themselves from the COVID-19 virus, which also significantly extends the useable life of scarce N95 face masks.

Across town at the University of Vermont Medical Center, an anesthesia resident named Vivek Chittineni, who sat on the hospital’s PPE committee, was approaching the same problem from the opposite direction. What if UVMMC could bolster its stressed supply chain with PPE produced by local companies?

Blend and Chittineni were active in the same networks, but it took UVM’s Dan Harvey ’84 — director of operations in the Office of the Vice President for Research and assistant dean of the Graduate College, who was also president of Generator’s board — to bring them together.

Blend, who had quarantined himself for safety, contacted Harvey and Generator’s executive director, Meg Hammond, and asked to re-enter the facility. “He pulled this crazy all-nighter,” Harvey says, and produced the prototype.

At about the same time, Harvey was scanning an email chain from Burlington entrepreneur and UVM alumnus Steve Arms ’81 and spotted a reply from Chittineni, who was obviously knowledgeable and clearly well-connected at the hospital. Harvey gave him a call and told him about Blend’s prototype.

“Vivek literally drove to Generator that night, picked up the prototype from Jake and took it to the hospital,” Harvey says.

Over the course of the next few days, Chittineni and his colleagues tested the prototype shields and made modification suggestions, which Blend incorporated. When the prototype shield came before the hospital’s PPE committee, it got rave reviews.

As momentum gathered for what looked like a very large order, Hammond and Elliott Katz, Generator’s designer and operation manager, confronted a challenge they’d never anticipated: how to turn a community makerspace geared to producing prototypes in small volume for budding entrepreneurs into what amounted to a manufacturing and distribution facility. The key was sourcing materials and building a supply chain, the team realized.

“We knew by then that Jake could laser cut the clear plastic face shields pretty easily,” Harvey says. But what about the flexible plastic headband, which required 3D printing, and the elastic piece that connected the headband and kept the face shield in place? For the headbands, Hammond and Katz enlisted Beta Technologies and its fleet of 3D printers. Queen City Dry Goods agreed to supply the disposable elastic piece. 

After jumping through the necessary hoops and being designated an approved UVMMC vendor, Generator began its new life on April 2 when a formal purchase order for 1,000 face shields landed in Harvey’s inbox. “It’s a day the Generator family will never forget,” says Harvey, who credits Generator’s board and staff for being supportive of the project.

Chittineni is thrilled — both with the face shields and the larger point the project has made. “I was hoping to prove to hospital administration that we have a massive group of talented, skilled designers and fabricators in our community who are able to make these things for us and help the medical establishment and the public in so many ways,” he says. “The Generator project proved that point and then some.”

Source: UVM News