When Covid started really hitting in the UK there started being a whole host of
conversations around how engineers and people with expertise in technology
development and manufacturing could start trying to support the healthcare system.
Here at UCL we've got a really nice collaborative setup where we have
really strong links between the engineering community and the healthcare
community through the hospitals so we already had really strong links with the
University College London Hospital. So what we did was basically going for a
drink with them and have a chat around what they really thought we needed in
terms of devices and technologies to support intensive care units in the UK
through the Covid surge. When patients presented at hospital needing intensive
care, suffering with Covid, what they really need is to get more oxygen into
their lungs. So they have respiratory failure and essentially you need to get
more oxygen into their bloodstream to enable them to survive.
Now one way of doing this for the most sick of patients is through ventilators and through mechanical
ventilators but these are really invasive so they require the patient to
be sedated for a long period of time, potentially two, three weeks and they
require a really close monitoring and inputs from a highly trained healthcare worker.
And now the data that was coming out of Italy and China at the time
indicated that if instead you used non-invasive ventilation methods
then we had the potential to alleviate around 50-60% of patients from
progressing to needing mechanical ventilation. But we don't have, or we
didn't at the time, have enough of these non-invasive ventilation devices in the
UK to supply the National Health Service. So we quite quickly started thinking
about how we could try and build capacity with non-invasive ventilators
within the NHS and specifically we were thinking about devices called CPAPs
which are continuous positive airway pressure devices.
What these devices do is essentially enable you to deliver pressurised oxygen
through a face mask and that pressurised oxygen essentially splits open the lung
bases and enables you to get more oxygen into the patient's lungs and bloodstream.
Now one of the advantages of these CPAPs is that usually
treatment takes around 3 to 4 days and it's also, in general, a lot easier to
train healthcare workers to use the devices. We went back to a historic
device called the Respironics WhisperFlow which is an off-patent device that
had been used very widely in the UK up to around 15 years ago.
- Becky picked up a couple of examples of the device that they were looking at and
literally had gone back in to, sort of, you know, storage and found devices that
had not seen the light of day for quite a number of years. I think also one of them
was actually taken out of the, they have almost like a museum of
some of the old equipment that they used to use.
- The surge for Covid was coming and coming
quickly and so if we were going to contribute something useful we needed to be
able to manufacture these devices at scale within, you know, a couple of weeks
was the timescales that we set for ourselves and I think one of the other
really important points was that we knew we needed to be able to get regulator
approval of support for what we were doing which meant that we took the
approach where we started from an off-patent device that had been used
already in the NHS because we knew that that would obviously, if we could
demonstrate like-for-like with that device that would be acceptable to the
regulator. And that was really a key step in enabling us to progress.
- To do this quickly we needed the skills of some of the Motorsports industry, that they could
manufacture and produce high-quality engineering in a very short timeframe.
It's also important to say that those those relationships were already formed.
So whilst perhaps other groups were still talking about non-disclosure
agreements, we were able to, you know, within 24 hours we had our team together.
And as soon as we saw this device we realised, you know, 'This is it! We can do this!'
We've got very close links in with Mercedes-AMG HPP which in
short term is the group that builds the engines for Lewis Hamilton, for the Formula One team.
So I got in touch with the Head of Mechanical Engineering there who
I know very well and I sort of suggested, my wish was, you know, could you come
along for a couple of days to work on the design of this device?
What we got back in return was even more than we could've hoped for
because their Managing Director Andy Carroll came back and said, I think the
exact message was 'Do not hesitate to call on the might of what we can do!'
The reverse engineering process is to go from the actual parts into into 3D,
or three dimensions, of a virtual design then turn that into two-dimensional
drawings which are then used for manufacture. So our aim was to go from the start of
that process to cutting material within 24 hours. And we missed it by a couple of hours
and it still took about another, sort of, 36 hours before we had all of
the designs ready for manufacture.
- The only reason that we were really able to move quickly was that we had all of these
relationships and partnerships already in place so, you know, we knew the clinical
teams, we had the engineering expertise and we had the manufacturing
capability but, for example, it meant that when it got to the point that Mercedes were
manufacturing the first devices and that they had a few ready they jumped in a
car down here to London, parked up in the UCL quad and we were in UCLH Hospital
on the seventh floor there with the clinical teams from the intensive care
unit plugging the devices into the hospital oxygen supply networks and testing them.
And really, because we had this whole team in place where we
had the clinical representation the engineers and the industry and manufacturing,
it really meant that we could move all of that very quickly and seamlessly.
We had volunteers in the hospital setting who had the devices on,
they were breathing through the masks and we were essentially testing to see
whether the devices were performing the way that they should do,
and the way that we anticipated they would.
At that point we could then make our first submission to the regulator.
We were demonstrating like-for-like in terms of performance
of our CPAP devices compared to the original WhisperFlow one and also
presenting our healthy volunteer test data and our plans for a clinical evaluation.
I remember we submitted that to the regulator within 10 days of that initial meeting.
We got approval for the device very quickly too, so virtually immediately
And we started talking to the Cabinet Office and the Department of Health and Social Care.
We were having a Zoom call with them and quite quickly the conversations
progressed and they put in an order for up to ten thousand of the devices.
So Mercedes were able to produce these devices at a rate of up to a thousand day.
so we knew we could deliver on these kind of volume of numbers.
We've started getting an increasing number of contacts coming in from hospitals
across the UK but then also internationally around getting access to the devices.
We released all of the designs and manufacturing processes at zero cost
to enable the international community to start manufacturing them themselves.
Within a couple of weeks now we've had over 1,800 approved downloads
and that's across over a hundred countries which is phenomenal.
And it's also been amazing to see that different countries are
starting to now produce their own versions of the CPAP devices and
prototypes and we're now getting photos from, for example, Kenya or Canada, Russia
and Bulgaria where people are sending in their initial prototypes.
I think to date we've supplied devices and consumables to over 40 hospitals.
From the beginning, you know, our complete motivations with this were to be able to
contribute and do something that would help in the kind of Covid fight.
From seeing the device for the very first time we went from that part
of the project through to making the first prototype and being back in
hospital for testing within a hundred hours and then within 10 days we'd
actually taken that prototype through the approval process with the MHRA.
In that first meeting we had, if we'd been told that within 4 weeks
we want you to manufacture 10,000 of these units that would've been probably
too much to take on board and we, you know, we would've had a different mindset.
To have delivered that 10,000 within four weeks, looking back on it, you know, it's an incredible achievement
Within two half days we were starting to run out of essentials so we sent one of the
younger members of the team up to sort of Kings Cross St Pancras to go and
see what they could find. We could've had sort of like nice white
dress shirts or pyjama tops or these bright pink T-shirts
and we got the bright pink T-shirt. It had something like tropicana...
- Yeah, it had palm trees and then like 'Ventura' on the logo.
- And 'Ventura' was the logo. And that's where the name for the device came from!