Ireland’s research, business and maker communities responded quickly to PPE shortages in the early days of the Covid-19 pandemic. Three researchers explain how they want to learn from that experience in order to prepare for the future.
Since the first reported case in December 2019, Covid-19 has spread rapidly and globally, creating a strain on healthcare services worldwide. The highly infectious nature of the disease, with no immunity in the population to date and transmission by respiratory droplets, means that the effective use of personal protective equipment (PPE) such as gloves, gowns, masks, and face shields is required to minimise the spread of the virus.
Yet due to the rapid progression and widespread nature of the pandemic, supplies of PPE became strained, creating difficulties in sourcing for healthcare institutions, with some healthcare systems facing estimated delays of three to six months for requested supplies.
The most significant supply chain bottlenecks for PPE under normal circumstances are in attaining raw materials, machinery, geographic concentration of manufacturers and export bans. Creating new production lines to accommodate increased demand takes time to achieve, with one study citing six months to assemble a production line for melt-blown fabric needed for masks.
‘It is essential that researchers and innovators reflect on the past months to create efficient, safe and operational products and supply lines for PPE’
In Ireland, while many efforts were taken to supply frontline staff with PPE, it is clear numerous shortages were experienced. SIPTU reported 18.9pc of surveyed members felt that they did not have access to sufficient PPE and nursing homes faced many difficulties in attaining supplies.
Responding to critical shortages, the Irish Government purchased and procured PPE from China. Unfortunately a proportion of these materials were considered unfit for use.
Many companies and resourceful innovators assisted in making up the shortfall, by diversifying their product lines or changing course completely to produce PPE shields, gowns and other materials. Even industrious individuals, hobbyists and school students went to great lengths to protect frontline staff.
These individuals and groups used additive manufacturing (also known as 3D printing) and crowdsourced designs to produce materials for dissemination. Inspiring examples such as Benchspace in Cork were able to produce 40,000 face shields for frontline staff by organising a depot for printed face shields, streamlining the testing and sanitising phases before release to frontline staff. So successful was their process that the Irish Defence Forces collaborated with this group in mid-April.
The Irish Defence Forces stepped in to help us yesterday.
They have taken over assembly and distribution of the 1,000 PPE face shields #benchspace are producing for healthcare workers each day. #corkppe #makersunite pic.twitter.com/KhluUHxP51
— Benchspace Cork (@BenchspaceCork) April 16, 2020
Joining the response, researchers and technical staff from the I-Form Advanced Manufacturing Research Centre, Dublin City University (DCU) and University College Dublin (UCD) pooled resources, opened laboratories and began to produce emergency PPE supplies. 3D printing and laser cutting were applied to produce polymer face shields and goggles which could be distributed to healthcare institutions.
In total, the group produced approximately 5,000 PPE items for frontline staff and relevant agencies, collaborating with voluntary organisations such as the motorbike community Bravo Charlie Tango to deliver supplies around the country.
As Ireland begins to move slowly and gingerly out of lockdown, many are beginning to focus their attention on more sustainable and sustained mechanisms for protection against the virus. From an environmental standpoint, the inflated use of PPE has created an extensive waste problem globally. In the UK alone, it is estimated that if every person used a single-use face mask a day for a year, it would create an additional 57,000 tonnes of plastic packaging.
Most PPE is designed to be single use, which provides maximum safety. However, when supplies are limited, cleaning and reusing PPE where possible may be permissible if treated carefully.
A recent Irish case study looked at the possibility of sterilising PPE for reuse. While reuse is not ideal, this report noted that vaporised hydrogen peroxide and UV irradiation are suitable methods that may deployed to sterilised used PPE when fresh supplies are not available.
Elsewhere, successful 3D printing of frames for face shields using open-source designs and biodegradable materials may offer more sustainable approaches to PPE in the future. However, these attempts are currently costly or time-consuming, reducing their efficacy for large-scale requirements.
I-Form is also conducting testing on the development of reusable copper filters for respirator masks. N95 respirator masks use disposable filters that must be discarded after use, which generates cost and waste and necessitates an ongoing supply. Copper has inherent anti-viral properties and is robust enough to stand up to sterilisation. If reusable copper filters can be developed with comparable filtering and breathability, they could replace the disposable filters, improving sustainability and mitigating this supply chain risk.
Learning from the past
While the supply of PPE is a critical component of the day-to-day life of frontline staff nationwide, it is essential that researchers and innovators reflect on the past months to create efficient, safe and operational products and supply lines for these materials. It is now, therefore, a good point in time to ‘take stock’ so that we may be prepared for the months and years to come.
Localised, open-source, emergency production of PPE is a novel method that has shown initial success, and with continued feedback and development could become an important factor in dealing with new waves or future outbreaks.
Further work is being done to update the design of these items to improve the user experience. A survey from I-Form and DCU will appraise the PPE produced and used by frontline workers to assess the quality of the existing designs and identify areas for improvement. The survey also examines the role that open-source innovation played in the rapid ideation and manufacturing process, and the efficacy of online communities to crowdsource solutions in times of crisis.
This feedback will allow bodies to improve national and international strategies in their efforts to fight the ongoing pandemic, and future crises that may require rapid ideation and manufacturing.
Éanna McCarthy is a postdoctoral research fellow in the DCU School of Mechanical and Manufacturing Engineering. Dermot Brabazon is professor of materials science and engineering at DCU and deputy director of I-Form, the Science Foundation Ireland research centre for advanced manufacturing. Roisin Lyons is assistant professor in entrepreneurship and innovation at DCU Business School.
If you are or were either receiving and using PPE, or participating in an open-source initiative to provide PPE, you can complete the survey here.