For those of us outside the US/EU, can someone explain about the change in tone here on HN ? There was a similar post a few weeks back and top-voted comments were uniformly scornful about such DIY medical equipment, and about how a ventilator was just one component in the ICU ecosystem.
Now, though, there is a complete 180 ? What gives ?
There is also the question of supply-side issues - uCs and IC boards are overwhelmingly manufactured in East-SE Asia. These projects can't get around these issues, right ? If only there were someway to hack the abundant numbers of smartphones in order to do something useful.
> For those of us outside the US/EU, can someone explain about the change in tone here on HN ?
HN is being HN, for better or worse. First skepticism, then shallow takes, then acknowledgement and analysis, now frenzied problem solving.
> a ventilator was just one component in the ICU ecosystem.
Yes, the ventilator is a CPAP machine on steriods. The Respiratory Therapist, Intensivist and Critical Care Nursing staff are what actually keeps someone alive. It's not uncommon for one or more of these to have multiple touches per hour for evaluation and adjustment of the parameters, management of other life support, etc.
We need to buy a shit-ton of ventilators and PPE from existing manufacturers and provide relief for the front-line staff who will be using them.
Everyone is different, and one size does not fit all; thereby causing complications which require a trained eye to appreciate (read: carry in your head the list of people/procedures to execute in case of problems, and list of things to ignore) in order to accomodate that.
It's called the "practice of medicine" for a reason. You can do everything "right" by the book and still have things go wrong. There is no substitute for eyes on the patient. Ever.
I’m still pretty scornful. There’s an existing satisfactory and easy to manufacture design (Manley ventilator) that addresses issues of controlling tidal volume and operating on whatever supply and even allowing manual operation. DIY could make thousands in a cottage industry if desired. Here we are instead with people designing devices and then asking for doctors to give them a pat on the back.
Sometimes it's good to remind yourself that HN comment threads are not written by single person and the opinions are not those of a single entity. Different posts attract different cross-sections of users which lead the discussion in various directions. In my experience it's not that uncommon to see completely different threads on similar posts here.
There is nothing wrong with an having an emotional factor in decision making. There is only shame in not being willing to eventually come to terms with writing the eventual rational check in order to pay for the inevitable run-up against the difference between the world as you imagine it vs how it actually is.
In fact, there is a much greater danger in abolishing emotion in its entirety from your decision making process period. It is very easy to end up in a situation where you create more problems than you created a solution for because you didn't take into account the fact you're dealing with other human beings. A practice famous for requiring good interpersonal communication; something dependent on being able to see things from another point of view.
Also, let them. The truly novel solutions tend to be hiding in places no one bothers looking because we're trying to take the rational structures have, and work backward to a solution whereby we can use as much of what we already have in place to make what we want. Working from a dearth of preconceived notions can lead to genuine innovation in some cases.
If it can get you a helicopter, it can get you a ventilator.
The calculus has changed; to put it simply. People don't like sitting around idly, and if there is the risk the official supply chain infrastructure can't keep up, people will rise to try to actually solve a problem.
Without the threat of an overwhelmed healthcare system, why worry about a DIY ventilator? It would comfortably register as SEP (Someone Else's Problem) on most people's radar given the complexity of the rat's nest of regulation around the industry. With the crisis being what it is, however, you suddenly have a very interesting optimization problem, with very high stakes.
I can't fault folks for at least trying; and at the end of the day, who knows, someone may make something better/more efficient/cheaper/reliable/good enough to help. You'll never know if you don't try.
Just remember: do your research, learn why the current state of the art is what it is first, then make sure you can justify any design alteration you make in your particular implementation, then consult a regulator. They are there to either help or to specifically be part of whether or not your design is good enough given the logistical shape of the field.
That doesn't mean everyone go spam the FDA at once, mind. You don't want to DDoS the regulatory pipeline. If you're serious about it though, and willing to jump through the hoops in hope of being able to provide an alternative just in case; do so. Note it doesn't hurt to put a little more strain on the regulatory infrastructure as well. It helps the regulator to justify innovating how they can do their job more efficiently to!
Then, once you have regulator buy-in, go to your investors, and make the case for getting some mass production spun up, or figure out whether your job is done in the sense you're more of a design person, and less of an implementer, and get your design to those who can run with it.
This is the magic of the market at work! Not some arbitrage scheme, but an honest to God shift toward creating a greater supply capability to fill increased demand.
Now, though, there is a complete 180 ? What gives ?
There is also the question of supply-side issues - uCs and IC boards are overwhelmingly manufactured in East-SE Asia. These projects can't get around these issues, right ? If only there were someway to hack the abundant numbers of smartphones in order to do something useful.