Those two numbers — 30 and 30,000 — and the chasm they represent could mean life or death for many as Britain moves toward peak infection this month.
To underline the stakes, the British Medical Association announced this week it is finalizing guidelines to help doctors decide which patients with serious underlying medical conditions may be denied access to ventilators if there are not enough devices for all.
Britain, like the United States, is scrambling to acquire ventilators to care for the critically ill coronavirus patients who need the oxygen machines to pump air into lungs ravaged by the virus.
There are 8,000 ventilators available today in England, home to 56 million people. Britain has far fewer critical-care beds and breathing machines than Germany, France, Italy and Spain.
Three weeks ago, the prime minister issued a plea for help to British manufacturers to switch their idled assembly lines over to make ventilators.
Health Secretary Matt Hancock called this “national effort” unprecedented in peacetime. The British media quickly recalled the life-or-death struggle of the late 1930s, when Morris Motors turned its factories from assembling boxy sedans to building Spitfire fighter planes.
And British industry did answer the call, even as the experts cautioned that these are sophisticated medical devices, not bicycle pumps.
Disease modelers warn that Britain will face a peak of cases in the next two to three weeks. Depending on whether strict social-distancing measures continue to be enforced through the spring and summer, this April wave could be the first of many.
National Health Service officials say they have enough ventilators on hand for existing intensive-care unit cases. If the number of cases explodes, as forecast, they may struggle.
The U.K. reported more than 34,000 confirmed cases and about 3,000 deaths, with Wednesday’s total of 569 deaths a daily record.
To triple its supply of ventilators in weeks, the British government is tapping three distinct supply chains.
The government is seeking to import machines from abroad and also pushing Britain’s small domestic ventilator manufacturers to massively scale up production of existing designs. And finally, the government has contracted with a vacuum cleaner maker to introduce an entirely new design.
Each supply stream faces formidable challenges.
A new, as yet untested, prototype
The engineering firm run by Sir James Dyson, the billionaire inventor best known for his vacuum cleaners and hair dryers, developed a prototype in a mere 10 days, which his company plans to build at the company’s laboratory in a former wartime Royal Air Force base.
The government placed an order for 10,000 of Dyson’s machines, called the CoVent. The inventor said he would donate 5,000 more.
“This new device can be manufactured quickly, efficiently and at volume,” Dyson announced. “The race is now on to get it into production.”
Dyson partnered with the Technology Partnership, a Cambridge-based group of science and innovation companies with expertise in medical equipment. Dyson was joined by the defense firm Babcock.
The Dyson machine is still awaiting approval from the health-care products regulatory agency, which usually takes months but promises to move more swiftly than ever before.
As remarkable as their turnaround may be, Dyson may not begin full production for weeks or longer.
Pairing manufacturing giants with small ventilator firms
Britain has only a handful of domestic producers of ventilators, including the companies Penlon and Smiths Group, and they’re both small shops.
“To provide some context, Penlon and Smiths ordinarily have combined capacity for between 50 and 60 ventilators per week,” said Dick Elsy, chief executive of the High Value Manufacturing Catapult, a group of manufacturing research centers here assisting the two mom-and-pops, with partners like the giants Ford, Siemens, Mercedes, McLaren and Meggitt.
“We are targeting production of at least 1,500 units a week of the Penlon and Smiths models combined within a matter of weeks,” Elsy said in a statement.
He cautioned, “Ventilators are intricate and highly complex pieces of medical equipment and it is vital that we balance the twin imperatives of speed of delivery with the absolute adherence to regulatory standards that is needed to ensure patient safety.”
It is Penlon that is producing the first 30 British-made ventilators that are now headed into NHS hospitals.
The government is also ready to buy the Smiths ventilator, which is used in ambulances. Industry partners say Britain is contracting for at least 10,000 of the Penlon and Smiths machines — to be delivered over coming months.
Like buying ‘on eBay’
There is already an intense competition worldwide to buy machines from existing suppliers. Recently, New York Gov. Andrew M. Cuomo complained, “It’s like being on eBay with 50 other states, bidding on a ventilator.”
Britain hopes to get at least 8,000 ventilators from abroad.
Gove, who is a leader of Britain’s virus response, blamed “communication confusion” over the government missing a deadline to join the European Union’s effort to acquire ventilators.
Gove told the BBC that the E.U. procurement plan offered “nothing that we can’t do as an independent nation that being part of that scheme would allow us to do.”
Aides to Gove stressed that Britain is no longer a member of the European Union and would find its own way.
Neil Campbell, CEO of Inspiration Healthcare, said his company was importing ventilators for the NHS from Israel and the United States. At $5 million, it was the largest order the company has ever received for ventilators.
Yet even that number illustrates the scale of need. A $5 million order for the kind of top-end ventilators placed in ICUs — which sell for $25,000 and more — might fetch just 200 devices.