Authors: Franco Arteaga, Manuel Aspilcueta, Lizbeth Díaz, Juan Palacios
The current SARS-CoV-2 pandemic has generated an environment of instability in most
sectors of the country, one of the most affected being the Peruvian Health System. This has caused that it is not possible to have the basic equipment and implements to treat patients in critical conditions given the limited amount of medical resources available in the country's hospitals, additionally it is emphasized that the import and acquisition process of these elements is It has become very slow and complex in these times. These problems have generated the present public health challenge: developing and producing our own required medical equipment and supplies.
A silent enemy
The main cause of mortality from SARS-CoV-2 is shortness of breath, which leads the patient to being admitted to an Intensive Care Unit (ICU), where they receive assisted breathing by means of a mechanical ventilator. In Peru, at the beginning of the pandemic the Ministry of Health (MINSA) stated that there were only 100 ICU beds to treat the most critical patients of the new coronavirus. Meaning that statistically there was available 1 ventilator for every 320,000 inhabitants, one of the lowest values across South America (Diario Gestión, 2020). However, although it is true that this amount managed to be increased to more than 1,556 units (Minsa, 2020), today there is still a large deficit of equipment that needs to be covered, considering the population size of each region.
As a result of this problem, the Peruvian government opted for the importation of mechanical ventilators, however, as there is a great demand for these equipment worldwide, the process of acquiring such life support therapeutic resources has become complex and difficult (Andina, 2020). Given this situation, various groups of Peruvian researchers and engineers began the race to implement innovative solutions that can help combat the present problem, and thus save the lives of hundreds of Peruvians. Some of the projects that are currently being developed in the country are mentioned below.
In the city of Lima, a multidisciplinary team, made up of students and graduates of Mechanical Engineering, Electrical Mechanics, Mechatronics, Physics, Telecommunications and Administration degrees, the National Engineering University (UNI) took on the challenge of developing the mechanical fan “FéniX”. An efficient and high-end equipment that will contribute positively in the fight against the SARS-CoV-2 pandemic, making sustainable and rapid progress both in the technical and logistical part of the project.
In this way, the device presented by this educational institution is characterized for using a variety of components certified under the highest quality standards required for equipment of its nature (Prensa UNI, 2020). It has a sophisticated system that allows it to be monitored remotely, and it also stands out for its optimal operation given the environmental and external conditions to which it could be subjected during its operation stage. It also has been tested at high altitudes (Morococha 4800 m.a.s.l.), an environment in which it has functioned correctly (Santivañez, 2020).
Currently the work team is in the process of developing five mechanical ventilators, which will be distributed to the Huánuco Hospital. For this, they have had the support of various strategic allies, among which are the Peruvian Army, Motores Diesel Andinos, ZyTrust S.A., the Navy, Auna Clínica Delgado, Antamina, Footloose and the Ate Vitarte Emergency Hospital.
Similarly, an initiative promoted by five institutions, BREIN (the Breca group's innovation hub), Diacsa, Zolid Design, Energy Automation Technologies and the Pontificia Universidad Católica del Perú (PUCP), promoted the creation of the MASI project, which in Quechua means' a partner or friend close that provides support'. This project seeks to create an emergency mechanical respirator, capable of helping a person when, due to different pathologies, loses the ability to breathe on his own; one of the main problems detected with the COVID-19 disease (Proyecto MASI, 2020).
Augusto Acosta, Design Coordinator (2020), in an interview, informs us that the first step in developing this kit was to investigate what type of mechanical respirator was the most appropriate for these circumstances. To achieve that, they interviewed intensivist doctors from the Dos de Mayo Hospital, the San Pablo Clinic and the International Clinic and finally validated the information with the Ministry of Health.
Thus, they managed to manufacture a mechanical ventilator from a biomedical perspective and following rigorous clinical parameters. This equipment, made up of both mechanical parts and high-end electronic components, has the ability to be synchronized with the patient, since it has input sensors to monitor different parameters of their medical situation. These ventilators include the telemedicine function, with which intensive care physicians who are on leave for belonging to risk groups can monitor patients connected to MASI from their homes. In addition, it has three ventilation modes.
Moreover, various entities have contributed to the development of the MASI project: AGP Group, AUNA, the National Council of Science, Technology and Technological Innovation (Concytec), the Faculty of Veterinary Medicine of the Universidad Nacional Mayor de San Marcos, Fondecyt, Hagroy Electronic, McKinsey & Company, the Minsa, NOX, the Presidency of the Council of Ministers, Rodrigo, Elías & Medrano Abogados and SIGFOX. PUCP, UGP and Asbanc alumni.
It is important to add that, to date, 150 MASI mechanical ventilators have been delivered and donated to the Ministry of Health, in order to attend to cases of covid-19 (Diario El Peruano, 2020). This represents a significant advance both in the development of the project and the effort that the work team has been making to combat the consequences of SARS-CoV-2.
Not only in Lima has the impact of the SARS-CoV-2 virus been noticeable. Lambayeque, a region located in the north of the country, was also one of the hardest regions hit by the pandemic, a look at the figures is enough to be aware of the impact. As of October 11, 26,969 confirmed infected and 2,146 reported deaths, giving a fatality rate of 7.95% (slightly more than double the fatality rate of COVID nationwide). And although it is true that the pandemic still does not seem to have an end near, the scenario has improved compared to April and May, months in which the fatality rate reached more than 11% and the hospitals of the region were overwhelmed by the number of patients.
In this scenario, the engineers David Vigil Zarpán, Segundo Quiroz Abanto and Junior Rospigliosi Gayoso, members of the Huayra research and development group; motivated by the lack of mechanical ventilators in the region and its urgency for patients with critical conditions, they undertook the development of a prototype of a mechanical ventilator (Vigil, 2020). The present work team proposed as objectives of its project to cover the aforementioned need and to be able to contribute to the fight against the pandemic (Vigil, 2020).
It is necessary to mention the importance of the allies they relied on during the development of the project, people and institutions that identified with the motivation of the team, such as two initial members who could not continue for personal reasons: Jesús Quesquén Esquen and Lenin Rivera Villalobos. Additionally, students, graduates and teachers of electronic and mechanical engineering; who supported the planning and acquisition of certain components.
Besides, institutions such as the Lambayeque College of Engineers and the Provincial Municipality of Chiclayo also gave great support to the initiative; as well as professionals such as Engineer Hildomaro Rodríguez, Mr. Valdemar Romero, among others.
It is important to mention that the fan prototype went through numerous challenges, successfully completing its development at the end of May. The work team managed to develop a team with a large number of ventilatory modes (giving the doctor more variety to choose according to the patient's clinical picture), with a fairly simple and easily replicable engineering due to its characteristics, and with medical grade sensors to ensure the fan works optimally.
Finally, it is worth mentioning that this project is still in the prototype phase, however, the efforts of this group of engineers have promoted various initiatives to face the current public health problem in the Lambayeque region.
Solutions to save lives and their continuity
Each of the initiatives mentioned in this article were lunched by professionals with the same thought: "Provide solutions to save lives." This thought has managed to bring together multidisciplinary teams, at the service of their communities, which have greatly helped to face the consequences of Covid -19.
The effort made by each of the people involved in each project mentioned in this article should motivate and encourage more entities to join in this initiative. Public and private institutions are required to join in this work together. In the same way, the government itself must generate the facilities and mechanisms so that this type of project can be carried out successfully in our country.
Likewise, we must not forget that the war is not over yet and that science and technology are playing a crucial role in it. The promising engineering teams in various parts of Peru compiled here are a clear example of this. Therefore, support for this sector must continue and should be increased rapidly and progressively, to be able to face situations such as the one experienced; as well as not to lose young talent in STEM like the ones involved in these teams.
Acosta, A. (2020). MASI interview [Email].
Andina (2020) Good news! Peru will produce mechanical ventilators for critical patients with covid-19. Retrieved on October 14, 2020, from https://andina.pe/agencia/noticia-buena-noticia-peru-producira-ventiladores-mecanicos-para-papatos-criticos-covid19-791549.aspx
Diario El Peruano (2020) Head of State participates in the delivery ceremony of 150 mechanical fans. Retrieved on October 14, 2020, from https://elperuano.pe/noticia-jefe-del-estado-participa-ceremonia-entrega-150-ventiladores-mecanicos-105038.aspx
Diario Gestión (2020) Peru goes from 100 to almost 2,000 mechanical ventilators for COVID-19 in four months. Retrieved October 14, 2020, from https://gestion.pe/peru/peru-pasa-en-cuatro-meses-de-100-a-casi-2000-ventiladores-mecanicos-para-covid-19-noticia/?ref=gesr
Grupo Huayra - Peru (2020) "MUCHIK-R1" MECHANICAL FAN FROM HUAYRA - PERÙ [Video file]. https://www.facebook.com/watch/?v=258884005323281
Minsa (2020) Covid Situation Room. 19 Peru. Retrieved on October 14, 2020, from https://covid19.minsa.gob.pe/sala_situacional.asp
Press UNI (2020) COVID-19: CTIC-UNI "FéniX" fan receives authorization from MINSA to be mass-manufactured throughout Peru. Retrieved on October 14, 2020, from https://rrppuni.blogspot.com/2020/07/covid-19-ventilado-fenix-del-ctic-uni.html
MASI project (2020) What is the MASI project? Retrieved on October 14, 2020, from https://www.proyectomasi.pe/el-proyecto
PUCP (2020, May 27) MASI Project - ventilator for the COVID-19 crisis. [Video file]. Recovered from https://www.youtube.com/watch?v=9j_YABLWG0s
Santivañez, J. (2020). FéniX Interview [Email].
Vigil, D. (2020). Muchik interview [Email].