B Y T H E N U M B E R S Capacity
treatment will become the standard for comparisons with new experimen- tal treatments. The initial sample size will consist of 440 trial participants, who will receive a placebo or remdesivir intra- venously for up to 10 days total, after which clinicians will monitor partici- pants regularly and assign them daily scores based on a scale of clinical out- comes that considers factors such as temperature, blood pressure and use of supplemental oxygen, along with others. No preliminary results of the study have been posted yet because it is being conducted double-blindly, according to the hospital, which means neither the patient nor the researchers know whether the patient is receiving the drug or the placebo. The methodology is considered the “gold standard” of such studies, according to the Journal of Postgrad- uate Medicine, because it prevents the researchers from unintentionally tipping o the study participants or unconsciously biasing their evalua- tion of the results. Baylor College of Medicine has also joined other TMC member institu- tions in gathering blood plasma aimed at treating COVID-19. “Using this strategy called ‘con- valescent plasma,’ we transfuse the antibodies from surviving victims in hopes that it will attack the virus and boost recovery,” said Dr. Henry Wang, executive vice chair of research in the Department of Emergency Medicine with McGovern Medical School at UTHealth. Houston Methodist Hospital was already given the go ahead March 28 by the Food and Drug Administration through an Emergency Investiga- tional New Drug application to trans- fuse donated plasma, while St. Luke’s Medical Center has already performed several of the same procedures under the same applications. Worldwide, there are 178 treat- ments for COVID-19 under develop- ment as of April 27, according to the Milken Institute. Manufacturing Another critical need has been for ventilators—equipment that keeps critical patients alive and gives them a chance to survive the disease. Work on improving the supply of ventilators has been ongoing at the Oshman Engineering Design Kitchen at Rice University this spring. The team has been developing an open- source ventilator for not only local
hospitals but also for any health care provider. “Considering the state of the health care system in the United States, we are running out of ventilators, and people are having to use transport ventilators and emergency venti- lators, which are essentially hand pumps, as the only ventilator solu- tion for patients,” Rice University engineering student Thomas Herring said. “That’s where we want to hit our mark.” Herring works as the only student member of the ApolloBVM team, tasked with creating an automated bag valve mask, or BVM, using o- the-shelf components to provide hos- pital-grade mechanical ventilation at less than $300 per unit. This compares to more expen- sive ventilators, which can range anywhere from $5,000 to $50,000, depending on the kind of gas delivery system, according to medical equip- ment provider Medtronic. The ApolloBVM team completely reworked a previous ventilator design rst developed by Rice University stu- dents as a senior design project in 2019 for underdeveloped countries with no access to ventilators, Herring said. The revamped ventilator would assist hospitals during the transport period from the ICU to getting a PET scan, for example, Herring said, as nurses would still need to ventilate their patients. But the team and university was able tomove to that point, as of April 23. Houston-based manufacturer Stew- art & Stevenson LLC signed a licens- ing agreement with the university to produce an advanced version of the ventilator. “This agreement combines the strengths of S&S’s engineering, high-volume manufacturing and global distribution capabilities with the outstanding work by the ventilator development team at Rice’s Oshman Engineering Design Kitchen (OEDK),” said Joe Reniers, president of Kirby Dis- tribution and Services, of which Stew- art & Stevenson is a subsidiary. S&S already applied for emergency use authorization of the design from the federal Food and Drug Administra- tion, and the designwasmade available as a set of open-source plans. “I am thrilled that the hard work by the OEDK team, in the midst of the COVID-19 pandemic, has resulted in this agreement with Stewart & Steven- son,” said OEDK Director Maria Oden, a teaching professor of bioengineer- ing and co-director of the Rice 360˚
A S O F A P R I L 2 7
As the Texas Medical Center ghts COVID-19, constant planning has been required to provide needed equipment, supplies and other resources without overextending.
total hospitalized COVID-19 patients in Texas Medical Center’s member hospitals across Greater Houston area
1,202 patients successfully discharged
624 patients hospitalized
Minimal - Little to no social distancing
Moderate - Under “stay at home” orders
Maximum - Complete lockdown
T M C I C U B E D S
With 259 ICU beds in use by a COVID-19-related patient in TMC hospitals, the system could accommodate as many as 1,750 more. However, the system could still fall short under moderate or minimal social distancing.
up to 12,600 needed with minimal distancing 2,900 with moderate distancing Estimated bed demand scenarios
1,187 additional surge capacity
259 occupied by COVID-19 patients
1,450 with maximum distancing
638 occupied by other patients
T M C V E N T I L A T O R S
TMC hospitals have 104 ventilators in use by COVID-19-related patients, with capacity for another 1,048, and an additional 2,000 ready in case of a surge. The TMC estimates that 80%-90% of COVID-19 patients in ICU will require a ventilator.
up to 10,700 needed with minimal distancing 2,500 with moderate distancing
2,015 additional surge capacity
104 occupied by COVID-19 patients
1,250 with maximum distancing
361 occupied by other patients
SOURCE: TEXAS MEDICAL CENTERCOMMUNITY IMPACT NEWSPAPER
Institute for Global Health. “They have the ability to produce the ApolloBVMat scale, providing emergency ventilation needs during this crisis and beyond.” More than 2,300 people from 105 countries have registered to download the plans so far, as of April 23. The manufacturer serves customers
worldwide from 43 U.S. and interna- tional locations. Ben Thompson contributed to this report.
For more information, visit communityimpact.com .
BELLAIRE MEYERLAND WEST UNIVERSITY EDITION • MAY 2020
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