Although hospital ventilators were initially the standard treatment for COVID-19 patients experiencing breathing difficulties, doctors are now increasingly first trying CPAP and similar breathing machines normally used by those with sleep apnea. In this case, CPAPs with added oxygen are used to avoid putting patients on ventilators from which most eventually die, notes professor John Banzhaf, an MIT-educated engineer and inventor who is now a law professor.
Banzhaf was one of the first to suggest and aggressively publicize using CPAP machines – sometimes called a “poor man’s ventilator” – in situations of only moderate respiratory distress where a patient might not require the full power and sophistication of a hospital-type ventilator, especially since the latter involves very serious risks, and is a treatment from which many COVID-19 victims never recover.
His suggestion received a major boost when the Food and Drug Administration [FDA] not only recommended the technique but made it legal by a ruling dated March 22.
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In a guidance document issued on that date, the agency said: “Continuous Positive Airway Pressure (CPAP), auto-CPAP, and bilevel positive airway pressure (BiPAP or BPAP) machines typically used for treatment of sleep apnea (either in the home or facility setting) may be used to support patients with respiratory insufficiency provided appropriate monitoring (as available) and patient condition.”
Sleep apnea patients to the rescue
The Australian counterpart of the FDA issued a similar ruling shortly thereafter, and doctors treating COVID-19 experimented with the devices, occasionally adding oxygen and/or making modifications.
This addition to the arsenal of weapons against the deadly virus is very important, says Banzhaf, because:
- Ventilators are in short supply while there are millions of existing CPAP machines;
- Hospitals are able to buy more CPAPs (at about $850) than ventilators ($25-50K), especially since there is little use for the latter once peak demand ceases;
- People are readily donating their machines which are no longer needed; something Banzhaf originally suggested in a TV interview.
The New York Times has just reported that “Doctors at North Shore University Hospital on Long Island have been using machines designed for people with sleep apnea to keep scores of coronavirus patients breathing,” and that such innovations “may have helped stave off the dire ventilator shortages and rationing that some had feared but have not come to pass.”
The report also points out that “many hospitals are using them to increase oxygen levels without resorting to intubation. The devices, doctors say, have been especially helpful for coronavirus patients with moderately impaired lung function.”
Of all the tools for fighting the deadly virus which have come out of universities, this may be one of the most useful. It is rather clearly one of the most unusual, since Banzhaf isn’t a medical person, nor even a scientist and engineer.
Rather, he is an interdisciplinary academic figure who has made his mark in fields as varied as public health (“The Man Behind The Ban On Cigarette Commercials”); computer science, game theory, and political science (the “Banzhaf Index”); and public interest litigation (“a Driving Force Behind the Lawsuits That Have Cost Tobacco Companies Billions of Dollars”).