Accidents and Improvements During Pandemic

The Hand of Fate

Many times in history the hand of fate can be seen weaving triumph in adverse times for humanity. Whether it be the discovery of penicillin in the Great War, which resulted in millions if not billions of future lives being saved, or use of the drug Remdesivir in Covid-19 patients. (Kupferschmidt, Cohen) When times are most pressing, humanity has a tendency to innovate at a better frequency than they usually would. I believe that this will be no different in the wake of the coronavirus, and so far events can be shown to have followed this prediction. Adjusting ventilators for it to suit more than one person, reforming societal structures through the use of quarantine in order to keep people safe with tented facilities being brought up in order to test possible carriers of the virus as well.

A truly wonderful story of innovation during these times that I would wish to point out would be the use of the previously mentioned Remdesivir in order to treat Covid-19 as its origins do speak for the amazing coincidences that can happen during trying times such as these.

Remdesivir’s Happy Little Accident

A possibly promising boon

Remdesivir was originally created to combat Ebola, to not much success. “Researchers tested Remdesivir last year during the Ebola outbreak in the Democratic Republic of the Congo, along with three other treatments. It did not show any effect.”(Kupferschmidt, Cohen) With it not having initial success in its intended use many would assume that this medicine would simply die out and be forgotten. However, the drug was shown to have effects on MERS and SARS, being able to stop the disease from reproducing inside of your cells. This gave it the potential to have extremely beneficial use in the efforts against the current Covid-19 pandemic, seemingly by accident. “The first COVID-19 patient diagnosed in the United States — a young man in Snohomish County in Washington — was given Remdesivir when his condition worsened; he improved the next day.” (Kupferschmidt, Cohen)

While the drug is still going through testing it cannot be used as a sure-fire method to counteract the symptoms of Covid-19 and has so far only rarely been administered to those under terrible and worsening conditions, with seeming results of success. Until the drug has undergone the proper testing and has been deemed safe for administration under correct intent and purposes it will only continue to be used in the way that it is now, as a last resort. Many may disagree with its usage as a last resort and say that if people are seeming to get better after its administration then it is best to use it. I find this point to be naive as many medicines can have unseen adverse effects on those administered many years down the line. In this case, I think the safest bet is to trust WHO, the World Health Organization, and medical professionals’ opinions on using this as a last resort, at least in that case it is better to suffer ill effects decades later than to die sooner right? This is however still excellent news in the fight against Covid-19 and an excellent way to take advantage of an accidental benefit of an already existing technology.

Innovation and Thought

Steven Johnson, a visionary in things relating to innovation and the author of the book Where Good Ideas Come From, would classify this phenomenon relating to Remdesivir as an Exaptation. Steven Johnson defines exaptation as adapting technology from another field and putting it into use in a separate field. While that may not exactly be the case for Remdesivir I believe it to be so for the following reason. Remdesivir was, as previously stated, originally intended to combat Ebola but instead became much more useful under the use of combating against COVID. So while it may be in the same field, medicinal, it is an example of modern-day exaptation due to it being used for a purpose other than its originally intended purpose.

It is important to understand the thought process in the change of the use of Remdesivir in order to inspire similar thought processes with other technologies, which could potentially lead to results similar to the positive effects being shown currently by Remdesivir. This thought process of manipulation of current technology can be shown in another format, shown relatively early on in the history of this pandemic. The use of a single ventilator to accommodate two separate patients. This was done popularly through some simple engineering on the hospital's side however while the technology is useful during this time and has helped accommodate for the fact that the supply of ventilators is far below what is needed currently, I would like to address the possible dangers of this innovation to show how improvements are needed.

The Stepping Stones of Progress

Hospital Ventilator

While this innovation has become crucial for making sure that patients heavily affected by Covid-19 are more likely to receive treatment this method of distributing a single ventilator to up to four patients can prove to potentially be dangerous. “A ventilator could inflate and deflate multiple artificial lungs, but could not address whether there would be adequate oxygen or any potential for lung injuries. A follow-up study on animals found that ventilators struggled to distribute air evenly. There has never been a controlled test on human subjects.”(Gabrielson, Edwards) As established by this quote there has been little to no testing on human subjects, which means that this potentially could cause injury and which means that ventilators will only be used amongst more than one person as needed. Secondly, the quote establishes the potential for harm to the patients if distributed to more than one person. This could either be caused by incorrect air pressure being pumped by the ventilator as the ventilator is only able to pump at a single air pressure to multiple people, it can’t cherry-pick the pressure individually for them once catering to more than a single individual, which means that some pressures can either be too much or too little for what a person means. This, in turn, means that they may either receive little to no help from the treatment or this may result in further injury. The air pressure also determines the amount of oxygen an individual is meant to receive from a ventilator. The keyword here is, “individual”. This means that we can run into a similar problem as we do with the air pressure, except instead with patients either receiving too little or too much oxygen which may also similarly result in either little to no help from the treatment or possible injury.

Ventilators modified to suit more than a single individual

The Importance of Critique

While this innovation is definitely welcome as it is better to be here than not, the more people getting whatever treatment they can get the better. I feel however it is important to criticize the flaws when you see them as that is what leads to improvement. Perhaps if modifications in the tubing, such as individualized sizes of tubing can be made in order to attempt to modify the air pressure a patient is receiving, as well as oxygen, can be considered? So that a single ventilator can be pumped at a consistent pressure and oxygen output while the tubing going to each patient can better cater to them.

No doubt this idea of mine is flawed. If it is I would highly encourage you to voice your educated opinions on how we can solve problems during this pandemic. Through collaborative effort and accidental improvements we can make strides during this pandemic in order to make significant progress in our fight against it.

Bibliography

Kupferschmidt, Kai, et al. “WHO Launches Global Megatrial of the Four Most Promising Coronavirus Treatments.” Science, 27 Mar. 2020, www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments#.

Johnson, Steven. Where Good Ideas Come from the Seven Patterns of Innovation. Penguin, 2011.

Gabrielson, Ryan, and Kyle Edwards. “Desperate Hospitals May Put Two Patients on One Ventilator. That’s…” ProPublica, www.propublica.org/article/desperate-hospitals-may-put-two-patients-on-one-ventilator-thats-risky.

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This is the web site for AIMM 170 class projects, taught in the Spring of 2020 at The College of New Jersey

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