The South African National Ventilator Project (NVP) is a co-ordinated national effort in response to the Covid-19 pandemic involving the local design and manufacture of breathing apparatus devices used in patient treatment. It is an example of our nation’s ability to innovate and collaborate to deploy a wide range of expertise and manufacturing competencies, and successfully deliver a fit-for-purpose solution in a very short space of time.

The project has been driven as a collaborative initiative between government and industry since its establishment. A meeting was initially held in early March 2020 attended by Ministers and representatives of the National Department of Health, the Department of Trade, Industry and Competition and the Department of Science and Innovation; in addition to a range of industry stakeholders. A global shortage and escalating prices of imported ventilators informed the need to develop local capacity for the manufacture of breathing support devices, and this was agreed as an urgent national priority.

A concerted effort to identify Covid-19 related treatment therapies for patients and develop a fit for purpose specification for breathing apparatus devices rapidly ensued.

It was becoming evident that compromised respiratory function was prevalent in all symptomatic cases, and respiratory support was mandatory for more severe cases. Continuous Positive Airway Pressure (CPAP) was shown to be very effective in the UK and Italy where ICUs were being overrun by patient demand, and CPAP devices were deployed to fill the gap between simple oxygen treatment and invasive ventilation.

South Africa was able to learn from the prior experience of these countries, and consequently CPAP was adopted as the respiratory support modality to be pursued by the NVP.

CPAP is a limited scope therapy requiring a relatively simple device and a simple standard operating procedure:

  • it is non-invasive: The respiratory gas is provided to the patient by a mask, not via intubation;
  • patients are conscious and cooperative during the therapy, and capable of spontaneous breath; and
  • it is an open-loop system: there is no requirement for complex control systems that vary the therapy parameters automatically.

The CPAP devices cannot be used at home as they require a reliable source of oxygen. A hospital bed with an oxygen point is therefore the ideal basic minimum required for treatment, although use with oxygen bottles may be appropriate during patient transport and for short periods of time when patients are waiting transport to hospitals with fixed oxygen points, for example.