3D Printing and COVID-19. How did small decentralized setups change the Med-tech industry during the pandemic around the globe?

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In November 2019, Wuhan reported the very first case of a highly contagious and deadly novel coronavirus (n-COV), which was officially named as SARS-COVID19. What began as a few hundred cases centered around a city in the Hubei province in China, caught the international attention when a few hundred cases were reported by the Center for Disease Control (CDC) in New York by early 2020 [1]. By mid-February, Director General of World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus [2] then declared COV-19 as an epidemic. Soon after, we witnessed hundreds and thousands of cases daily from around the globe and WHO declared coronavirus as a global pandemic.

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For us millennials and our parents and grandparents, the word ‘pandemic’ was not an alien as we often used it earlier during the 2009 H1N1 virus [3] and EVD and EHF variants of Ebola virus [4], but the intensity and shock with which the pandemic has hit us, has left the healthcare systems shattered and economies devastated for almost all the countries of the world. It has been more than eighteen months since the first documented case of coronavirus. Where are we now, what have we learnt through this and how new and emerging technologies like 3D printing has helped us fight it? Let’s dive deep into it.

As the COVID cases increased, WHO issued a set of guidelines which required individuals to wear PPE kits, masks and gloves. This created panic among the civilians, and they started hoarding masks and other essential products [5]. By April 2020, we faced a global shortage of personal protection equipments like masks, protective gears and gloves and the entire supply-chain industry got disrupted due to the lack of infrastructural capabilities by the industries to meet the increasing demand in such a short duration of time, so much so that governments were not able to provide PPE kits to the essential service providers and frontline workers like doctors, nurses and hospital staff.

Face-shields came into the picture when CDC and ICMR suggested that they are more effective as masks cover only the lower half of the face. Face-shields, then, were rarely available in the market and industries were unable to prototype, iterate, test and mass manufacture them without die-casting and injection-molding at such a small duration of time. [5]

As we witnessed an exponential growth in the number of cases, more and more ventilators and respirators were in demand and the global health care system was on the brink of collapsing where figures suggested more than 2 million cases only in New York. [6]

COVID-19, COV, Pandemic, covid19, COVID19, Global Pandemic

We witnessed 4 million deaths as of July 2021. A survey by Johns Hopkins University suggested that due to COVID-19, 60% of an average American family has at least one chair empty in their dinner table. And mind you, in most developing countries, there is a huge difference between the actual data and the official state data. So, the actual deaths cases stand much more than the state documented cases. [6]

But why did we fail? Because we lacked medical professionals and researchers like paramedics, doctors or surgeons; or do we lack proper healthcare infrastructure and network?

NO. We failed because we lacked a faster mass manufacturing technique which can take care of the immediate supply chain needs in a short time. We failed because the existing conventional manufacturing techniques that can cater the industry needs immediately.

During mid-2020, the shortage of masks and PPE kits was at its epitome. The entire supply chain industry had collapsed, prices of PPE kits were rising left and right and governments were unable to cater their supply even to the healthcare and frontline workers. However, during these darkest hours, we witnessed something which was never imagined before.

Small groups of individuals and technology enthusiasts, decentralized around the globe, came forward at the eleventh hour and distributing 3D printed face shields for the COVID warriors. In India, these groups comprised of individuals, student clubs, startups and maker communities who started mass printing the face shields and started distributing them to the hospitals and police stations without the need of any mass manufacturing techniques like die-casting and injection-molding [7] [15]. 3D printing has thus, eliminated the need of large infrastructural capabilities and can address the prototyping, iterating and manufacturing process immediately at minimal expenses. In US, the maker communities were tying up with their respective state governments and helping the supply chain industries coming back to its foot.

COVID, 3D Printing, Face Shileds, PPE Kits

This digital versatility and quick prototyping of 3D printing has helped the additive manufacturing technology emerging as a rapid response to COVID emergency. Multiple 3D printing companies and startups like Pursa, Formlabs, and Stratasys have come forward during the sever disruption of supply chains and have helped in the manufacturing of critical parts on-demand using the decentralized 3D printing facility around the globe by open sourcing their designs online which consists of multiple types of respirator designs, face shields, among others. After getting huge appreciation from international agencies like WHO, CDC, etc. the scope of 3D printing was not only limited to personal protection equipments but also have inspired researchers and healthcare practitioners to collaborate with additive manufacturing experts to test 3D printing in various testing devices, visualization aids and emergency dwellings in addition to the existing PPE kits [8].

Face Shileds, PPE Kits, 3D Printing

During August-December 2020, when Northern America was facing a very severe wave of COVID cases [9], many countries especially the United States faced a severe shortage of ventilator and CPAP (continuous positive airways pressure) machines which were widely used to sustain highly critical COVID patients which requires sub-intensive technologies. Then, researchers from an Italian engineering company called Isinnova [10] came up with what is known as the Charlotte Valve which is specially designed to connect the CPAP machines with the snorkeling masks which were manufactured by several sports companies like Decathlon.

Initial nasopharyngeal swabs [11] for the real-time PCR tests were manufactured, tested and iterated on 3D printed prototypes which are fabricated with complex tip structures which eliminated the need to apply flocks at the tips for enhanced sample collection efficacy. These 3D printed nasal swabs were one of the major outcomes of the collaborations of testing agencies and pathologists with additive manufacturers.

COVID-19, Testing, RTPCR, 3D Printing

Mass customization is one of the major USP of 3D printing. Personalized face shields and masks are on high demand now due to the ergonomic fit and reusability of the PPE kits. These mass customizations can be done easily using 3D scanning. The reusability of 3D printed PPE kits was appreciated by WHO and a number of NGOs who were concerned about the piled up disposable medical wastage due to the pandemic. 3D printing, thus, offers promising environmental-friendly solutions by minimizing the wastage and by making reusable products.

3D printing not only addressing COVID needs but also is being actively used to provide training and visualization aids for doctors and healthcare workers. Let us take another case study where a patient is affected by osteosarcoma and the doctors have to surgically take out a part of a patient’s affected bone. The process to fill this void in the patient’s bone is extremely excruciating not only for the patient but also for the surgeons as they must fit the mass-produced titanium rods in the void by reshaping them in the operation theatre. This leads to error in surgeries, post-operative complications and increased rate of infections in the patients. This is applicable for other surgical fields and dental implants as well [12].

3D Printing, Dental Implants, Patient Specific Models

New tools and advanced technologies are bringing doctors closer to patients, delivering treatments and devices, customized to better serve each unique individual. For doctors, this newly accessible technology provides a greater understanding and visualization of complex cases and provides new tools that will result in a higher standard of care. Producing patient-specific, tactile reference models from CT and MRI scans is affordable and straightforward with 3D printing which will help physicians prepare better for surgeries, leading to reduced time and cost in the ORs while improving patient satisfaction and less recovery time. 3D printing, can thus, scale innovative ideas to tangible products and help mass customization of products with custom designs [13] [14]. You can read more about 3D printing in prosthesis from here.

Metal 3D Printed pelvis hip knee

3D printer owners around the world, from hobbyists to industry users, have been amplifying their commitment with innovative solutions to help in the global COVID-19 supply efforts. With lives at stake, it is paramount that the 3D-printing community works in parallel with medical professionals to avoid creating undue risks to public health. Collaborations between 3D printer users and medical experts can ensure the safe and effective performance of 3D-printed medical devices and translate the good intentions of individuals into meaningful contributions.

Advanced Image Processing And 3D Printing In Radiology

It is true that despite all the efforts, 3D printing did not meet the entire demands quantitatively, but it was a milestone in portraying the potential and power of additive manufacturing and rapid prototyping. With this, we are optimistic that full potential of 3D printing can be utilized in healthcare technologies and can bring significant changes in patient care by using low-cost manufacturing of customized anatomical models and surgical equipments as and when required. Government collaborations and joint research can also help additive manufacturers increase the quality of products and introduce a safety regulation which can provide a standard process for regulatory checking for clinical applications of 3D printed medical devices.

During the COVID-19 pandemic, 3D printing has stepped up to become a vital technology to support improved healthcare and our general response to emergency. The pandemic has taught us how direly we need a more decentralized, environmentally friendly manufacturing methods which can produce parts on demand and can reduce waste and inventory. Its inherent flexibility and the possibility to modify designs available online are unleashing creative and sustainable solutions that can carry the technology forward in the ‘new normal’.

New minds in the COVID-19 pandemic

COVID-19 has taught us that supply chains are expected to be shorter, decentralized and ready to meet new demands and prototype, iterate, test and mass manufacture items without the need of die-casting, injection moldings and any other conventional manufacturing techniques in a short duration of time. These changes, if implemented with the help of 3D printing and additive manufacturing can disrupt the entire conventional manufacturing industry and can help 3D printing become the fourth industrial revolution.
You can read more about the space from here.

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