According to a July report published by non-profit Kaiser Family Foundation, just one percent of people in low-income countries have received at least one dose of a COVID-19 vaccine. That incredibly low number comes amid the Delta variant and a devastating surge in COVID-19 cases in low- and middle-income countries.
Not only do they not have vaccines to protect their citizens, these countries often do not have the healthcare infrastructure required to treat persons with mild and severe COVID-19. Researchers from the University of Leeds (UK) have stepped in by creating a prototype breathing device designed specifically for resource-poor countries.
The device relies on a simple electrical fan, akin to those used to cool electronic devices, to overcome the lack of access to high-pressure air and oxygen supplies. The prototype provides a form of oxygen therapy called continuous positive airway pressure (CPAP).
Hospitals in the UK have found CPAP is as effective as traditional respiratory treatment for those with severe COVID-19. It has prevented patients from needing advanced care, such as ventilators and ICU beds—both of which are in short supply in many countries, including the U.S.
The situation worsens for countries without as much wealth as the UK and U.S. Uganda, for example, only has 500 ICU beds for 42 million citizens. Additionally, clinics and hospitals in poorer settings typically do not have access to centralized oxygen supplies or a steady supply of oxygen cylinders. Instead, they rely on oxygen concentrators, machines about the size of a suitcase that take in ambient air, strip out the nitrogen and provide a supply of oxygen at low pressure.
That’s why the simple fan design of the new prototype is so critical—it is specifically designed to provide a safe air flow supply without complex or costly control systems or a high-pressure air source.
“The fan or CPAP blower is connected to what is known as a breathing circuit. That circuit is made up of a filter to catch viruses and bacteria in the air flow, tubing, face mask, a valve that controls the flow of oxygen from the oxygen concentrator and an expiration outlet,” explains the study’s lead author Pete Culmer, associate professor at Leeds.
Together, those components provide a simple and robust means to generate an airflow sufficient enough to open a patient’s airway, allowing oxygen to get into the tiny air sacs in the lungs without adverse effects. The oxygen concentrator is used to enrich this airflow with oxygen, conserving valuable supplies, and offering the ability to generate four different levels of air pressure dependent on clinical need.
The team behind the prototype recently published the results of a pilot study in Frontiers in Medical Technology. The so-called LeVe CPAP system was tested to evaluate safety and acceptability in a group of 10 healthy volunteers at Mengo Hospital in Kampala, Uganda. According to the data, desirable oxygen saturation levels in the blood—between 96 and 100 percent—were maintained in the volunteers throughout the trial. Additionally, the CO2 range at the end of exhalation was between 3.6 and 4.9 pKA, again within accepted healthy limits.
Overall, the researchers demonstrated the performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP, without inducing hypoxia, hypercapnia or other serious adverse effects.
Components for the protype device cost around $207. Conventional CPAP machines typically go for $825, while a ventilator used in an intensive care unit can cost more over $40,000.
“By adopting the approach of frugal innovation, we have been able to redesign an important piece of medical equipment so it can function effectively in poorer resourced healthcare settings,” said Nikil Kapur, professor of applied fluid dynamic at Leeds and supervising academic on the project. “We have stripped away unnecessary complexity. The prototype is an important step in developing a device that will create greater access to critical-care technology and help save lives.”
A trial involving sick patients at the Mengo Hospital in Uganda is planned to begin in September, with the developing team working with Uganda-based epidemiologist Edith Namulema.
Photo: The LeVe (“Light”) CPAP system designed by researchers at the University of Leeds. Credit: University of Leeds