20 THENEWYORKER,M AY18, 2020
a plastic resuscitator bag and a motor.
Groups in Ireland and at M.I.T. were
pursuing the same idea—all open
source, with instructions and parts lists
posted freely online. Cohen, who is not
an engineer, turned to friends to help
him find a project that New Lab could
assist with. One wrote back immedi-
ately and said that M.I.T.’s effort was
a good bet.
The M.I.T. E-Vent, as the school’s
ventilator is known, was based on a
prototype that had been created ten
years earlier, as a student project in a
class on medical-device design. The
students’ prototype ran on a battery for
three and a half hours, and consisted
of a resuscitator bag placed in an en-
closure and squeezed by a motor-driven
cam. It had a pressure sensor, and set-
tings for tidal volume (squeeze more
or less air from the bag) and breaths
per minute (squeeze the bag more or
less often). The idea had never been
developed beyond the class, but it had
been revived in early March, and was
now being worked on by a team of
alumni, professors, and graduate stu-
dents from the mechanical-, civil-, elec-
trical-, and environmental-engineering
departments. The rig had been given
to Albert Kwon, an anesthesiologist at
Westchester Medical Center, in New
York State, who had tested it on a live
pig. By Porcine Study No. 4, the de-
vice was said to perform comparably
to a commercial ventilator operated in
a volume-control mode.
The M.I.T. team aimed to build a
“reference implementation”—a proto-
type that proved the viability of its de-
sign, which could then be shared for
anyone to build. Like other open-source
ventilator efforts, it had attracted in-
terest not just from organizations staffed
with experts but from amateurs who
might try to build a device of their own.
“I’m not in favor of this open-source—”
Cohen said, interrupting himself. “It’s
misleading at a critical time to have
people cowboying devices.” He and his
friend Marcel Botha, the founder of
10xBeta, a product-design and -devel-
opment firm in New York, wanted to
build the ventilators themselves, or to
oversee their production. For a time,
engineers in New York and Cambridge
worked together; among other things,
Botha persuaded Bon Ku, an emergen-
cy-medicine doctor at Thomas Jeffer-
son Hospital, in Philadelphia, to loan
the M.I.T. engineers one of his hospi-
tal’s ventilators, so that they could com-
pare it with their prototypes. But, even-tually, the designs “forked,” as often
happens in open source.
The New Lab team began calling
its device the Spiro Wave, after the
Latin word meaning “to breathe.” It
has two hundred and fifteen parts; to
avoid supply-chain problems, the en-
gineers sourced as many of them as
they could from within the state, and
persuaded their suppliers to stay open
as essential businesses. Under the
vaulted ceilings of New Lab’s converted
Navy hangar, and, later, at a manufac-
turing facility operated by Boyce Tech-
nologies, in Long Island City, a dozen
engineers have been working day and
night, in twelve-hour shifts, to perfect
the design and solve production chal-
lenges. The group has received a ten-
million-dollar purchase order from
New York City: three thousand units,
at $3,333 each. Regulatory experts were
brought on to help push through an
application for an F.D.A. Emergency
Use Authorization. The device—still
essentially a pair of robotic arms that
squeeze a bag—has a slick plastic cas-
ing and instructional videos. The Boyce
facility is assembling about a hundred
units per day.
A similar story has unfolded on the
West Coast. On Wednesday, March
11th, David Van Buren, a senior engi-
neer at NASA’s Jet Propulsion Labora-
tory, began wondering if, under the cir-
cumstances, the lab was working on the
right projects. He wrote an e-mail to
colleagues proposing that perhaps they
should be trying to solve the ventilator
problem. His idea quickly made its way
to the lab’s senior management. “I do
space missions,” Roger Gibbs, the dep-
uty director of the engineering and sci-
ence directorate at J.P.L., told me. “I
build things and we send them to other
planets.” By Monday, J.P.L. had also de-
cided to build a ventilator.
At first, the engineers began in the
spirit of Apollo 13. “The spark of this
idea was ‘Gee, can we at J.P.L. design
a ventilator that uses parts scrounged
from a garage, or from a vacuum cleaner,
or a Home Depot?’” Gibbs said. “That
idea lasted about six hours.” They next
considered developing a reference de-
sign and open-sourcing it for do-it-
yourselfers. A doctor who had come in
to consult waved them off, explaining
that his hospital would only use a de-“In light of the current situation, we’ve dispensed
with the weather report.”