This is because, like John Deere, Apple, and so many other electronics companies, the major device manufacturers have spent the last several years cementing a repair monopoly. They've done this by lobbying against legislation that would make it easier to repair machines, keeping access to repair guides out of the hands of independent repair professionals, and using software controls to limit who can perform repairs.

As hospitals face the prospect of a critical ventilator shortage caused by the worst public health crisis in a century, they face another problem: not being able to repair the ventilators that they do have.

Besides software, manufacturers also maintain control over the repair parts and diagnostic tools market and have attempted to keep service manuals out of the hands of independent repair professionals. Device manufacturers have also taken legal action against independent databases of repair manuals , such as those collected and hosted by a biomedical technician who works in the developing world known as “Frank.”

Core to the fight against coronavirus, then, will be keeping the ventilators hospitals do have online. Many of them are not empowered to fix their own machines, however, due to the exact same issue that we’ve outlined before with John Deere tractors and other devices: medical devices, including ventilators, have gotten more complicated over the years. They are now controlled by microprocessors and software. That complexity hasn't made them inherently more difficult to repair, but manufacturers have artificially put “software locks” on them, meaning that only those who are authorized can make modifications.

President Trump has said that states are more-or-less on their own when it comes to securing devices like ventilators, which are necessary to treat people with critical cases of Covid-19. “Try getting it yourselves,” Trump recently said . New York governor Andrew Cuomo, meanwhile, said that the state is struggling to create enough ICU beds for the expected number of people who will be sick: Getting enough ventilators “remains the challenge, and the numbers are daunting … you can't find a ventilator for sale. We're looking desperately,” he said.

Frank has posted some ventilator service manuals, and gotten cease-and-desist letters from some manufacturers: “Download prohibited by Dräger. Support is not desired,” is a message he posted next to some previously-available repair manuals. In Italy, device manufacturers have threatened to sue makers who have 3D printed parts for medical devices used to treat Covid-19 patients.

To be clear, no one is suggesting that unqualified people try to repair complicated medical equipment that is going to be used on sick people. Most hospitals have their own service staff, and independent repair professionals are often certified to be doing the types of life-saving repairs that are needed.

“We have an issue where many of the independents work officially for the manufacturers on Monday and Tuesday, and then they’re doing work for themselves the rest of the week,” Rob Kerwin, general council for the International Association of Medical Remarketers and Servicers, said. “If earlier in the week they were safe and sound, why aren’t they allowed later in the week?”

"Even hospital employed biomedical technicians with the best training and qualifications aren't fixing things anymore, they're becoming shipping clerks packaging things to be sent away for repair," Gay Gordon-Byrne, the executive director of Repair.org, said. "In the context of ventilators, the on-site biomedical technicians can fix a ventilator in hours and return it to service more quickly than anyone else. If they can't get the info they need to fix and restore to use—a whole lot of very sick people won't have essential care."