Australian doctors who are worried the system will not be able to provide them with the equipment they need to protect themselves and their patients during the COVID-19 pandemic are looking at ways to design and produce their own.

Doctors are concerned about the availability of equipment to protect both themselves and patients, one Melbourne anaesthetist, who wished to remain anonymous, told the ABC.

"Many doctors and health professionals are very concerned and confused about the requirements for, and current supply of, personal protective equipment (PPE) for hospitals," she said.

"Some hospitals now have less than one week of available stock of this type of equipment to deal with any potential or known COVID-positive patients.

"This situation is applicable to normal or emergency surgery, emergency rooms and inpatient ward care, as well as the treatment of COVID-positive patients."

A large centralised group involving Victorian university staff, clinicians and manufacturers has been working tirelessly to develop suitable products and to co-ordinate the supply and demand of these essential items, and it has begun to network with other similar groups across Australia and internationally.

They have reached out to philanthropical organisations and local engineers and manufacturers to open up supply lines and found them keen to help.

The PPE items they are working to create in order to reduce the risk to staff and secure their safety include:

Face shields

Face shields Hooded oxygen respirators for both patients and staff to protect from airborne exposure

Hooded oxygen respirators for both patients and staff to protect from airborne exposure PPE masks with viral filters

PPE masks with viral filters Clear anaesthesia "splash boxes" for intubation

Clear anaesthesia "splash boxes" for intubation Rapid portable CPAP (continuous positive airway pressure) devices for nursing home patients needing increased support for ventilation

Rapid portable CPAP (continuous positive airway pressure) devices for nursing home patients needing increased support for ventilation Ventilators and ventilator parts or "splitters" to enable one machine to support two patients' breathing

On top of the doctors' efforts, a Department of Health and Human Services (DHHS) task force has been established to assess this dynamic supply and demand situation, while the Federal Department of Industry, Science, Energy and Resources has set up a ventilator task force.

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All DHHS-supplied equipment needs to be approved by the Therapeutic Goods Administration (TGA).

The TGA has created a rapid approval process to speed this up for COVID-related equipment.

Con Kolivas, a retired anaesthetist and software engineer who is helping to coordinate one of the groups, said it started as a casual chat between a few people about the lack of ventilators in Italy at the time.

They wondered whether it would be possible for Australia to build some kind of simple ventilator in case of a shortage locally.

"The rate of infection of medical staff in the worst-affected areas overseas is now very high and, to make matters worse, doctors who've been infected at the front line appear to have a higher death rate than people who've caught it in the community," he said.

"I and others approached people from different disciplines in industry, medicine, engineering, software and so on about what we could do and found a cohort of people willing to help out.

"After the initial discussion about ventilators, talks turned to things we could manufacture locally and personal protective equipment (PPE) was top of the list.

"This is an infection that we've never faced before so we need novel approaches to things.

"Government and health suppliers don't actually give us any of this sort of equipment, so we needed to innovate because there isn't an easy path to find these novel pieces of equipment."

Dr Arun Ilancheran is an emergency physician and intensive care fellow.

Emergency physician and intensive care fellow Arun Ilancheran said a severe shortage of equipment was looming.

"The whole world is trying to acquire the same resources at the same time and we are falling into the toilet roll trap," Dr Ilancheran said.

"Our group feels is it imperative that we source local engineers and manufacturers to continue to have the supply chain of the essential equipment that we need to save lives during this pandemic.

"We are aware that as the lockdown phase gets stricter, we will have further supply chain issues."

Dr Kolivas said the Victorian Government was keen to support any firm designs the group could come up with, but for any complex designs, the regular government channels of approval and funding could slow things down.

Fortunately, various philanthropical organisations were also very willing to assist, he said.

"With the help of 3D printing it makes it possible to tackle any kind of design we want," Dr Kolivas said.

"The problem with 3D printing is it's slow, so it's great for producing the prototypes, but you can't mass produce them if each one takes two hours to print."

That is where support from local manufacturers comes in.

Dr Kolivas said that, again, there was a desire to help.

Toyota is one example of a company which has offered its design and engineering capabilities to produce equipment on a large scale.

Crucially, Dr Kolivas said, ventilator manufacturer Medtronic had opened up one of its designs for free use during the pandemic, without intellectual property restrictions, meaning there was potential for manufacturers to produce the vital piece of equipment in Australia.

A website, COVID SOS, has been set up as a central hub for the various groups out there working on novel solutions.

It is also trying to address frontline medical equipment shortages through community-sourced methods of design and manufacture.

Here are some examples of the equipment the group is working on:

Intubation boxes

An intubation box is a vital piece of equipment to protect medical staff from potentially highly infectious patients. ( ABC News )

Dr Kolivas:

"The "intubation box" is an example of an alternative novel PPE to deal with the unique threat of coronavirus. When a patient is so severely affected by the respiratory complications that they need to be put on a ventilator, they need to have a tube put into their trachea to connect them up to the ventilator. That particular procedure puts the doctor (usually an anaesthetist, intensive care specialist, or emergency physician) and assisting staff in very close proximity with the patient's respiratory tract — they're literally staring down the patient's throat. The potential for aerosol exposure there is extreme, and our clinicians had seen perspex shells used overseas for that scenario to limit that exposure. We developed our own solution, as you can see in the diagram, where the patient is under perspex with rubber-like seals to drop around the patient, and it has self-sealing hand holes for the clinicians to do their intubation. The design was revised and simplified a few times and is made from laser-cut perspex, so is ultimately not that complex to build, which is important. It has been tested clinically with success already and we're looking to produce a number of these for multiple hospitals."

This intubation box is relatively simple to build, which is important. ( ABC News )

Face shields

A face shield prototype Australian doctors are hoping to mass produce. ( ABC News )

Dr Kolivas:

"The facial shield is a very simple guard to/from the staff member which provides an impermeable barrier to any aerosols being sprayed in either direction. It obviously doesn't provide a perfect airtight seal but it affords a great deal of confidence when performing procedures on infected patients. We were able to prototype these from an open-source design on the internet and 3D print them. 3D printing has allowed us to rapidly get a design built, so it allows for rapid prototyping, but is very slow in production. A local manufacturer has taken up the need for facial shield designs and has said they'll be able to produce them in the thousands. We have been connecting hospital networks with this manufacturer to allow them to test out their prototypes and they should be able to order them immediately."

Ventilation splitters

It may not look like much, but the ventilation splitter effectively doubles the capacity of ventilators. ( Supplied: Alexander Clarke )

Dr Kolivas:

"The ventilator splitter is a simple three-way hard piece of tubing. With the potential for running out of ventilators being very real, the splitter gives us a means to use one ventilator on multiple patients instead of the one person which it's normally designed for. It's a use that ventilators were never approved for, and we have not used them in that manner locally, nor do they work ideally in such circumstances. However, it effectively doubles the capacity of ventilators we have should we run out due to the demand, and allows us to keep using sophisticated ventilators to manage patients, instead of trying to use a much simpler and riskier "bag squeezing" design that would be more in keeping with third-world life-saving emergencies."

Oxygen hoods

A commercial manufacturer of oxygen hoods has given permission for local manufacturers to build them without intellectual property restrictions. ( Supplied: Amron International )

Dr Kolivas:

"The oxygen hoods we've been looking at are a tent that sits over a person's head that allows us to use higher oxygen concentrations in a closed system than the usual "oxygen masks" that are used in abundance in hospitals. Regular oxygen masks vent all their excess gas back into the room and have practical upper limits to the inspired oxygen concentration they provide. The higher the oxygen concentration we are able to administer, the less likely a patient is to require to be intubated and ventilated. A commercial manufacturer of these has given permission for local manufacturers to build these without intellectual property issues."