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The Race To Make Ventilators

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The Race To Make Ventilators

The Race To Make Ventilators

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UNIDENTIFIED PERSON: This is PLANET MONEY from NPR.

(SOUNDBITE OF MUSIC)

KAREN DUFFIN, HOST:

Todd, how much time do you have? Let me ask that first.

TODD OLSON: I've been working till about 10:00, 11:00 at night so you might just have to make me work till midnight.

KENNY MALONE, HOST:

Todd Olson is CEO of Twin City Die Castings Company. They make metal parts for other companies that make things.

DUFFIN: Twin City is a 100-year-old employee-owned company. They've got a few factories, a couple hundred employees. And Todd says about 50 to 60% of their business comes from automotive companies.

MALONE: So if I get in my car, like, what parts came from your place?

OLSON: Yeah, we don't have a lot of real sexy parts a lot of times, but we've got parts in your transmission. We've got - we do a lot of housings for electronics, also do dashboard parts for BMWs.

MALONE: Oh, that sounds a little sexier.

OLSON: Yeah. Yeah. That's a little more fun for you.

DUFFIN: Yeah.

MALONE: Yeah.

DUFFIN: But about two weeks ago, Ford and GM announced that they were stopping car production altogether. So a huge chunk of Todd's business was about to dry up.

OLSON: So last Thursday, we're meeting remotely over the phone once a day, having a senior management call, and a lot of discussion going there isn't real fun. It's, you know, what do we do if the company goes the other way from growing here because of the COVID-19 crisis? And what employees are safe? Is anybody sick? Who's showing up for work?

MALONE: Towards the end of that meeting, Todd says, the president of his company says, hey, Todd, I just got some news.

OLSON: Said, I think - I've been talking with Ventec today, and it looks like we might be getting a purchase order tomorrow.

DUFFIN: Ventec is a medical device company near Seattle. They're known for this sort of multipurpose machine that is, first and foremost, a ventilator. And Ventec was looking for parts, including a piece that Todd has a lot of experience with - pistons.

OLSON: So just like in an automobile, it's a piston, but it's much smaller. Yep. You're signaling the right size there.

MALONE: Yeah. I'm trying to make it with my fingers, so I'm making, like, I don't know, like, an inch or something.

OLSON: Correct. Yeah. It's about that.

MALONE: A ventilator, fundamentally, is a machine that helps people breathe - move air in and out of the lungs. Ventec's specialized ventilator uses a piston in its oxygen system, and so Todd is thinking, well, we know how to make that part.

OLSON: All right. Great. Boy, we kind of need a little bit of that good news, and so we're fairly happy.

DUFFIN: That order was for just 150 of those teeny pistons a month, so kind of a small order. But Todd had been reading the coronavirus news like the rest of us, so he suspected that Ventec might be needing more ventilator parts very soon.

MALONE: Todd had no idea his small company in Minnesota had just been drafted into a manufacturing effort the likes of which we have not seen since World War II.

DUFFIN: Hello, and welcome to PLANET MONEY. I'm Karen Duffin.

MALONE: And I'm Kenny Malone.

America needs ventilators, possibly hundreds of thousands of new ones in the next few months. Today on the show, we take you inside the scramble to make more ventilators fast. From the frantic emails to the supply chain nightmares to the maxed out assembly lines, all across the world, factories are trying to turn on a dime with hundreds of thousands of lives at stake.

DUFFIN: The world is at this strange moment where there is a direct connection between life and death and the ability of a small auto parts company in Minnesota to churn out pistons small enough to fit in the palm of your hand.

MALONE: The story of how Todd Olson's company got drafted into this worldwide mission to do their little part to make those little pistons begins in Seattle, where the coronavirus outbreak started in the United States.

DUFFIN: Seattle is where Dr. Nick Mark works in an ICU and where he spends a lot of time thinking about breath, about breathing, a lot of time thinking about lungs.

NICK MARK: I'm a board-certified pulmonologist, so being asked to wax poetic about the lungs is like a dream come true.

MALONE: Nick is an ICU doctor, and the poetry of the lungs, as Nick tells it, is this - lungs are these exquisite machines, containers of air that just kind of blow life-giving oxygen into the blood through a thin wall, a membrane.

MARK: And what's so elegant about it is that that membrane is so thin and delicate.

DUFFIN: And it's this thinness of our lung walls that lets them expand and contract and pass oxygen so smoothly. It's why breathing is so easy.

MALONE: But it was also that membrane that had Nick worried when he first heard about COVID-19 back in January, because what COVID-19 does is inflame that membrane. It makes our thin, delicate lung walls very thick.

MARK: Suddenly, the lung gets really stiff. And instead of it being really easy to get enough oxygen in, now, suddenly, it requires tremendous work to do it.

DUFFIN: This is why some COVID-19 patients need a machine to breathe for them. They need a ventilator. This is also why Dr. Nick Mark's ICU, which normally has beds and ventilators to spare, is packed right now.

MARK: Not everybody who has COVID is going to need a ventilator. But for the people who do, there really isn't an alternative. And if there aren't enough ventilators, some of those people are going to die.

MALONE: Demand for ventilators is rising in places like Dr. Nick Mark's hospital. As for supply, there aren't that many companies that make ventilators. One of them happens to be just 10 miles down the road from Dr. Mark's hospital. It's the company that contracted Todd to make those little pistons, a company called Ventec.

CHRIS KIPLE: We were getting these phone calls from ministers of health, presidents of countries, all looking for ventilators. And the orders started coming in for 50, a hundred. And then people were seeking thousands.

DUFFIN: Chris Kiple is the CEO of Ventec. And for the last few months, he has been fielding these heartbreaking calls from doctors and hospitals and dignitaries around the world.

MALONE: But, he says, when COVID showed up in Seattle - like, you know, when the hospital 10 minutes away started to fill up with patients - this is when it got even more real. It was around this time that his own governor's office reached out. They called his cellphone, his office. They emailed.

KIPLE: All within two minutes, saying urgent, urgent, urgent, need to talk about ventilators - trying to learn as much about ventilators as possible and what the true problems were with the ventilator supply in the world. Why is it difficult to get a ventilator all of a sudden?

MALONE: Now, at its most basic, a ventilator is just a machine that pushes air into people's lungs and helps pull it out. In fact, the first mechanical ventilator was just a bag and a face mask invented in the 1700s. You manually squeeze the bag of air. That helped the person breathe.

DUFFIN: Today's ventilators can be complex machines that often can automatically sense and figure out how to mix just the right blend of room air and oxygen in just the right amounts with just the right pressure, all of which is a different and very precise amount for each individual patient.

MALONE: So to make an additional ventilator, you don't just need another bag and another mask. You may need flow sensors and pressure transducers, exhalation valves, mixing valves, circuits and resistors, and in the case of Ventec's machine, little metal pistons.

KIPLE: It's easy to create a pump. But we're trying to ventilate lungs. We're trying to deliver really precise airflow to the patient. So if that part is off by thousandths of an inch, you're opening up a leak. And that leak can prevent our device from delivering precision air...

MALONE: Oh, my God.

KIPLE: ...To the patient.

DUFFIN: Which is an engineer-y (ph) way of saying, if the pistons are even the slightest bit off, it is not good. And the pistons are just one part of Ventec's machine.

KIPLE: Our device has about 700 components, the majority of which are custom designed to our device. We source from about 80 different suppliers from around the world.

MALONE: That sounds really complicated, and it is. But the simplest way for the world to get more ventilators is for existing companies like Ventec to max out production - pay overtime, hire extra workers and run the factory 24/7. They already know how to make ventilators and already have FDA approval.

DUFFIN: The problem with that strategy is that there is a ceiling to it because Ventec is set up to make around 200 ventilators a month normally. And Chris says, you know, maybe they could get that up to a thousand a month. But even that, five times their normal capacity, that won't even be close to enough.

KIPLE: To get to more than 4 or 5x, you are past the limits of your facility, past the limits of your suppliers. At that point in time, you've got to say, we've got to think about this production completely differently to save lives because this pandemic is so significant. We have to find a different way.

DUFFIN: One different way is something you've maybe heard about, the Defense Production Act - the DPA. And what this does is allow the federal government to become, essentially, a pandemic project manager. It lets the feds boss the private sector around, tells companies up and down the supply chain what to make, how much it will cost and just direct supplies to where they're needed most.

MALONE: But back when Chris is starting to think about ramping up in a huge way, the DPA had not been invoked yet. So this other different way started to happen organically - it was unlikely matchmaking between, let's say, a smallish ventilator-maker in Seattle and one of the largest car companies in the world.

DUFFIN: Ventec, meet GM - General Motors. GM, meet Ventec. The two companies formed a partnership.

KIPLE: If you had asked me at that moment in time if it was possible for a medical device company to work with an auto manufacturer, I would've said, no.

MALONE: But what Chris sees quickly is that GM is not so much an auto fabricating company as much as it is a massive supply chain management marvel. And Chris suddenly has this global supply chain of his dreams at his disposal.

KIPLE: We told them we were having problems with a manufacturer in India. They had people on the ground that night at that manufacturing location in India helping us get some of our supply lines up and running and moving forward again.

MALONE: Chris is like, OK. Well, the other problem is that there are, like, hundreds of parts in our machines. And we're having trouble sourcing them.

KIPLE: They literally woke up their entire supply chain team on Saturday morning at 6 a.m. and challenged their 80-member team to source 700 parts from around the world and the United States.

MALONE: And in a small tool shop in Minneapolis, Minn., Todd Olson, piston-maker extraordinaire, hears the call.

OLSON: GM put out a mass email to anybody in our industry that they've worked with that Project V needs die castings. And...

MALONE: Project V. They were calling it Project V?

OLSON: Project V, that's right. Yep. Ventilator.

MALONE: If it's supposed to be a secret, it's not a good secret nickname.

DUFFIN: (Laughter).

OLSON: Yeah. That's right. Well, you got to have a project name. It makes you feel like James Bond or something.

DUFFIN: (Laughter).

MALONE: That's definitely true.

DUFFIN: Project V, Todd learned, was the name for GM's plan to help Ventec make more ventilators than humanly possible.

MALONE: So Todd had originally thought he was just dealing with Ventec, you know, to make a handful of parts, including those 150 little metal pistons. But now that GM was involved, Todd's president comes and finds him and says, this plan is changing fast.

OLSON: He goes, just got off the phone with General Motors. And they're talking about 20,000 of these a month instead of 150 (laughter).

MALONE: Twenty thousand instead of 150?

OLSON: Hundred and fifty. Yeah. So, yeah, a much different scale than we ever imagined. And normally, this would take about 12 weeks for us to get into production. And we were directed that it's not going to be 12 weeks. It's going to be as fast as you can possibly do it.

MALONE: What goes through your mind?

OLSON: We better make this happen.

DUFFIN: The thing about this scramble to make more ventilators is that some version of this conversation that Todd was just having was also happening maybe hundreds of other times for every single part in the ventilator supply chain. And some of the parts will be easier to get, some of them will be harder. But if the scale-up for any single one of those parts falls behind, it will hold up the entire effort to build more ventilators to save people's lives.

MALONE: Here's what it took for Todd's company to scale up just one of the hundreds of parts, the teeny pistons. What Todd's company does, die casting, is essentially pouring molten aluminum into a custom mold. So before he can even make a single piston, his company has to call up a different company to make that mold.

DUFFIN: And this is a serious varsity mold. It's got to be made of steel, weighing almost 2 tons. But it also has to be so precise that every single piston is accurate to the micron. And it will cost more than $100,000.

MALONE: Todd got that General Motors order two Fridays ago. He immediately jumps on the phone with one of his most trusted mold makers.

OLSON: A company out in Grand Rapids, Mich., called Die-Tech Engineering. And they came back and said, we can probably do it a lot faster than you think.

DUFFIN: Because everyone there also knows that this is a life-or-death mold. They are all part of making ventilators in this crisis, so it's all hands on deck. The Michigan company pulls in all of its engineers, runs their shop around the clock all weekend long.

MALONE: And then Todd pulls in all of his engineers, even the ones who are now managers - not anymore. You're an engineer again. Get on the phone with Michigan.

DUFFIN: Meanwhile, other engineers are running computer simulations of how this mold will work in practice. You have to figure out the optimal speed for the molten aluminum - too slow and the mold doesn't fill, too fast and the piece has bubbles.

MALONE: All of this is months' worth of man hours condensed into a single long weekend. In fact, this interview you are hearing with Todd, this was conducted just three days after he made that call to Michigan. And while we were talking, Todd kept checking his computer for updates on this thing being made 600 miles away in Grand Rapids.

OLSON: So I - yeah. I just received pictures right now of them loading the tooling up into one of their company vehicles. And one of their...

MALONE: Like, right now while we're talking, you got that picture?

OLSON: Right now, when we're talking. They're probably somewhere around Gary, Ind., now. I'm not sure. (Laughter) But they're on the road coming to us. So I'm going to turn this...

MALONE: Yeah, please.

OLSON: ...Towards...

DUFFIN: OK.

OLSON: Let's see here. Can you see what a die looks like?

MALONE: Oh, yeah.

DUFFIN: OK.

OLSON: So there's six pistons in each die.

MALONE: It's like a giant waffle iron.

OLSON: Yeah. And the waffle batter is about 1,300 degrees.

(LAUGHTER)

OLSON: Yeah. And so we will have that in our die cast machine early tomorrow morning. I plan on being in our plant early tomorrow because I want to see these historic first parts out there.

MALONE: Yeah.

DUFFIN: Yeah.

MALONE: Is there any universe in which we could kind of be there telephonically when that first part is made?

OLSON: I bet I - I bet you we can do that. Sure. I'll make that happen for us. How's that sound?

MALONE: That would be incredible.

(SOUNDBITE OF MUSIC)

DUFFIN: For Ventec and GM to change course as quickly as possible, they need hundreds of Todd Olsons to also simultaneously change course as quickly as possible.

MALONE: After the break, we hear from that one Todd Olson from the factory floor.

(SOUNDBITE OF MUSIC)

DUFFIN: At 8:06 in the morning, the day after we first talked to Todd, he FaceTime-ed (ph) us from the factory floor.

OLSON: How you doing?

MALONE: Yeah. It's pretty loud there.

OLSON: Just a little bit - yep.

MALONE: You could see Todd walking past all these giant die-cast machines and these guys in hardhats and safety glasses.

OLSON: Hey, Greg. Wave.

OLSON: All right. Greg's holding a cup of coffee there.

OLSON: And Greg Hansen, our president - he's the one that brought Ventec in for us.

MALONE: I see a lot of buttons. Like, there's - somebody's pressing a lot of buttons.

OLSON: Yes. Exactly. He's our head die-casting engineer.

DUFFIN: This is the machine. They've got the new piston mold that was just custom-made and delivered freshly from Michigan loaded up inside of it. There's a group of guys standing back watching the head engineer inject the molten aluminum and then open the mold.

OLSON: So there it is. Hey, Ireland (ph). Why don't you show that to me?

MALONE: Oh, what is that?

OLSON: So those are the first person piston parts for Project V.

MALONE: That's...

OLSON: That is...

MALONE: So that's it. That's one of the pistons right there.

OLSON: Here we go - a part of history right now. I'm going to get out of their way here. They've got some work to do and...

MALONE: OK. How are you feeling right now?

OLSON: I'm feeling awesome. This is pretty cool. We've been in business a hundred years. And this might well be our biggest moment in a hundred years.

MALONE: That is quite a statement, Todd.

OLSON: Yeah.

DUFFIN: And with this, Todd has handed off his part of this global relay race. Todd's pistons will get tested and machined and then sent off to Ventec in Seattle, where this all began and where Chris Kiple, the CEO of Ventec, is eagerly awaiting Todd's pistons.

MALONE: So that's just one part. Like, that's just one of 700. How many more are there left to source?

OLSON: At this point, we've sourced 100% of our parts.

MALONE: A hundred percent.

OLSON: It - 100% of our parts for up to 200,000 units.

DUFFIN: That's incredible.

MALONE: Amazing.

OLSON: But to your point, it's not just Ventec. It's not just GM. It's the entire manufacturing base of the United States and the world, everyone coming together to save lives.

MALONE: Do you know how long it will be before, like, one of those pistons ends up in a ventilator in a hospital saving somebody's life?

OLSON: We plan to be producing ventilators within weeks. It's highly probable that that piston will be responsible for helping save someone's life in April.

MALONE: With GM's help, Chris Kiple says that Ventec, a company that's used to making a couple hundred ventilators a month, is now looking at possibly tens of thousands of ventilators a month. It is a staggering number. But it still may not be enough, not to mention that we may not have enough people to run those very complex machines. And if we did, they may not have all of the protective equipment they need. There are a lot of problems to address beyond just making more ventilators.

DUFFIN: But as for the supply, this same scramble at Ventec is happening all over the world with all of the other ventilator companies. Also, Ford just announced that they will make 50,000 ventilators in the next hundred days. Tesla said they're going to make some, even Dyson, the vacuum company. Someone in Italy even 3D-printed valves for ventilators. New startups are starting up. Some of them are trying to make simpler ventilators.

MALONE: We have no idea if those kinds of projects will come together in time. But what we know is that ventilators are the supply and demand problem of the COVID pandemic. If too many people need ventilators at the same time, people will die. And so one solution, the solution we just spent the entire episode talking about, is increasing ventilator supply.

DUFFIN: But you can also reduce demand. And that is at the heart of all of the advice that we are hearing from health officials right now. That is why we are all hopefully staying home and socially distancing. We are collectively reducing demand for ventilators. You sitting on your couch watching Netflix - you are part of the highest stakes possible, supply-and-demand mismatch of our lifetime.

MALONE: So go ahead, queue up, you know, eight more episodes of "Breaking Bad" or Date Blind - Blind Date - Blind Love...

DUFFIN: "Love Is Blind."

MALONE: Yeah. That is your part in solving the global ventilator problem.

(SOUNDBITE OF MUSIC)

DUFFIN: If you are finding solutions to this pandemic or you have a Netflix show to recommend to us, email us - planetmoney@npr.org. Or be in touch on social media - Instagram, Facebook, Twitter. We are @planetmoney.

MALONE: And if you enjoyed this episode, check out our sister podcast The Indicator. It is daily, full of amazing information with incredibly charming hosts. That is PLANET MONEY's The Indicator. Today's episode was produced by Alexi Horowitz-Ghazi and Nick Fountain. Our supervising producer is Alex Goldmark. Bryant Urstadt edits the show.

DUFFIN: Special thanks to Andy Slavitt, Dr. Hargo Khurana (ph), Mark Van Sumeren (ph), Larry Smith (ph), Stephanie Kass (ph) and Camila Domonoske. I'm Karen Duffin.

MALONE: I'm Kenny Malone. This is NPR. Thanks for listening.

(SOUNDBITE OF MUSIC)

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