The novel coronavirus disease or COVID-19 pandemic has clearly illustrated the vulnerability of conventional global supply chains. Over the past decade, natural disasters, including the eruption of the Eyjafjallajökull volcano in Iceland in 2010, the Japanese earthquake and tsunami in 2011, the Thailand floods in 2011, the category five hurricane Maria in 2017, and the category four hurricane Harvey in 2017, resulted in major disruptions to company supply chains. Although the global supply chain and the majority of companies recovered from these natural calamities, the overemphasis of firms on cost-cutting measures by concentrating on production overseas through manufacturing clusters has caused many of the current problems, such as vast shortcomings in the supply of much-needed medical and non-medical products required to fight the COVID-19 pandemic. As a result, there is unavailability of personal protective equipment (PPE) for medical workers, scarcity of ventilators for patients, inadequacy of sanitiser liquid, and shortage of test kits for the public.
Bans issued by countries on the export of PPEs and products critical to fighting the pandemic have caused the global supply chains to collapse. These instances illustrate the fragility of the global supply chains amid a large disruption.
The COVID-19 pandemic put the flexibility of supply chains to a major test by causing a significant shift in consumer demand in many industries—a spike in "essential items" and a reduction in "non-essential items." On March 27, General Motors Company was ordered through the invocation of the Defense Production Act to retool for the production of much-needed ventilators. On March 30, Ford Motor Company and GE Healthcare announced a plan to produce 1,500 ventilators by the end of April and to deliver 50,000 ventilators in 100 days. Although 100 days may seem like a rapid retooling and a production ramp-up in the world of conventional manufacturing, it still falls behind the acceleration rate of new daily infections. The daily number of confirmed cases in the United States grew by about 26% and reached 26,365 on March 31 based on data from the Johns Hopkins University’s Coronavirus Resource Center.
Among advances in digital technologies, 3D printing is a new manufacturing method that enables us to create whatever we can conceive by using the digital file and the right material. With the growing importance of 3D printing and with the current COVID-19 crisis, we aim to answer two questions related to the implication of 3D printing in the fight against the COVID-19.
How can 3D printing help in humanity’s fight against the COVID-19 pandemic?
The Director-General of the European Association for Additive Manufacturing referred to 3D printing as “an immediate solution for hospitals” amid shortages in equipment at the time of the COVID-19 pandemic.
3D printing has major differences with conventional manufacturing that can be utilised during this pandemic. Production can be initiated locally, with no tooling from a design file developed anywhere in the world and shared on the internet. 3D printing uses digital CAD files for production, making it suitable for reverse engineering. This feature, coupled with the tool-independence of 3D printing, significantly shortens the design-to-market cycle from multiple weeks to a few days, and this is invaluable for pandemics such as COVID-19.
Venturi Ventilator Valves - Photo Credit - Christian Fracassi and team - Isinnova - Printed in Italy on a ProX 6100 in Medical Grade Nylon (Image via 3D Systems)
We see these advantages in the development of ventilator valves by ISINNOVA, an independent Italian research institute with design and 3D printing capabilities. They were called by a hospital in grave need of ventilators for their COVID-19 patients. At that time, the hospital had insufficient number of ventilators and severe scarcity of valves connecting the ventilators to the patients. The valves in question must be replaced from a patient to another. Using 3D printing, ISINNOVA was able to provide 95 ventilator valves to the hospital within two days. This example is a clear illustration of how 3D printing enables rapid transition from design to local manufacturing.
For the impending shortage of ventilators in hospitals, the prominent solution is “ventilator sharing,” while “the other option is death.” Ventilator sharing was previously used in the immediate aftermath of the 2017 Las Vegas shooting; doctors installed “T-tube” splitters on the inflow and exhaust tubes. This solution is currently used across Italy and the United States. To help with the medical treatment of COVID-19 patients, South Carolina-based Prisma Health 3D printed an FDA-approved splitter tube that enables a single ventilator to treat four patients. As such, any hospital can minimise the strain on frontline response efforts and treat four times as many patients by 3D printing the ventilation expansion splitter device (VESper), which has been made available as a free 3D design file. This shows that 3D printing is used as a bridge manufacturing to fulfil immediate need while conventional manufacturing processes catch up with the demand shock.
The flexibility offered by tool-less 3D printing encourages the production of innovative and entirely novel temporary products that can be used during the COVID-19 crisis. The products can be produced as the demand forms and increases and can be quickly changed to another product as the need is obviated. For instance, Stratasys avails its resources to produce thousands of disposable face shields. Meanwhile, in Spain and Italy, a 3D printed custom-made tube allows the transformation of snorkelling masks to an uncertified medical device for medical workers and patients as the scarcity of masks persists. Similarly, Materialise and HP offer products for hands-free door opening, which allows the opening of doors by using the elbow to help stop the spread of the COVID-19.
Stratasys 3D printed face shield visors.
The pervasiveness and availability of 3D printers make 3D printing a useful, readily available technology during the COVID-19 pandemic. Everyone with CAD knowledge can design and share free and open-source design files for necessary parts and products using platforms, such as Thingiverse. Users can access the design anywhere in the world, and 3D print the needed parts on their 3D printer. This may be contrary to conventional manufacturing and logistics, but it provides an opportunity to bypass bureaucratic and time-consuming steps. For instance, on March 31, The Pentagon reported that they have 1,000 ventilators ready to be shipped to any location in the United States where they are needed; however, due to misalignment between the decision-making organisations, the delivery was put on hold.
What are the limitations of 3D printing in the fight against the COVID-19?
3D printing falls short on a number of aspects. Technological, economic, and educational barriers still prevent this technology from reaching its full potential.
The 3D printing process consists of various steps in pre- and post-production that are still labor intensive, and in a pandemic, this can impact the industrial use of the technology. At present, efforts to automate different steps in the 3D printing process are ongoing and can enable higher levels of autonomy in future production.
The raw materials used for 3D printing methods are all produced through conventional processes and supply chains; therefore, similar to any other conventional supply chain, it can be disrupted in the event of a pandemic such as COVID-19. We suggest a localised production of raw material for 3D printing. This can be enabled by a recycling scheme for discarded 3D printed parts.
Up until now, most of the innovative projects undertaken to help the fight against the COVID-19 have been community based and were in the realm of polymer raw material. This may be because metal 3D printers are still expensive and scarce, and operating them requires precautionary considerations. In the case of powder bed fusion 3D printing, the metal powder is as fine as talcum powder and should not be inhaled; hence, it requires special handling procedures.
Multi-material 3D printers and 3D printing complex multilayer electronic circuit boards are not yet widely available; therefore, bridge manufacturing of systems, such as ventilators, are not possible at this time.
Although design for performance through 3D printing is known to designers, and 3D printers are currently exploited to fight COVID-19, there is still room for improvement, particularly in educating traditional designers to think beyond design for conventional manufacturing and accelerating innovation through 3D printing.
We believe that the COVID-19 can provide the push that 3D printing needed to enter the mainstream manufacturing realm. Remembering that the West, particularly the United States, was caught “flat footed” by broken supply chains and inadequate systems, unable to cope with shocks caused by the magnitude of the COVID-19 pandemic.
Authors
Mohammad Ehteshami is the President and CEO at EEC, Ehteshami Engineering Consulting Inc., Retired CEO at GE Additive, and former Vice President and General Manager, Engineering Division at GE Aviation.
Siavash H. Khajavi is a Postdoctoral Researcher and a Project Manager with the Department of Industrial Engineering and Management, Aalto University, Finland.
Alireza Jaribion is pursuing a doctoral degree at the Department of Industrial Engineering and Management, Aalto University, Finland.
