ON APRIL 6, Wockhardt hospital in Mumbai was declared a containment zone after three doctors and 26 nurses tested positive for the novel coronavirus. This is just one among many instances of frontline health care professionals being infected while on duty. Nurses, doctors and paramedics countrywide had held protests to highlight the shortage of personal protective equipment (PPE). The issue had even reached the Supreme Court. Nagpur-based Dr Jerryl Banait had moved court to ensure WHO-grade PPE for health care professionals. The Supreme Court had asked the Union government for a response on the matter.
The Indian Express, citing sources, reported that the country will require about 27 million N95 masks, 15 million PPEs, 1.6 million diagnostic kits and 50,000 ventilators by June. While there is no official data on how many health care professionals have been infected with Covid-19 in India; the ballpark figure as of mid-April is 50.
Rohit Asil, director and co-founder of Fracktal Works, a 3D printing enterprise based in Bengaluru, first understood the magnitude of the issue when he spoke to a doctor based in rural Karnataka. The latter worked in a primary health centre, most of which are woefully understaffed. “They did not have even basic equipment like face masks,” said Asil. “The doctor seemed resigned to his fate. He said he was sure that he had been infected, but was worried only on one count: what his absence would mean for villages in the area.”
Plastic forcefield: About 7,000 face shields are manufactured daily by Boson Machines, a 3D printing enterprise in Mumbai.
Fracktal Works mostly produced automotive parts, but the doctor’s helplessness moved the company to print face shields—a PVC film face visor secured around the head by an elastic band—and donate them to health care facilities in Karnataka. Compared with a mask, the face shield had an additional advantage—it protects the eyes, too. Moreover, as an outer protection equipment, it helped elongate the lifecycle of N95 masks, already in short supply.
The relative simplicity of 3D printing is what aids fast production. A Computer-Aided Design (CAD) file of the product is fed into a 3D printer, and the three-dimensional structure is broken down into two-dimensional layers and printed.
3D printing has evolved by leaps and bounds over the years, transforming itself from a process limited to quick prototyping to playing a major role in the production of industrial and automotive parts, aviation mechanics, and even construction of houses. Bioprinting is an evolving system, where even tissues used for physical reconstruction procedures are produced with the help of a biopolymer gel.
India is also quickly adapting to the evolving 3D-printing market; 6Wresearch says that domestic demand is projected to cross $79 million by 2021. Perhaps, the most high-profile example of 3D printing would be this: the GSAT-19 satellite launched in 2017 was fitted with a feed cluster antenna 3D printed by Wipro. 3D printing has its drawbacks too. For example, it might not be the best choice for mass production. A process like injection moulding, where molten substances are injected into a mould and then cooled, is cost-effective and yields much better results for bulk production.
The initial design for the face shield produced by Fracktal Works was open-sourced, and it took around 40 minutes to produce a single batch. The team tinkered with the design and cut the production time by half. To raise capital, Asil and his colleagues launched a crowdfunding campaign. “We started off with an initial target of Rs1.55 lakh, (but raised) Rs5.2 lakh”. Thanks to the windfall, they doubled their initial target of 1,500 face shields and added hand sanitisers to the kit. “We made a new injection mould to speed up the process. The biggest problem we faced was logistics, because of the lockdown,” Asil said. Altogether, he said, the production cost for a kit came to Rs150.
PPE manufacture is governed by strict international protocols and all the startups are adhering to these guidelines. Boson Machines, a Mumbai-based 3D printing company, had manufactured and distributed face shields to several institutions in the city, including Jaslok and Kasturba hospitals. “We ensure that the face visor has the height, breadth and cut to block any splatter from the patient,” said Arjun Panchal, co-founder of Boson Machines. “We have 250 machines for printing; each batch takes around two hours.” He said they can produce 6,000-7,000 pieces a day, each costing around Rs150. Finding capital and labour were the bigger challenges. “We started a crowdfunding campaign on Ketto,” Panchal said. “The machines are manned mainly by family members and two office staff. We hiked the production capabilities after a request from the Maharashtra government.”
The Atal Innovation Centre (AIC) in Coimbatore, a startup incubator supported by NITI Aayog, was flooded with enquiries when startups under AIC started producing face shields. “We got requests for almost one lakh pieces when we could make only 1,000 per day,” said Ebin Ephrem Elavathingal, senior manager, AIC. “We got requests from places as far away as Sikkim and Mumbai.” The AIC first produced face shields based on their own design and donated them to sanitation workers in the city. Later, they supplied to the ESI Hospital in Coimbatore. The material costs alone came to Rs100 per piece. “We have now created an open source file with guide and designs simple enough for anyone with a 3D printer to start manufacturing,” Elavathingal said. AIC’s initial plan was to manufacture ventilators. Reportedly, 90 per cent of a prototype is done. It is expected to cost around Rs10,000; off the shelf ones cost between Rs4 lakh to Rs5 lakh.
Many of the startups—Boson Machines, for example—have tweaked their initial designs based on inputs from doctors who used the products. The tweaking is easily done in the 3D printing ecosystem, but it would not have been as effortless in traditional production.