O&P Community Rallies to Produce PPE

As medical professionals around the world fight the COVID-19 pandemic, communities have stepped forward to help them however they can.

O&P professionals around the country have been using their skills to make personal protective equipment (PPE) to help fill the gap in critical medical supplies. They have been researching the best ways to contribute, trying to find the safest designs for PPE, and sharing their knowledge with others. In these challenging times, hospitals and medical offices have welcomed the help. Hospitals around the country, including those in South Carolina, Nebraska, and Colorado, have all reported to the media that they accepted some donated PPE. As more people become infected and supplies dwindle even more, the need for high-quality supplies will be even greater, the hospitals report. What hospitals will accept varies from place to place, depending on their need and their confidence in the quality of the items. Those in the O&P world who are trying to help say their efforts have been both rewarding and frustrating as they rush to try to find the best solutions in very little time. Denver, Colorado Amy Ginsburg, CPO, lead clinician at Handspring, Denver, has been using a 3D printer to make medical masks since mid-March. She's trying to build something flexible, to conform to the healthcare workers' faces and that has a filter that can be switched out.

"I have a bunch of friends who work in the hospital emergency room, and they posted about the conditions and how things are running out, and I just felt like I wanted to help out within my community and also my friends who live pretty far away," she says. Ginsburg sees the potential of 3D printing in this crisis. Handspring had already invested in the technology, and she's seen the possibilities for 3D-printed sockets and lightweight and durable prosthetics. She was so interested in 3D printing that she bought her own printer in December to learn more about the technology and its possibilities. Soon after, she learned of the COVID-19 pandemic and wanted to help. With the blessing of her company, she's been researching the best way to create a mask. It's tough, she says. There are many different designs and it's hard to know which one is best and what the most appropriate materials are for that design. At the end of March, she said she was in the midst of figuring out the best path forward, but said she was committed to finding a solution. "In the back of my mind, I think they will need it even if they don't need it right now," she says. "I'm trying to stay ahead of the game if I can. There may be a point where no clean masks are available. At that point, hopefully, I will have made multiple comfortable, reusable, and reliable masks that I can provide to my friends and my community. I don't want them to be without anything, so even though it's not completely tested, it's better than re-using a single use mask or using a handkerchief—which is what the CDC recommended." Lake Placid, New York Finding the right way to help can be a tough process, says Jeff Erenstone, CPO, who founded and sold Create O&P, which built high-tech 3D printers for prosthetics and other medical devices. Now he's based in Lake Placid, New York, and is founder of Operation Namaste, a nonprofit organization that helps bring tools and support to O&P practitioners in developing countries.

In his career, Erenstone has seen a lot of poorly made 3D-printed medical devices and worries about the ramifications of hospital workers using medical equipment that doesn't work. "I think it's very important that people need to understand that these things need to work 100 percent of the time in very extreme circumstances," he says. "Bleary-eyed doctors and nurses need to grab them out of a bin, and it needs to work." He says that 3D printing can help in this crisis, but it shouldn't be seen as the end-all-be-all solution. For instance, he's heard of some places printing parts for ventilators. He worries that these untested parts might be subpar and fail, leaving hospitals in a worse spot than where they started. "As soon as a bunch of people say, ‘Hey we have these 3D printers,' some people might think they are magical and stop trying to go after other sources for these parts," Erenstone says. When it comes to masks, he says they are difficult to produce on scale to fit everyone who will need them. "You have to seal the plastic against someone's face," he says. "3D plastics aren't as flexible. They have to be thoroughly tested with a wide variety of face types." However, he says, there is definitely room in the 3D printing realm to create face shields—the clear plastic guard that protects a healthcare worker's face. Those, he says, are easier to make and don't require as much printing expertise as ventilators or masks would need. "The barrier of complexity is low enough that you could get good quality control without as complex a process," Erenstone says. "The most important part is the clear piece of plastic and then it's a matter of making a bracket to attach it to a person's head, which is essentially just an elastic strap." He's been researching designs for face shields and found a design created by Prusa Research in the Czech Republic that has been well-tested and vetted. Erenstone is now lending his printing expertise to three local high schools and a university to start printing out face shields with this design that they can then send to local hospitals. His own high-tech 3D printers aren't made for this kind of work, he says. "My printers are designed for large objects," he says. "The best type of printers for this work are the hobbyist type. I'd have to re-tool my printers to make them work. Right now, it's best to recruit as many people as I can. I'm offering my experience and expertise to make sure what they print is as medical grade as possible, and I'm lucky to have a good road map to do that quickly." Gainesville, Florida Jay Rosen, a web developer for OPIE Software in Gainesville, has also been contributing to the efforts. He joined a group of local 3D-printing enthusiasts who wanted to help find a solution to shortages. The group has been working with medical professionals and universities to discover the best design.

Rosen, who is also an artist, had sculpted artwork masks and prosthetics before the healthcare crisis. He became interested in 3D printing when he learned of its possibilities to help in the crisis and joined the group Gainesville Makers Against COVID. Now he's devoting himself to helping fill the gap in safety gear for healthcare professionals. He hopes others in the O&P world will join him. "There's a lot of O&P clinics out there with a printer," he says. "With the O&P industry, we try to help people. This isn't only our patients we want to help. It's everybody." Toward the end of March, Rosen was shifting from 3D printing masks to learning how to sew them. A University of Florida anesthesiology professor had recently patented a design using the sterile wrapping that is normally used to surround surgical instrument trays. The material, which is widely available at hospitals, is typically discarded. Tests show that the masks block 99.9 percent of particulates, says Bruce Spiess, MD, inventor of the masks. Rosen hopes these new masks will be a game-changer. "I had bought all of these 3D-printer supplies and then realized I'd be sewing," he says. "It would be great if there was something we could print out and save the world. It feels like a gold rush and everyone is trying to strike gold. With these masks, I feel like we struck gold." Rosen said he's been impressed with the way that a community of people has stepped up to help. "It's cool to see everyone coming together," he says. "When we started with this, it was my community from college, and now we're interacting with scientists and medical professionals. We're all keeping our distances but we're all sharing information." Working Toward a Solution Even though it can be difficult to find the perfect way to help, the experts say that giving back in one form or another is necessary during this crisis. The effort to find the right solutions and help protect the community from the virus is a massive undertaking, they say, and will require everyone to do what they can.

"On these Facebook groups, whenever a new mask design comes out, it is posted. Every day there seems to be a new design," says Ginsburg. "It's amazing to see people coming together to help, but there is an enormous challenge to print a mask that can come close to an N95 and be reusable." It will take a lot of work from a lot of people to overcome these shortages, Erenstone says. "It's a herculean effort no matter how many people are working on it." Maria St. Louis-Sanchez can be contacted at msantaray@yahoo.com . Editor's note: Policies regarding accepting homemade PPE vary widely and are changing frequently. If you are interested in helping, please check with the local health facility before making donations.

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