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How Many Mechanical Ventilators Are there In The United States?

The past few days has brought a lot of hand-wringing about whether or not we have enough mechanical ventilators for the impending tsunami of COVID cases. Many news sources are reporting that we only have 62,000 ventilators nationwide. This simply isn't true. Best estimate of the number of mechanical ventilators in the United States is just over 200,000. For more details, keep reading.

A typical mechanical ventilator

The best estimate of the number of mechanical ventilators in the US come from a report published on 3/13/20 by the Society of Critical Care Medicine (SCCM), the group that represents ICU healthcare providers.  This report utilized a 2009 survey of hospitals to estimate that about 62,000 mechanical ventilators were readily available -- this is where the 62,000 ventilators being reported in the press came from. However, if you read the entire report you will notice that there are additional sources of ventilators, including 98,738 that hospitals keep in storage for emergencies, about 8,900 that are held in the Strategic National Stockpile (SNS) which can be deployed within 24-36 hrs after an order from the federal government is given, and thousands of anesthesia machines. Anesthesia machines are used during surgery to administer anesthesia, but they also have mechanical ventilators built into them. Additionally, SCCM report did not include VA or Military hospitals in its analysis, which adds thousands of more ventilators to the total count.

One caveat that I should add is that not all of the ventilators in storage are appropriate for treating patients with COVID. 8,567 of the ventilators in storage are CPAP machines, 22,976 are non-invasive ventilators (usually BiPAP machines), and 32,668 are automatic resuscitators. Still, between the ventilators in hospital storage, those in the SNS, anesthesia machines, and ventilators in the VA and military systems, I estimate that the number of mechanical ventilators that can be used to treat patients with COVID-19 at over 200,000.

The limiting factor in in treating patients with respiratory failure is trained personnel, not mechanical ventilators. While some locations (e.g. NYC and Seattle) may end up having a shortage of mechanical ventilators, the greatest challenge on a national scale will be finding enough providers to manage all of the patients requiring mechanical ventilation. The SCCM report provides some preliminary recommendations on how to address this problem -- those recommendations deserve more attention!

Please comment below if you have additional input, feedback, or other questions!


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