PDF vs CORONAVIRUS - Call to Arms!

[Amaa'n]

@RescueRanger

 

[Amaa'n]

 

[Amaa'n]

 

[Mumm-Ra]

Dear All

I know that most of us are helping each other as well as the less well-to-do section of our society. It is a very good step and may Allah reward us all for this act. However, please keep in mind that you must do your due diligence when giving money to variosus people who claim to be providing sustenance to the needy. It is very easy to raise funds for nefarious purpose under the cover of this noble cause. Kindly follow a few steps to ascertain the authenticity of these persons.
1) Please do some background checking on the person who claims to be collecting funds for the needy.
2) If you are raising funds, please provide full background info about the person too, as in, how you know them, what's your relation and how are these funds being utilized, what's the mechanism for food/other items distribution
3) Do not believe anything that you receive from WhatsApp or any other form of social media.
4) If you are yourself raising funds, kindly always tell your bank why there is an unusual influx of money in your account. That may save your account from wrongly being marked as suspicious.
5) The best solution is to donate to established charities or government accounts as they already have mechanism in place for fund raising and distribution.

I hope we can control things soon but until then stay indoors, stay vigilant

 

[RescueRanger]

There are many posts on social media and misinformation / confusing and contradictory advice by both people in official and unofficial capacities regarding face masks during the coronavirus outbreak.

And as I write this I am well aware that the World Health Organisation is reviewing data from China, South Korea and Hong Kong that suggests the general public should wear face-masks and that by doing so could help contain the pandemic. [1]

This practice of spreading misinformation or misleading claims that certain masks help protect against coronavirus has created a vacuum in the supply available in the market for those who need it most and the rising demand for these items has resulted in sky rocketing prices by unscrupulous vendors looking to make a quick penny in a time of crisis.

In this write up I hope to explain how the virus is transmitted and summarise scientific evidence in support of or against each of the available masks in the Pakistani Market. Before I begin with the meat of the article, let me lay down it's bones and discuss the difference between what constitutes a face mask and what constitutes a respirator:

Paper Mask / Surgical Mask:

• Paper dust masks: Also called surgical masks, these loose-fitting masks have only one strap and don’t form a tight seal to the wearer’s face. They are designed to stop liquid droplets and aerosols coming out of the wearer’s mouth, not filter the air coming in. With no filter and no facial seal, they are not designed to prevent the inhalation of respirable particles found in smoke. Although they may look the same, dust masks are not respirators and should not be used for that purpose.

N95 and P100 respirator:

• N95s and P100s: These respirators have two sets of straps and form a tight seal to the face. The entire respirator is made of filtering material. N95s are the most common, with P100s being more protective (similar to a HEPA filter). Both types can often be found in hardware stores and other retail outlets. These respirators are certified by the National Institute for Occupational Safety and Health (NIOSH), so look for “NIOSH” and the designation “N95” or “P100” on the respirator.

Within the N95 range of masks, 3M makes a very specific mask called the 3M N95 1860S (S = Surgical) this mask is solely designed for the health care sector and is the mask that is needed in hospitals at the moment but due to hoarding and increased demand is not available.

When worn correctly, these respirators are effective at filtering out the small respirable particles found in wildfire smoke. However, they do not filter out fumes and gases; for that, see the next type of respirator listed.

Half-face or full-face respirator:

• Half-face or full-face respirator: Unlike N95s and P100s, which are disposable, half-face and full-face respirators offer a tight-fitting, flexible facepiece with replaceable filter cartridges. N95 particulate filters or purple (P100 or HEPA) filter cartridges will protect against particulates in wildfire smoke. When used with a combination filter that has an organic vapor cartridge, these respirators would also protect against harmful fumes and gases. However, neither these respirators nor N95s supply oxygen.

So at a time when you are already practising physical distancing/social distancing, staying at home, washing your hands, why are we talking about masks? As presented in my opening paragraph, the issue circulates data that supports the view that SARS-CoV-2 that virus that causes COVID is transmitted by aerosols both large and small at or near to source. The available data also suggests that people who may not show any symptoms (asymptomatic) or yet to develop symptoms (pre-symptomatic) are spreading the virus this way. [2, 3, 4]

Figure 1: Droplet larger than aerosols, when exhaled (at velocity of <1m/s), evaporate or fall to the ground less than 1.5 m away. When expelled at high velocity through coughing or sneezing, especially larger droplets (> 0.1 mm), can be carried by the jet more than 2m or 6m, respectively, away.[5]

What the above graph shows is that when someone coughs or sneezes they disperse a gas spray / aerosol that initially cluster near the person, being next to someone when they sneeze or cough will mean you will be exposed to the aerosol spray and larger particles given your proximity (distance) from the person coughing or sneezing.

As further time passes the larger particles settle from the air and the chance of exposure is limited. The best way to explain this is to use the diagram below:

Figure 2: In the above figure you can see that Person B will breath in both the larger and smaller particles whereas because person C is further way, whilst s/he will still inhale the particles these will be finer and smaller in concentration and this is why social distancing is so important.

Now that we understand the basics of the transmission, we will explore the available PPE options and I will hopefully set my stall argue against mass public use of expensive masks.

1. Home made cloth masks:
A randomised trial comparing the effect of medical and cloth masks on healthcare worker illness found that those wearing cloth masks were 13 times more likely to experience influenza-like illness than those wearing medical masks.6

2. Surgical paper mask:
Several randomised trials have not found any statistical difference in the efficacy of surgical masks versus N95 FFRs at lowering infectious respiratory disease outcomes for healthcare workers.[7] However it should be noted that both the CDC and the WHO guidelines recommend N95 or FFP3 rated respirators for doctors and health care professionals working in a setting where there are procedures that would involve aerosol generating particles, procedures including swabbing, intubation/extubation, suction and ventilation.

3. N95 / P100 Masks:
A study found that health care workers risk of SARS (severe acute respiratory syndrome, also caused by a coronavirus) was lower with consistent use of N95 FFRs than with consistent use of a surgical mask.[8]

So does this mean that surgical masks are useless? Not quite, surgical masks still provide a barrier and are excellent for use by people who may be showing symptoms and people caring for people who may have symptoms.

Does this also mean that you should go out and buy N95 or FFP3 respirators to protect yourself? No, I want to make this clear that using a FFP3 respirator is pointless unless it is fit-tested and used by trained personnel, an N95 respirator or any FFP3 rated respirator should not be seen as a silver bullet and unless you are working with patients in a "hot" ward, you should please reserve these items for health care professionals who need it most.

For N95 and FFP3 masks to offer the correct protection, they have to be put on in the correct fashion and fit-tested by the user and using a "qualitative fit test":

Speaking to a friend who is a leading supplier of PPE, there is a global shortage of respirators and this is where you need to play your part and be sensible in your purchasing, do not bulk buy or hoard masks and ppe, even if it's face masks, leave some for others, if people bulk buy, it will lead to a shortage and with rising demand, business owners will hike up the prices and the poor will suffer.

It is important to mention that leading experts in their field such as Dr. Brosseau in the U.S. still advocates for the general public "not to wear masks". In comparison, in Germany The Robert Koch Institute has updated its position regarding people wearing protective face masks in public places, saying more widespread use could help slow the coronavirus spread.

To conclude, this was a non exhaustive desktop study on the transmission of COVID19 and the efficacy of the PPE available, I am in no position to predict if the WHO will change its existing position of everyone wearing masks, the data from China and elsewhere does support the general opinion that wearing masks coupled with physical distancing, staying at home and practising good hygiene can flatten the curve.

Source: Prof. Sui Huang.

[1] Devlin H, Campbell D. WHO considers changing guidance on wearing face masks. Guardian Newspaper UK 2020 Apr 1. https://www.theguardian.com/world/2...patients-should-wear-masks-says-doctors-group
[2] Gralton J, Tovey E, McLaws ML, et al. The role of particle size in aerosolised pathogen transmission: a review. J Infect 2011 Jan;62(1):1-13
[3] Yang S, Lee GWM, Chen CM, et al. The size and concentration of droplets generated by coughing in human subjects. J Aerosol Med 2007 winter;20(4):484-94
[4] Yan J, Grantham M, Pantelic J, et al. Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community. Proc Natl Acad Sci USA 2018 Jan
[5] Van Doremalen N, Bushmaker T, Morris D, et al. Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1. medRxiv 2020 Mar 13
[6] MacIntyre CR, Seale H, Dung TC, et al. A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.BMJ Open 2015 Apr 22;5(4):e006577
[7] Loeb M, Dafoe N, Mahony J, et al. Surgical mask vs N95 respirator for preventing influenza among healthcare workers: a randomized trial. JAMA 2009 Nov 4;302(17):1865-71
[8] Loeb M, McGeer A, Henry B, et al. SARS among critical care nurses, Toronto.Emerg Infect Dis 2004 Feb;10(2):251-5


@Slav Defence @fatman17 @The Eagle

 

[WebMaster]

There are many posts on social media and misinformation / confusing and contradictory advice by both people in official and unofficial capacities regarding face masks during the coronavirus outbreak.

And as I write this I am well aware that the World Health Organisation is reviewing data from China, South Korea and Hong Kong that suggests the general public should wear face-masks and that by doing so could help contain the pandemic. [1]

This practice of spreading misinformation or misleading claims that certain masks help protect against coronavirus has created a vacuum in the supply available in the market for those who need it most and the rising demand for these items has resulted in sky rocketing prices by unscrupulous vendors looking to make a quick penny in a time of crisis.

In this write up I hope to explain how the virus is transmitted and summarise scientific evidence in support of or against each of the available masks in the Pakistani Market. Before I begin with the meat of the article, let me lay down it's bones and discuss the difference between what constitutes a face mask and what constitutes a respirator:

Paper Mask / Surgical Mask:

• Paper dust masks: Also called surgical masks, these loose-fitting masks have only one strap and don’t form a tight seal to the wearer’s face. They are designed to stop liquid droplets and aerosols coming out of the wearer’s mouth, not filter the air coming in. With no filter and no facial seal, they are not designed to prevent the inhalation of respirable particles found in smoke. Although they may look the same, dust masks are not respirators and should not be used for that purpose.

N95 and P100 respirator:

• N95s and P100s: These respirators have two sets of straps and form a tight seal to the face. The entire respirator is made of filtering material. N95s are the most common, with P100s being more protective (similar to a HEPA filter). Both types can often be found in hardware stores and other retail outlets. These respirators are certified by the National Institute for Occupational Safety and Health (NIOSH), so look for “NIOSH” and the designation “N95” or “P100” on the respirator.

When worn correctly, these respirators are effective at filtering out the small respirable particles found in wildfire smoke. However, they do not filter out fumes and gases; for that, see the next type of respirator listed.

Half-face or full-face respirator:

• Half-face or full-face respirator: Unlike N95s and P100s, which are disposable, half-face and full-face respirators offer a tight-fitting, flexible facepiece with replaceable filter cartridges. N95 particulate filters or purple (P100 or HEPA) filter cartridges will protect against particulates in wildfire smoke. When used with a combination filter that has an organic vapor cartridge, these respirators would also protect against harmful fumes and gases. However, neither these respirators nor N95s supply oxygen.

So at a time when you are already practising physical distancing/social distancing, staying at home, washing your hands, why are we talking about masks? As presented in my opening paragraph, the issue circulates data that supports the view that SARS-CoV-2 that virus that causes COVID is transmitted by aerosols both large and small at or near to source. The available data also suggests that people who may not show any symptoms (asymptomatic) or yet to develop symptoms (pre-symptomatic) are spreading the virus this way. [2, 3, 4]

Figure 1: Droplet larger than aerosols, when exhaled (at velocity of <1m/s), evaporate or fall to the ground less than 1.5 m away. When expelled at high velocity through coughing or sneezing, especially larger droplets (> 0.1 mm), can be carried by the jet more than 2m or 6m, respectively, away.[5]

What the above graph shows is that when someone coughs or sneezes they disperse a gas spray / aerosol that initially cluster near the person, being next to someone when they sneeze or cough will mean you will be exposed to the aerosol spray and larger particles given your proximity (distance) from the person coughing or sneezing.

As further time passes the larger particles settle from the air and the chance of exposure is limited. The best way to explain this is to use the diagram below:

Figure 2: In the above figure you can see that Person B will breath in both the larger and smaller particles whereas because person C is further way, whilst s/he will still inhale the particles these will be finer and smaller in concentration and this is why social distancing is so important.

Now that we understand the basics of the transmission, we will explore the available PPE options and I will hopefully set my stall argue against mass public use of expensive masks.

1. Home made cloth masks:
A randomised trial comparing the effect of medical and cloth masks on healthcare worker illness found that those wearing cloth masks were 13 times more likely to experience influenza-like illness than those wearing medical masks.6

2. Surgical paper mask:
Several randomised trials have not found any statistical difference in the efficacy of surgical masks versus N95 FFRs at lowering infectious respiratory disease outcomes for healthcare workers.[7] However it should be noted that both the CDC and the WHO guidelines recommend N95 or FFP3 rated respirators for doctors and health care professionals working in a setting where there are procedures that would involve aerosol generating particles, procedures including swabbing, intubation/extubation, suction and ventilation.

3. N95 / P100 Masks:
A study found that health care workers risk of SARS (severe acute respiratory syndrome, also caused by a coronavirus) was lower with consistent use of N95 FFRs than with consistent use of a surgical mask.[8]

So does this mean that surgical masks are useless? Not quite, surgical masks still provide a barrier and are excellent for use by people who may be showing symptoms and people caring for people who may have symptoms.

Does this also mean that you should go out and buy N95 or FFP3 respirators to protect yourself? No, I want to make this clear that using a FFP3 respirator is pointless unless it is fit-tested and used by trained personnel, an N95 respirator or any FFP3 rated respirator should not be seen as a silver bullet and unless you are working with patients in a "hot" ward, you should please reserve these items for health care professionals who need it most.

For N95 and FFP3 masks to offer the correct protection, they have to be put on in the correct fashion and fit-tested by the user and using a "qualitative fit test":

Speaking to a friend who is a leading supplier of PPE, there is a global shortage of respirators and this is where you need to play your part and be sensible in your purchasing, do not bulk buy or hoard masks and ppe, even if it's face masks, leave some for others, if people bulk buy, it will lead to a shortage and with rising demand, business owners will hike up the prices and the poor will suffer.

It is important to mention that leading experts in their field such as Dr. Brosseau in the U.S. still advocates for the general public "not to wear masks". In comparison, in Germany The Robert Koch Institute has updated its position regarding people wearing protective face masks in public places, saying more widespread use could help slow the coronavirus spread.

To conclude, this was a non exhaustive desktop study on the transmission of COVID19 and the efficacy of the PPE available, I am in no position to predict if the WHO will change its existing position of everyone wearing masks, the data from China and elsewhere does support the general opinion that wearing masks coupled with physical distancing, staying at home and practising good hygiene can flatten the curve.

Source: Prof. Sui Huang.

[1] Devlin H, Campbell D. WHO considers changing guidance on wearing face masks. Guardian Newspaper UK 2020 Apr 1. https://www.theguardian.com/world/2...patients-should-wear-masks-says-doctors-group
[2] Gralton J, Tovey E, McLaws ML, et al. The role of particle size in aerosolised pathogen transmission: a review. J Infect 2011 Jan;62(1):1-13
[3] Yang S, Lee GWM, Chen CM, et al. The size and concentration of droplets generated by coughing in human subjects. J Aerosol Med 2007 winter;20(4):484-94
[4] Yan J, Grantham M, Pantelic J, et al. Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community. Proc Natl Acad Sci USA 2018 Jan
[5] Van Doremalen N, Bushmaker T, Morris D, et al. Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1. medRxiv 2020 Mar 13
[6] MacIntyre CR, Seale H, Dung TC, et al. A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.BMJ Open 2015 Apr 22;5(4):e006577
[7] Loeb M, Dafoe N, Mahony J, et al. Surgical mask vs N95 respirator for preventing influenza among healthcare workers: a randomized trial. JAMA 2009 Nov 4;302(17):1865-71
[8] Loeb M, McGeer A, Henry B, et al. SARS among critical care nurses, Toronto.Emerg Infect Dis 2004 Feb;10(2):251-5


@Slav Defence @fatman17 @The Eagle

Nice article, please create a thread so we can promote this. @Foxtrot Alpha Please tag Foxtrot once done.

 

[RescueRanger]

Nice article, please create a thread so we can promote this. @Foxtrot Alpha Please tag Foxtrot once done.

Thank you very much, thread created .

 

[WebMaster]

Thank you very much, thread created .

No, thanks to you brother!

 

[litman]

@RescueRanger

View attachment 618691 View attachment 618692 View attachment 618693 View attachment 618694 View attachment 618695

they are doing lot more then most of our media members, patwaris and many of the moulvis.

 

[El Sidd]

Respected Chairman "Think" Tank Analyst, @Slav Defence

I would like to draw your attention to the adverse effect of the platform being used to downplay the pandemic as some conspiracy.

Please do not insult Pakistan Egypt relations nor undermine the Al Azhar University and President of Pakistan's appeal in this regard by limiting or by quarantine of the conspiracy threads.

We maybe experiencing social distancing but that does not mean we have no responsibility to the society.

Thank you and happy tin foil hat day as well.

Retards,
El Sidd

 

[Slav Defence]

Respected Chairman "Think" Tank Analyst, @Slav Defence

I would like to draw your attention to the adverse effect of the platform being used to downplay the pandemic as some conspiracy.

Please do not insult Pakistan Egypt relations nor undermine the Al Azhar University and President of Pakistan's appeal in this regard by limiting or by quarantine of the conspiracy threads.

We maybe experiencing social distancing but that does not mean we have no responsibility to the society.

Thank you and happy tin foil hat day as well.

Retards,
El Sidd

Respected "Elite member",
I have absolutely no clue what you are talking about. As per my limited knowledge, the nonsense blame game was played between Chinese and Americans at every level which I tried my level best to encounter. I will however, will look forward to your non serious but serious issue and try to fix this.
No thankyou at all and please remain in the tincan to stay safe.

Retards

 

[El Sidd]

Respected "Elite member",
I have absolutely no clue what you are talking about. As per my limited knowledge, the nonsense blame game was played between Chinese and Americans at every level which I tried my level best to encounter. I will however, will look forward to your non serious but serious issue and try to fix this.
No thankyou at all and please remain in the tincan to stay safe.

Retards

Honorable Think "Tank" Analyst,

It is a pleasure indeed to have been blessed with China in one hand and America in other. But my non serious concern is for a serious matter that Pakistanis should not be allowed to open such threads at all since they are more influential.

I wish you best in this retard.

Regards,

 

[BATMAN]

Seeing as the world has been held up by the first pandemic we've seen. I think instead of sitting on our behinds, let's do something instead of fighting each other. Let's fight the virus. The panic is also very real and right now you can make the world of a difference. So, I'm calling for a ceasement of all hostilities, for now, and calling to arms all members who are passionate and worried for their families and communities.

Please, below just write where you are and what can you do (i.e. anything you can provide or do such as programming, are you a doctor, psychologist, writer, etc.,). Please, let me know how many of you are interested but I want to strike back and arm our people against this menace.

ME: Psychologist, PK.

There's already peace in middleast. Arabs must thank Zulfi Bukhari.

 

[Asian.Century]

80% of NYC's coronavirus patients who are put on ventilators ultimately die, and some doctors are trying to stop using them

A patient with COVID-19, the illness caused by the coronavirus, wears a snorkeling mask converted into a ventilator in Paris on April 1. REUTERS/Benoit Tessier/File Photo

• Some doctors are trying to reduce their reliance on ventilators for coronavirus patients because of reports of abnormally high death rates for patients using the machines, The Associated Press reported on Wednesday.
• New York City officials have said at least 80% of coronavirus patients who were on ventilators in the city died, the AP reported. Unusually high death rates have also been recorded elsewhere in the US and the world.
• Ventilators are typically used only for the worst-affected patients, and there are no drugs approved to treat COVID-19, so this could help explain the higher death rate.
• But doctors have also said ventilators can damage the lungs — and while the machines may be an effective way to treat other respiratory illnesses, some are looking for alternative treatments.
• Because there is a global ventilator shortage, doctors and healthcare systems have called for more to be made or bought quickly to treat the worst-affected patients.
• Visit Business Insider's homepage for more stories.

Some doctors are trying to use ventilators less frequently as some areas have reported high death rates among coronavirus patients who were on them, The Associated Press reported on Wednesday.

Ventilators, machines used to bring oxygen into a person's lungs, are typically used only for the patients worst affected by respiratory diseases.

Experts have said that some 40% to 50% of patients with severe respiratory issues die while on ventilators, the AP reported.

New York City officials have said at least 80% of coronavirus patients who were put on ventilators there ultimately died, the AP reported. New York state has the most confirmed coronavirus cases and deaths in the US.

There have also been reports of unusually high death rates among patients on ventilators elsewhere in the US and in China and the UK, the AP said.

Workers make ventilators at a plant in Barcelona, Spain, on Tuesday.
Europa Press News/Europa Press via Getty Images
Putting a person on a ventilator is an extreme step saved for the worst-affected patients, who typically already have the highest chance of dying from respiratory failure.

The higher death rates could be a result of this, as well as the fact that there are so far no drugs approved to fight the coronavirus.

Ventilators could be further harming coronavirus patients, some doctors say
Some doctors are also concerned that ventilators could be further harming certain coronavirus patients, as the treatment is hard on the lungs, the AP reported.

Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.

Dr. Negin Hajizadeh, a pulmonary critical-care doctor at New York's Hofstra/Northwell School of Medicine, also told NPR that while ventilators worked well for people with diseases like pneumonia, they don't necessarily also work for coronavirus patients.

She said that most coronavirus patients in her hospital system who were put on a ventilator had not recovered.

She added that the coronavirus does a lot more damage to the lungs than illnesses like the flu, as "there is fluid and other toxic chemical cytokines, we call them, raging throughout the lung tissue."

Medical workers wearing personal protective equipment wheel bodies to a refrigerated trailer serving as a makeshift morgue at Wyckoff Heights Medical Center in New York City on Monday.
John Minchillo/AP
"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."

Doctors are trying to find other solutions and reduce their reliance on ventilators
The lack of treatment options for coronavirus patients has caused much of the world to turn to ventilators for the worst-affected patients.

But the high death rates reported among patients on ventilators have prompted some doctors to seek alternatives and reduce their reliance on ventilators, the AP reported.

Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."

A GE worker in Massachusetts takes part in protest on Tuesday demanding that the company use the workforce to produce ventilators and calling for more safety measures.
REUTERS/Brian Snyder
According to the AP, doctors are putting patients in different positions to try to get oxygen into different parts of their lungs, giving patients oxygen through nose tubes, and adding nitric oxide to oxygen treatments to try to increase blood flow.

Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

The global ventilator shortage
The global shortage of ventilators has become one of the big stories of the pandemic, as doctors around the world desperately try to treat patients.

Private companies in the UK have shifted to producing them because of a shortage in the health service, but they aren't likely to make enough before the outbreak peaks in the country, The Guardian reported on Friday.

In Italy, doctors have had to decide which patients are more likely to survive and therefore who they will put on a ventilator; they have turned patients away because of the shortage.

In Spain, the police have asked people to donate snorkels so that their parts could be used to build makeshift ventilators.

The police in Madrid on Monday asked people to donate full-face snorkel masks that could be used as makeshift ventilators for COVID-19 patients.

Madrid Police/Twitter
In the US, New York Gov. Andrew Cuomo has decried a ventilator shortage in the state, while other states have said they've had to battle the federal government for new ones and enlisted private companies to fix broken ventilators received from the federal stockpile

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

 

[Asian.Century]