R.I. group seeking old sleep apnea machines for new use amid ventilator shortage

Alex Hornstein, leader of VentilatorProject.Org, estimates the state contains 9,000 unused CPAP and BiPAP machines

Alex Hornstein, leader of VentilatorProject.Org, appears in a video explaining how to prepare a sleep apnea machine for donationCourtesy of Alex Hornstein

The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Edward Fitzpatrick at [e-mail].

This week’s Ocean State Innovators conversation is with Alex Hornstein, leader of the VentilatorProject.Org.

Question: What is VentilatorProject.org, when did it launch, and what gave you the idea for it?

Answer: VentilatorProject.org is a volunteer-run group that started about a month ago. I am the leader of it. The goal is to collect and refurbish sleep apnea machines to serve as supplementary equipment to hospitals that are treating patients affected by COVID-19. We got in touch with pulmonologists and clinicians in hospitals working with COVID-19 patients to understand their perspective on the front lines. The traditional supply chains for hospitals are disrupted. Ventilators are being ordered and made as quickly as they can, but they may not arrive in the right time frame. So we looked at what steps we can take to mitigate that situation. A lot of folks feel a desire to do something, so I put the responsibilities in my day job on ice for a month to do this.

Q: How many sleep apnea machines are out there?

A: Based on industry statistics, there are 8.5 million of these machines in America, including 8 million CPAP (Continuous Positive Airway Pressure) machines and 500,000 BiPAP (Bilevel Positive Airway Pressure) machines. A large number -- 35 percent, or 2.9 million -- are not being used regularly. We estimate there are 9,000 unused machines in Rhode Island. So that gave me the idea that there is a lot of latent supply. These machines are not designed to be ventilators, but in many cases, they share some functionality in common with ventilators. A ventilator’s fundamental job is to blow air through a tube into a mask, but the machine doesn’t know if it’s blowing into a mask or a set of lungs.

Q: If you have a sleep apnea machine that you would like to donate, where should you bring it and where will the machines go?

A: We are only looking for sleep apnea machines that you are not using and only machines that you own -- as opposed to being leased from an insurer. Go to VentilatorProject.Org and there are a few simple steps to take to prepare your machine for donation. Then you can bring the machines to one of 23 firehouses in Rhode Island. The website has a list of the firehouse addresses and drop-off times. The machines will be taken to a processing center at the University of Rhode Island, where 100 volunteers will refurbish them. They will sanitize it, refurbish it, and test it. Then they will inventory it and pack it for distribution to hospitals that need them. My first preference is to work in Rhode Island. If there is a need in neighboring states, we could respond to it. My hope is other states can follow Rhode Island’s lead and execute similar drives.

Q: Have any hospitals used sleep apnea machines in this way before?

A. There is significant precedent for hospitals incorporating these home-use machines in this crisis. The U.S. Food and Drug Administration issued guidance to help facilitate their use in hospitals, and doctors at The Mount Sinai Hospital and Northwell Health in New York both issued recent protocols for using home-use BiPAP-ST machines in a hospital setting to treat COVID-19 patients. I want to be very clear that a lot of CPAP and BiPAP machines may not be ideally applicable in treatment for COVID-19 because non-invasive masks can aerosolize the virus and expose health-care workers. You have to mitigate that by putting on filters when you intubate to keep the patient from breathing in the virus and to keep whatever is coming out of a patient from going into health-care workers. And sleep apnea machines can be used for other patients to free up ventilators for COVID-19 patients.

Q: Who are the partners that you are working with here in Rhode Island on this project, and what are their roles?

A: This was organized under the umbrella of the Rhode Island Commerce Corporation, which spearheaded the COVID-19 supply groups. And through them, URI stepped up to offer their space and over 100 student and faculty volunteers to help refurbish the machines. The state Department of Health, fire stations, and other hospital and industry partners have helped. At VentilatorProject.Org, my group wrote this plan in Pawtucket.

Q: What is your day job?

A: I am the co-founder and chief technology officer for Looking Glass Factory Inc., which makes digital, real-time holographic displays. Holographs are one of those dreams we had as kids. The headquarters are in Brooklyn, but the research and development is at Hope Artiste Village in Pawtucket. I live in Providence. I studied engineering and computer science at the Massachusetts Institute of Technology. I have a background in engineering with a shortage of resources. So seeing the infrastructure strained in this way captured my interest.