'Pandemic ventilator' could offer solution in potential 'worst case' scenario

Furthermore, there is a difference between observations of aggregate numbers, like the number of people on ventilators and their survival rate, and small numbers of uncontrolled drug interventions where there are obvious ways for the data to be deceiving. Not all observed data has the same reliability.

That's nice, but most science isn't reproducible at scale. We need to do a drug trial for SARS-CoV-2 because we need to 1)establish efficacy and 2) establish safety for this drug in this disease. There are a significant amount of adverse drug effects in individual infectious diseases. Jarisch–Herxheimer reaction when treating syphilis, epstein-Barr mononucleosis and penicillin; Reye syndrome with Aspirin and influenza. The list is long here. We want the most vetted research possible because even if the chance of death is less than half a percent, half a percent of what seems like is going to be over a million is going to be in the tens of thousands here.

Here's a recent review: https://www.sciencedirect.com/science/article/pii/S088394412...

They find hundreds of relevant-sounding papers, registered trials, and guidelines, but almost no data beyond one in vitro study to back it up. That one study is promising--and it'll be great to see what the trials show--but the road from "works in a dish" to "drugs for all" is a long, bumpy one at the best of times.

We need to do this right so that if it works, we know that it works, and if it doesn't, we can make informed decisions to do something else.

Take out the seats, equip the cabin with ventilators, and when one outbreak gets under control, send the aircraft to the next outbreak zone.

They even have their own generators lol.

Not sure if this is supposed to be better. And who would fly all these people? Access to the cockpit is through the rest of the plane.

There are cabin pressurization test carts for use on the ground, as well as start carts to provide bleed air for starting engines, and bleed air in turn can supply cabin pressurization in flight, although this probably requires some rigging on the ground.

Interestingly, they switched to electric compressors for the 787 [0] because those no longer provide bleed air from/to each engine to simplify the plumbing.

[0] https://aerosavvy.com/aircraft-pressurization/

Your lungs operate on the principle of differential pressure. During normal breathing, hen the pressure inside your lungs becomes less than that of the surrounding atmosphere, air rushes in to normalize and fill it until they are again equal pressures. Gradually increasing or decreasing the pressure of the atmosphere around you (as on a plane or while diving) does not change the physical difficulty of breathing. It may slightly alter the diffusion coefficients of gasses passing through the membranes in your lungs, but this effect is mild at the pressures you could attain in an aircraft hull (and toxic at higher pressures! [0]).

For this reason, you'll notice in images of people in iron lungs, their heads are outside of the device. This allows those who cannot create negative pressure (due to damaged or paralyzed diaphragms or ribcage muscles) to follow a different path. The pressure outside of their chest becomes lower than that experienced in their lungs, forcing an expansion; in order to breath out, the pressure in the chamber is increased. In an aircraft hull a person's lungs/trachea/mouth would be exposed to the same pressure as their chests.

This of course does bring up the very valid question: What happened to all of the iron lungs after the decline of Polio?

[0] https://en.wikipedia.org/wiki/Nitrogen_narcosis

EDIT: Oh I realize I didn't fully discuss the possibility of using a plane as a hyperbaric chamber [1]. The constraints around this concept also rule it somewhere outside of what I would consider feasible. Aircraft typically use bottled oxygen (I believe the 737M does) or a chemical generator, neither of which can produce continuous oxygen or fill the entire plane with it to high levels [2]. If you were able to outfit patients with individual tanks (which would also have to accommodate for increased pressure), the gains seem mild at best compared to 100% O2 in a hospital setting. Fick's Law for the membranes in your lungs is roughly

Rate of diffusion = (Area * Solubility of gas * concentration gradient) / (membrane thickness * sqrt(molecular weight of solute))

The factor that increasing pressure would modify is the solubility of the gas, which according to Henry's Law [4] is directly proportional to pressure. At absolute best (100% O2 on the plane at 2atm), you could expect to get 2x improvement in blood oxygen saturation. Unfortunately I don't believe the breathing issues that are being described can be overcome by this strategy. It's an incredibly creative concept though!

[1] https://en.wikipedia.org/wiki/Hyperbaric_medicine

[2] https://en.wikipedia.org/wiki/Emergency_oxygen_system

[3] https://clinicalgate.com/gas-exchange-between-air-and-blood-...

[4] https://en.wikipedia.org/wiki/Henry%27s_law

Novel thought...

Theoretically, yes. The Environmental Control Systems on all our commercial airplanes positively charge the airflow at a nominal Delta P of 9.8 psi and have HEPA filtration down to 10µm, but at $100M+ per 737 MAX, delivery customers highly frowning upon such a practice and not being able to deliver them as a "New" airplanes after contamination, highly unlikely.

The A380 fleet is starting to retire prematurely only after 10 short years of service due to lack of profitability and demand due to COVID-19. Those huge retired Behemoths could serve very well as a quarantine base in remote locations.

Covid19 is not the only germs they will be carrying. The people who are the sickest are the ones that most need oxygen supplementation. Reports suggest that most of the people dying from it already have other serious medical conditions.

This is exactly how antibiotic resistant infections get bred. You would be creating a melting pot of horribleness and cross-contamination and god-knows-what would come spewing out of it.