The Humanitarian Engineering Free-libre Open Source Pandemic Response Organizations

— Robert L. Read, January 2021

In 2020 something happened that we had been warned about: the COVID-19 pandemic scourged the whole planet. I will not repeat the statistics here, except to say two things: many loved ones died before their time, and it would have been much worse if society had not responded vigorously.

Almost everyone did fight the pandemic. For every one person that denied the science or preferred a strong economy and massive casualties to social distancing, there were dozens more who stood up and did what they could, from wearing a mask to bringing food to their neighbors to working long hours under dangerous conditions in clinics.

This article is about only one of those groups of people: the engineers, makers, business people, artists, writers, managers and leaders who came together and chose to address the pandemic with their specific talent by making open-source medical devices and personally protective equipment (PPE). If you want to support these efforts, this review of major organizations may be useful to you.

The Story of the Pandemic

In March of 2020, experts predicted a massive shortfall of invasive ventilators. However, by May it was clear that treatment involved less invasive ventilation while therapeutic oxygen, non-invasive ventilation and PPE remained (and remains) sorely needed. Oxygen is widely available in high-resource communities in “the West,” but much less so in low-resource communities throughout the global South. Furthermore, a lack of PPE has plagued the United States even up to the time of this writing, although a mask is a much simpler device than a ventilator.

The diagrams below give my personal view of the basic timeline of the pandemic, from March 2020 to the present day, when vaccination has begun but daily cases and deaths remain high. On the day of this writing, more people died of COVID-19 than in the terrorist attacks of 9/11 that precipitated several wars.

The future remains uncertain.

The Organized Free-libre Open Source Response

Starting in March, four umbrella volunteer organizations were quickly formed.

These included:

• Open Source Medical Supplies (OSMS), which delivered more than 5 million pieces of PPE and began as a Facebook Group and a set of Google Docs.
• Helpful Engineering (HE), whose slack channel of 18,000 volunteers became a nexus for many volunteers and projects.
• Collective Open Source Medical Innovations for COVID-19 (COSMIC).
• Public Invention (PubInv), my own organization, which existed before the pandemic.

The United Nations Technology Access Partners (UNTAP) and Engineers Without Borders-USA (EWB-USA) serve important roles by trying to provide information about global need.

More than a 100 projects were created just to quickly design and construct ventilators. A community effort led by Public Invention collected and evaluated these ventilator projects, which are too numerous to report here. Some of these projects were assisted by or under the umbrella of the big four organizations (HE, OSMS, COSMIC, and PubInv).

The following opinions may help you understand which of these charitable organizations (501c3, in the US) is right for you if you want to volunteer (and all of them need money!):

1. Open Source Medical Supplies (OSMS) has focused on delivering supplies and has probably saved more lives than these other organizations by focusing on PPE. They have organized volunteers to make simply designed masks, gowns and other equipment, and coordinated the actual delivery of these products. If you want to help provide PPE, this is the organization for you.
2. Helpful Engineering (HE) has an active Slack community and is running about 10 interesting engineering projects. Even if you choose to join other organizations, you should join HE’s Slack team and whatever channels interest you (although the traffic can be dizzying). Submitting a profile there may allow you to be tapped by a team for a specific need. Helpful Engineering is dedicated to the painstaking process of bringing medical devices to market. HE has 18,000 people who have signed up but probably 200 active people in a given week, though most of those people may not be putting in many hours.
3. Collective Open Source Medical Innovations for COVID-19 (COSMIC) is smaller and based out of British Columbia, Canada. COSMIC has skilled medical advice and is well organized; their monthly livestreams have about 30 part-time volunteers and report on four interesting projects.
4. Public Invention (PubInv) focuses on research and invention in the public interest and is dedicated to promoting an open-source ecosystem of modular components for ventilation support. The VentMon monitor/tester is our flagship project. With the recent addition of PolyVent ventilator project, we are now making free-libre open source modules for every needed part of a complete ventilation and oxygen concentrator system. Public Invention has about 15 volunteers working 4 hours a week or more, on both pandemic and non-pandemic related inventions.

A more detailed diagram that categorized color-codes projects run by these organizations is shown below.

To see it in greater (zoomable) detail and links to all projects, click on the Plectica Map here.

Two smaller organizations, the Fonly Institute and ArcanaProBono, are making interesting reusable or reference implementations.

This community self-organized and shared knowledge through a variety of conferences (Vent-Con 2020, VentCon QA, Supply Shortage Solutions Symposium, and PuvInvCon2021).

Videos of Vent-Con 2020, VentCon QA, and PubInvCon2021 can be found at the Public Invention YouTube channel.)

Blind Spots

There were at one time more than 100 ventilator projects attempting to address the pandemic, but sadly many have stopped making progress or have become closed-source and gone dark. Some of these dark projects may yet succeed in bringing a life-saving product to market, but since their progress is hidden, it is very difficult to judge. Some of the better open-source projects have been interviewed and analyzed.

Finally, this article is no doubt unintentionally biased, especially toward the anglophone projects which use English as their primary language. I know there are interesting and advanced ventilator projects developed in Spanish and French, for example. I would enjoy having large umbrella opens-source design organizations parallel to the four highlighted here brought to my attention.

The Present Need

In March of 2020, the shortfall of ventilators was a hair-on-fire emergency. The adoption of social distancing, medical learnings, and the production by major corporations that rapidly manufactured ventilators abated the shortfall in the US and the wealthy nations. The vaccine gives legitimate hope that herd immunity will clamp down the pandemic by this summer.

But the less wealthy nations continue to have a dire need which has not been met. The world now needs long-term volunteers who have the faith and vision to make medical devices abundant. Steady, long-term dedication by a few dozen skilled volunteers with engineering, medical, legal, and business skills can create something new for humanity: a shared public commons of designs and test data for a growing ecosystem of open-source medical devices that are supply-chain resilient and more transparently open, and therefore safer and less monopolistic, than existing devices.