Open Source COVID-19
Medical Supply Guide
Version 1.0, last updated 3/18/2020 @ 7:45 AM Pacific Time
Version 1.1, last updated 3/20/2020 @ 5:06 PM Pacific Time.
Version 1.2, last updated 4/1/2020 @ 6:44 PM Pacific Time
Version 1.2.1, last updated 4/12/2020 @ 11:33 AM Pacific Time
Version 2.0, last updated 4/29/2020 @ 5:54 AM Pacific Time
Version 2.1, last updated 5/8/2020 @ 8:35 Pacific Time
* Two new supply categories: Aerosol Boxes and Noninvasive Ventilation Helmets, complete with designs.
Table of Contents:
Epidemiology of COVID-19
Transmission of COVID-19
Diagnosing COVID-19
Treatment of COVID-19
A Note About Safety and Liability
Design, Manufacturing, & Engineering Projects
Supply Categories
Community Items
PPE
Medical Supplies
Medical Devices
Manufacturing Processes
FAQ
Glossary
Acronyms
Epidemiology of COVID-19
The COVID-19 pandemic has exploded since the disease was first identified in China in December of 2019. As of April 26, 2020, more than 2.91 million cases of COVID-19 have been reported globally, including more than 203,000 deaths, across 185 countries and territories (including all 50 states of the United States). It is estimated that more than 828,000 people have recovered. [1]
Individuals of all ages are at risk for infection and severe disease. However, the probability of serious complications and fatal disease is highest in people over the age of 65 years and those living in long-term care facilities or nursing homes. Others at especially high risk for COVID-19 are people of any age with existing underlying conditions, especially when not well-controlled. [2,3]
Transmission of COVID-19
The onset and duration of viral shedding and period of infectiousness are not completely defined. Asymptomatic or pre-symptomatic individuals infected with COVID-19 may have viral RNA detected in upper respiratory specimens before the onset of symptoms.[4] Additionally, transmission from asymptomatic individuals has been described.[5]
The time from exposure to onset of symptoms is typically around five days but may range from two to fourteen days.[6] The virus is primarily spread between people during close contact,[7] often via small droplets produced by coughing, sneezing, or talking.[8] Additionally, these droplets fall to the ground or onto surfaces where people may also become infected by touching a contaminated surface and then touching their face, nose, mouth, or eyes.[9]
Clinical Presentation of COVID-19
The spectrum of illness from COVID-19 can range from asymptomatic infection to severe pneumonia with acute respiratory distress syndrome (ARDS) and death. In a summary of 72,314 persons with COVID-19 in China, 81% of cases were reported to be mild, 14% were severe, and 5% were critical.[10] In a report of 1,482 hospitalized patients with confirmed COVID-19 in the United States, the most common presenting symptoms were cough (86%), fever or chills (85%), and shortness of breath (80%), diarrhea (27%), and nausea (24%).[11] Other reported symptoms have included, but are not limited to, sputum production, headache, dizziness, rhinorrhea, anosmia, dysgeusia, sore throat, abdominal pain, anorexia and vomiting.[12]
Common laboratory findings of COVID-19 include leukopenia and lymphopenia. Other laboratory abnormalities have included elevations in aminotransferase levels, C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase.[13]
Abnormalities in chest X-ray vary, but typically reveal bilateral multifocal opacities. Abnormalities seen in computed tomography (CT) of the chest also vary, but typically reveal bilateral peripheral ground-glass opacities with the development of areas of consolidation later in the clinical course.[14]
Diagnosing COVID-19
The diagnosis of a COVID-19 patient requires detection of SARS-CoV-2 RNA by reverse transcription polymerase chain reaction (RT-PCR). Detection of viral RNA is best when collected from nasopharynx samples compared to throat samples.Lower respiratory samples may have better yield than upper respiratory samples.[15,16] The detection of SARS-CoV-2 RNA in blood may be a marker of severe illness.[17]
Viral RNA shedding may persist over longer periods among older persons and those who had severe illness requiring hospitalization.[18] Infection with both SARS-CoV-2 and with other respiratory viruses has been reported, and detection of another respiratory pathogen does not rule out COVID-19.[19]
Treatment of COVID-19
Patients with a mild clinical presentation (without viral pneumonia and hypoxia) may not require hospitalization, and many patients will be able to manage their illness at home. The decision to monitor a patient in the inpatient or outpatient setting should be made on a case-by-case basis.[20] This decision will depend on the clinical presentation, requirement for supportive care, risk factors for complications, and if the patient is able to self-isolate at home. Patients with risk factors for severe illness should be monitored closely given the possible risk of progression to severe illness during the second week following symptom onset.[21,22]
Some patients with COVID-19 will have severe disease requiring hospitalization for management. No specific treatment for COVID-19 is currently FDA approved. While corticosteroids have been widely used in hospitalized patients with severe illness in China [23], the benefit of corticosteroid use cannot be determined based upon uncontrolled observational data. Therefore, corticosteroids should be avoided unless indicated for other reasons, such as management of chronic obstructive pulmonary disease or septic shock.[24]
Inpatient management revolves around the supportive management of the most common complications of severe COVID-19: pneumonia, hypoxemic respiratory failure/ARDS, sepsis and septic shock, cardiomyopathy and arrhythmia, acute kidney injury, and complications from prolonged hospitalization including secondary ba