Medics and Makers Transcript

Narrating (Lupita): 

On March 4th, the Department of Health and Human Services confirmed that the United States has only 1% of the N95 respirator masks that would be needed if the number of Coronavirus infections reached  pandemic levels. N95 Respirator masks are a crucial part of the Personal Protective Equipment, known as PPE,  that healthcare workers need to protect themselves from the virus. 

 IB: So  put this into perspective okay, you have an anesthesiologist who went to school for 10 years to become an anesthesiologist. She's literally the most important person in her in the building at her hospital and she's wearing a crowdfunded, homemade, protective shield to intubate patients are dying of Covid-19. That is the epitome of the American Healthcare System

That was Isabelle Bartter, our guest for this week’s episode “Medics, Makers and Mutual Aid”.  Isabelle is a web developer living in Portland, Oregon. She has also worked as an Emergency Medical Technician and for UPS and other logistics companies, and she has been an activist for many years. Towards the end of our interview she’ll talk about some of her political experiences, including her time as a street medic in 2017 at the Standing Rock encampment that indigenous people organized to stop the Dakota Access oil pipeline. As the pandemic spread Isabelle  knew from working in both ambulances and delivery trucks, that the United States imports most of its PPE supply, and did not have a robust national stockpile nor the infrastructure to produce and deliver it quickly. Healthcare workers in major cities are reporting shortages of equipment and high infection rates among staff. They have organized protests to demand increased production of PPE for Hospitals who are rationing and re-using supplies.  Isabelle Barter is one of many volunteers who have worked tirelessly to address this crisis.  

After this short break, she’ll talk about why and how she got organized in her community and together began to use commercial 3D printers to make PPE for hundreds of frontline workers.

LR: As someone who stepped up to fill in that shortage, what is your understanding of it? 

IB: What we are seeing, I'm part of a group that is 3d printing PPE, and we have a group in the Pacific Northwest called the Pacific Northwest PPE makers alliance and we have an intake form for medical facilities. And we've been told by EMS, long term care facilities, facilities for assisted living, that it's impossible for them to get PPE right now. 

I have a Battalion chief in a local fire department telling me that they would have to spend the rest of their year's budget on PPE this month to be able to keep up with what they use. And so not only have the prices gone up, cases are up, the level of PPE needed has gone up. So you might have an infectious disease on an ambulance once every week or two maybe before and now you have to treat every call as if it’s an infectious disease call.

Doctors and nurses are on the same boat, they have to wear N95 respirators which are single use. They are meant to be used for 15-20 minutes. Drs and nurses are being given 2 N95 mask respirators, 4 surgical masks and one face shield which all of those are meant to be worn 15-20 mins, and that’s what they get for a week. 

For us, in the maker community, first stop, we are a stop gap. What should be happening is that coca cola should be taking all the plastic meant for their two liter bottles and they should be sending that to someone that makes foam and making millions and millions of single use face masks to be sent out to hospitals and medical centers. They should be making those by the millions per day but they are not. 

What we decided is we needed to come up with a reusable option. When you 3D print, you end up with a basic structure. Which can be sanitized in various ways and then re-used. 

LR: How did you personally put two and two together like, oh my god, this is all unfolding in this way and I have a 3D printer right here? 

IB: I just saw a file on the internet and I started printing it. I don’t know, I just kinda jumped into action. Then I found, through a friend of a friend, another person who has a CNC machine and he was making face shields. He was cutting the plastic shield part that goes over and we started a group called the Pacific North West Medics and Makers and yeah we just started making shields. 

Between the two of us alone and then some of the other people who were in the original Medics and Makers group, we've already supplied around 700 face shields. Mostly to local hospitals and to emergency medical services, some long term care facilities.

LR: So hospitals are accepting them? 

IB: There is a hospital in Central Oregon that was looking into using these 3D masks. When the medical director was asked what he thought it would take to get them approved and he laughed about it and said, “18 months!” 

That's how long it takes to get them approved by the FDA and get them manufactured in NIOSH tested materials and FDA approved facilities.  

When we first started, no hospitals were taking them, so we were providing them for nursing homes, and long term care facilities. Now all of them want it. We are supposed to provide an order of 1000 of these on monday, from the larger group. In the larger group right now we have a hundred and nine 3D printers and something like 80 or so volunteers. 

LR: Where did you get the file for printing?

IB: There is a larger group on facebook that is called Open Source Covid-19 Medical Supplies and that group has spawned smaller groups. So the group I’m a part of was Pacific North West Open Source Medical Supplies. 

We would share information on that forum on that facebook group and people would put it through different various groups of tests and then share the results and it was a mad dash of peer review essentially. Through that, a number of files that had been approved by medical centers in certain areas, or made by more established 3D printing firms bubbled up to the top. 

There’s a design by PRUSA, a 3D printed manufacturer,  which worked with the ministry of health of Czech republic where they are located. They rapidly went through three or four versions of a 3D face mask and now they are making a 1000 of them a day. Just that company is making 1000 a day. Most people are using that Prusa design.

But that Prusa design can take around 2 hours to print and so there's another design that was made by a Swedish engineer which is basically a hole punch design and it's much thinner, much faster print. Those print, usually, in about half an hour to 45 minutes. That's what I started printing. It's kind of a quantity quality thing. Those are lower quality, higher quantity. I can print probably 70-80 a day alone. 

LR: And they're meant to be multi-use? 

IB: Yeah. They are still multi-use. They are as durable as a pair of glasses essentially. So they are not indestructible like some of the other models which take a lot longer to print but they work and they're approved by the Swedish Ministry of Health. 

It’s very DIY, so when's design might be approved by one Hospital in Florida and then you bring that design to a hospital in Maryland and they're like “absolutely not, we would never” and then a week later the hospital Maryland is like  “okay you know that thing you brought us a week ago, we want 500 of them tomorrow.” 

LR: Who are the people who are involved in this operation, what do they do for work? Is there overlap for them in this? 

IB: Yeah definitely, there’s overlap.  I would say three-quarters of us are tech workers. Sohere’s several of us who are medical workers. most of us are software developers, engineers of one sort or another.

LR: I'm really curious what your roommates think of all of this. I remember seeing a picture of your layout and it definitely looks like a factory room to an extent. Has the actual laying out and printing of all of this been sustainable for you in the house?

IB: Here's a working class story from COVID-19. I have two roommates. And we work eight hour shifts to keep the 3D printers running 24/7. One of us stays up all night long with the printers,  pulling off print jobs when they finish, starting new ones, handling any problems that occur. Then another one of us takes over and he works a regular day job while babysitting the printers and then I take over and yeah we are essentially factory. 

The thing is we all know how to do that because we are working class people so there's no confusion about what happens next. Right you figure out a system. make it reproducible, make it work, quality control, we all know how to do these things. 

Lupita Romero: You are listening to Working Class Heroes on WBAI 99.5 FM

We are talking to Isabelle Bartter, a tech worker who has been making and distributing Personal Protective Equipment to Hospitals to help address a massive shortage of supplies in the country. Let’s get back to it. 

LR: How long do you think you'll be printing for? 

IB: We had a group meeting today, of the folks of us who are administrating things, and we said the same thing that we have said in all of our meetings: We hope that we stop tomorrow. 

We’ve been waiting for industry now for three weeks and they have not stepped up. We’ve heard rumors that NIKE is gonna make aerosol boxes, which are kind of a plexiglass boxes that you put over a patient with COVID 19 when you need to intubate them. They have a place for your hands with gloves to go into and you intubate the patient through a plexiglass screen. That way you don’t need as invasive, full PPE, you just put a N95 respirator and you can intubate a patient because you are never coming in contact with them. NIKE was supposed to make those. I haven’t seen them. INTEL, HP, and what I was saying before about CoCa-Cola, they were meant to do this already. They haven’t.

All of these companies, we keep hearing rumors from people inside of the companies where these companies are saying how much of this PPE they could produce. But when it comes to it showing up at the Hospitals, I haven’t seen any of it. 

What we are seeing is small businesses which are losing sometimes 50% of their business, they are stepping up and they are not just stepping up and selling equipment to Hospitals. they are stepping up and paying it out of their own pocket and they are donating it PP, that they are retooling their operation to make. 

We have a number of people and small, medium sized businesses ,who are manufacturing businesses, who have re-tooled. They are making hand sewn masks, making sheets that goes around our 3D printed frames. 

We are seeing a lot of people step up, Independent Producers or regular Joe Working Class People  and we've seen basically none of these corporations step up.

LR: Are you fronting this out of your own pocket?

IB: My house, we are fronting it all out of our own pocket. There is a GoFund me and people should feel free to donate. We’ve probably put one thousand dollars into all of this, buying equipment and buying the materials and stuff. It’s all out of our pocket because at the end of the day if I get sick and i go to my local hospital, I would rather see them wearing a 3D printed mask than wearing nothing at all. 

It’s not the best manufacturing, its incredibly slow. One of the masks takes 3-6hrs, one of the face shields takes, 2 hours. It’s better than nothing. 

I want nothing more than to hear that an injection molder is gonna make 250 silicone face masks a day so we don’t have to but I just, I haven’t. It’s not happening. It’s all just independent producers who are now coming together in collectives and having intake forms and literally driving PPE to the hospitals and dropping it off. 

LR: That is truly the epitome of neoliberal US. We are GoFunding this entire operation. 

IB: Yeah I just want to put this in perspective. Anesthesiologists are on the frontlines of COVID-19. Not a lot of people, its not common sense that this might be the case. They are absolute experts in ventilation. They are on the frontlines. An anesthesiologist in a local hospital a major Hospital reached out to us and asked us for face masks so now put this into perspective okay, you have an anesthesiologist who went to school for 10 years to become an anesthesiologist. 

She's literally the most important person in the building at her hospital and she's wearing a crowdfunded, homemade, protective shield to intubate patients dying of Covid-19. That is the epitome of the American Healthcare System.

LR: I've known you to be a street medic. I know that you are down and Standing Rock helping out as well as the street medic and that you're largely driven by the politics of mutual Aid can you just talk to me a little bit about that what Mutual Aid means for you and how what your trajectory responding to these different crisis has sort of taught you? 

IB: I was an EMT for 3 years and I’ve taken my  medical experience working in an ambulance for 3 years to working in the movement and being a street medic. I worked with medics and healers at Standing rock, im a street medic here in portland as well now. 

 I see a very strong connection to the mutual aid groups that are popping up all over the country like we have in portland, like you have in New York, and Standing Rock. I mean when I went to standing rock we had universal healthcare, there was a hospital, a medical center, 20 kitchens, a place to sleep if you got snowed out. 

We had a unified goal, and that was to stop the pipeline, but that takes a lot of support, it takes medics, it takes cooks, builders. I’ve seen glimpses of what society can look like if it was based around human need and this another glimpse of that. Covid-19 and the mutual aid groups that have popped up, even the way our federal government is responding, resisting it tooth and nails, but there's been talk in the US senate about universal healthcare as an emergency measure to stop Covid-19 and I’m like yeah duh! 

I think that we are going to come out of this with a radically different society. I think for the better and hopefully a society that understands that a society based on profit is incapable of handling a catastrophe like this. 

We absolutely need Medicare for All, we absolutely need reusable equipment, and to get rid of the economy that we have, both in the way we handle logistics and the way we handle funding and supplying our hospitals.

 I mean it's a heroic effort but it's one that should have never existed. It's like a volunteer fire department putting out an arson case. 

I mean this is arson. This is medical arson. 

I interviewed Isabelle Bartter, on April 1st as the two groups that she is a part of, the Pacific Northwest Medics and Makers and Medic Force were gearing up to fulfill their largest orders of PPE yet. Almost a month since then, public officials have announced that the National Stockpile of PPE is almost depleted.  Trump has called on companies to shift towards PPE production.  However he has resisted calls to enact and enforce the Defense Production Act, which would give the federal government authority to mandate and distribute mass produced PPE from big Corporations. 

To this day, only two companies, General Motors and Phillips have been ordered under the DPA, to start PPE production. In the meantime, mutual aid groups continue to fundraise, organize and keep their printers running to protect as many frontline workers as possible. 

I’m lupita romero, your correspondent. Thank you for listening.