Some thoughts on the relevance of citizen scientists – hackers, makers, tech enthusiasts, DIYers – and open source hardware. Writing this commentary might have been a bit of a coping mechanism, but it nevertheless raises issues that are crucial for allowing and supporting volunteers in exploring (technological) means for fighting covid-19.

In this time of crisis, many people are willing and eager to help tackling the challenges related to covid-19. While medical staff fight the pandemic and key workers maintain indispensable infrastructures and services, also people outside of these sectors explore possibilities for contributing to emerging issues. An important domain of civic support emerges at the intersection of citizen science and ‘disaster technology’.

Disaster technology[1] refers to technological, often ad hoc developments and appropriations aimed at addressing crisis-related problems. In the context of covid-19, citizen scientists and civic collectives quickly started examining what technology would be needed and feasible for them to develop. Stories about their activities and contributions, like the example below, are more than just a silver-lining in otherwise largely devastating news: citizen scientists offer valuable local, technological support and expertise that require further attention. In this opinion piece, I therefore reflect on the relevance and implications of citizen science during the covid-19 pandemic.

Italy, in early March 2020: feared shortages of medical devices for lifesaving covid-19 treatment have become reality. A hospital in in Brescia was about to run out of valves needed for respirators, as the supply chain was exhausted.[2] When realising that the valve could not be obtained on time from suppliers, people turned to additive, digital manufacturing, i.e. 3D printing. In 3D printing, objects are produced by a machine that adds material layer-by-layer, instructed by digital designs. Considering the possibilities of 3D printing, journalist Nunzia Vallini and Massimo Temporelli, who is i.a. affiliated with the FabLab Milano, discussed whether the needed medical device could be manufactured that way. They reached out to local communities and companies.[3] In response, engineers Cristian Fracassi and Alessandro Romaioli swiftly started exploring how the valve could be printed.[4] They could not obtain the blueprints from the supplier, according to the company “due to medical manufacturing regulations”, and thus started reverse engineering, i.e. measuring and modelling, the device: with success, the hospital was able to start using the 3D printed valves for respirators that are crucial in covid-19 treatment.

Complimenti a Cristian Fracassi, @temporelli73 e tutte le persone che lo hanno aiutato nella impresa di stampare in 3d le valvole mancanti per i respiratori dell’Ospedale di Chiari a Brescia.
(qui l’articolo completo https://t.co/QYZu6x9X1T) #SolidarietaDigitale #iorestoacasa pic.twitter.com/dF3G2RJY8S

— Paola Pisano (@PaolaPisano_Min) March 15, 2020

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The story made headlines on various news platforms and was widely shared on social media,[5] thus inspiring and reinforcing civic tech communities and individuals in their efforts to contribute to the societal challenges raised by covid-19. In anticipation of possible, similar shortages groups such as maker- and hackspaces, fablabs, and other tech collectives are mobilising: they scrutinise and explore possibilities for countering shortages of medical devices by DYI-ing needed parts for the fight against covid-19. Because of social distancing measures, much of this mobilisation takes place online. For example, the crowdsourced Coronavirus Tech Handbook brings together projects and ideas for tackling the crisis, with volunteers discussing issues and solutions via social media groups or messaging services.

In particular, considering (looming) shortages of ventilators and masks, civic tech communities have started exploring means for producing these.[6] Moreover, they discuss technological solutions for sterilizing those medical devices that are normally considered disposable, but – due to scarcity – may now need to be re-used. Open source hardware is crucial in this context. While medical technology tends to be subject to patents, open source hardware moves beyond a proprietary approach, thus allowing for a free exchange of information on how to build technological objects. Relevant blueprints and instructions are circulated via platforms such as Thingiverse, Github and Instructables.[7] While my observations of these developments – which are clearly highly dynamic and in early stages – raise many questions, I will focus on two main points:

First, it is striking that, for instance in the United Kingdom but also elsewhere in Europe, larger manufacturers were urged to start producing medical devices such as ventilators.[8] However, small-scale civic initiatives tend to be overlooked. Policymakers should pay closer attention to the possibilities related to additive manufacturing and citizen science. While they may not be able to produce devices on a large scale, the flexibility and locality of technological expertise held by local communities and access to equipment can be immensely beneficial. As the already ongoing initiatives show, these communities tend to be self-starters, but still they could use support in what they do – for instance with regards to information on clinical utility and safety of use. Related to that, one should also keep in mind that DIY devices create additional moments of risk assessment for medical staff.

Second, shortages of medical devices needed for the fight against covid-19 make a compelling argument for the relevance of open source hardware. Patent law and the dominance of proprietary, medical technology were main reasons for why the Italian volunteers were not given any blueprints that could have accelerated their production of needed valves. Moreover, it put them in a precarious situation and legal grey zone. Medical device manufacturers have long been adamant in arguing that patents are needed for incentivising research and innovation, thus improving medical care. However, in recent years the counterpoint has been made that patents ultimately impede research as well as medical care.[9] The problems around medical devices during the covid-19 pandemic support the latter argument.

In cases when manufacturers realise that they will not be able to uphold the supply chain, patents and proprietary information stand in the way of alternative approaches for producing live-saving devices. Thus, the question emerges when manufacturers should (and may) allow for access to blueprints to ensure the production of such devices. Moreover, the described developments show that open source hardware approaches enable medical technology that is easily shareable and reproducible when its most needed.[10]

In this opinion piece, I have argued that citizen science and disaster technology make an important contribution to societal crisis responses. Policymakers should pay further attention to this domain and consider how citizen scientists may be supported. Moreover, the challenges in maintaining supply chains for proprietary medical devices needed in the fight against covid-19 show the importance and advantages of non-proprietary solutions: open source hardware approaches to medical devices can make a vital difference.

[1]             For an annotated bibliography see Manning, D. (2013). Disaster technology. Elsevier.

[2]         Peters, J. (2020, March 17). Volunteers produce 3D-printed valves for life-saving coronavirus treatments. The Verge. Retrieved from https://www.theverge.com/2020/3/17/21184308/coronavirus-italy-medical-3d-print-valves-treatments.

[3]         Sher, D. (2020, March 14). Italian hospital saves Covid-19 patients lives by 3D printing valves for reanimation devices. 3D Printing Media. Retrieved from: https://www.3dprintingmedia.network/covid-19-3d-printed-valve-for-reanimation-device.

[4]             See Fracassi, C. (2020). Facebook post ‘Diamo a Cesare quel che è di Cesare’. Facebook. Retrieved from https://www.facebook.com/Ing.Cristian.Fracassi/posts/10222339428782713.

[5]             This case is also interesting in terms of difficulties for assessing (mis)information in times of crisis. At the time of writing this article, it was still contested whether the company producing the valves was threatening to sue the volunteers 3D printing the valves on grounds of patent infringement.

[6]         Bender, M. (2020, March 17). People Are Trying to Make DIY Ventilators to Meet Coronavirus Demand. Vice. Retrieved from: https://www.vice.com/en_uk/article/5dm4mb/people-are-trying-to-make-diy-ventilators-to-meet-coronavirus-demand.

[7]         See e.g. Face Shield (2020). Retrieved from https://github.com/GliaX/faceshield; or panvent (2020). Retrieved from: https://www.instructables.com/id/The-Pandemic-Ventilator.

[8]         Otte, J. (2020, March 15). Coronavirus: UK manufacturers urged to consider switching to making ventilators. The Guardian. Retrieved from https://www.theguardian.com/politics/2020/mar/15/coronavirus-uk-manufacturers-urged-to-consider-switching-to-making-ventilators.

[9]         Gold, R. et al. (2010, January 5). Are Patents Impeding Medical Care and Innovation? Plos Medicine. Retrieved from https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000208.

[10]        This is also reflected in the recently published HardwareX call for papers “Special Issue on Open-Source COVID19 Medical Hardware” (see https://www.journals.elsevier.com/hardwarex/call-for-papers/special-issue-on-open-source-covid19-medical-hardware).