Open-source hardware to face COVID-19 pandemic: the need to do more and better

Purpose: The usage of open-source hardware (OSH) designs has been put forward as a means to mitigate the shortage of core medical equipment, such as ventilators and of personal protection equipment (PPE) in medical facilities worldwide, resulting from the ever increasing number of individuals affect by COVID-19. This is due to the model allowing for the lowering of costs and widespread distribution of manufacturing. On the other hand, low adherence to its best practices and insufficient development may jeopardize OSH as a viable aid against the pandemic. In this work, we sought to clarify to what extent publicly available designs of ventilator and PPE are developed and abide by OSH standards as measure of the true openness of the solutions. Methods: We searched the Internet and the literature to compile a comprehensive list of ventilators and PPE, while assessing available documentation in order to objectively evaluate key development landmarks (e.g., testing and governmental clearance) and indicators of adherence by OSH standards, as described by the Open Source Hardware Association. Results: Only a few peer-reviewed articles have been found, while a good number of Internet entries of open ventilator and PPE designs were found. Available documentation varied a lot in quantity and quality. Overall, adherence to OSH best practices and level of development were only partially fulfilled. Conclusions: Although this suboptimal performance regarding openness of designs may limit the benefits of the model, data suggests that present open-source efforts are highly beneficial and that they will be able to completely fulfill their mission given more and better OSH is carried out. © 2021, Sociedade Brasileira de Engenharia Biomedica.