[Question] Could you save lives in your community by buying oxygen concentrators from Alibaba?

[abergal]

Alibaba (and Amazon) sell lots of “portable oxygen concentrators” in bulk for $200 - $300 a piece, e.g this one. These seem to differ from medical-grade oxygen concentrators (which you need a prescription to buy) in that they deliver less oxygen at less purity, i.e. medical-grade oxygen concentrators can provide >5L/​min of oxygen at > 85% purity, whereas one of these goes from 1L/​min at 92% to 5L/​min at 30%.

Here’s a case for why buying one or more could be life-saving, which I would love LessWrong’s opinion on. I think any of these points could be quite wrong.

• Some sources I’ve consulted suggest that something like ~7% of infected patients must go to the hospital, are put on low-flow (<5L/​min) ventilation, and then recover.

  • The source above suggests that this could be a life-or-death difference.

  • Seems plausible that one Alibaba oxygen concentrator would be enough for some patients.

  • In a pinch, seems like you could put several of these together with some tubing to make a 5L /​ min concentrator at high purity.

• Ventilators are much more limiting than oxygen, but if hospitals become absurdly overwhelmed, it seems plausible that even oxygen access will be limiting.

• These are produced in China, which has (for now) enough health-care capacity to deal with its patients, so you may not be taking away medical supplies from people who use them otherwise. I worry that they will be used by more legitimate institutions in the future, but maybe they can just be donated to those institutions if that seems to be the case. Alibaba also lists these as “Hot New March 2020” products, suggesting they might be increasing supply to meet demand.

Even if this is a good idea, I’m not sure if it’s cost-effective over other life-saving interventions, but it seems plausible that you could convince someone who wouldn’t otherwise give money to buy them (e.g., they could buy one if they were particularly concerned for a family member and then donate it as necessary).

[Thomas Kwa]

Seems plausible that one Alibaba oxygen concentrator would be enough for some patients.

Agree that this is plausible; 2L/​min at 70% can raise a patient’s FiO2 from 21% to ~26%, more if used with a reservoir cannula.

However, in much of the USA, it seems like ventilators and healthcare workers will be limited, but hospital O2 supply will be sufficient—from what I’ve read, Italy is short of ventilators, personnel, and protective equipment but not O2. The advantage of O2 concentrators would mainly be to relieve overcrowding by treating moderate cases outside of hospitals, which doesn’t seem sufficiently impactful, especially if the concentrators aren’t in constant use. Maybe e.g. the UK (with fewer hospital beds per capita) or a developing country would be a better candidate.

Edit: I think hospital surge tents use oxygen tanks: see here for an example. I don’t know how they’ll be supplied, but increases in liquid oxygen supply or donations of used home O2 concentrators could each probably meet demand alone. Also, US Society for Critical Care Medicine is worried about ventilators, personnel, and hospital beds but not O2.

[Gunnar_Zarncke]

Actually it looks more like 400$ - including shipping and taxes. Plus the risk that it will get there at all or not in time.

[Davidmanheim]

Do you have an MD or RN (or at least and EMT) that can monitor people’s conditions while getting oxygen? And are you planning on keeping the person properly isolated?

[jimrandomh]

This isn’t a question that can really be answered, because access to resources like RNs and places to isolate people is very local but the top-level post is about the effectiveness of oxygen concentrators in general.

That said, the Bay Area rationality community, at least, does have these things.

[Davidmanheim]

″ access to resources like RNs and places to isolate people is very local ”

...so it seems like a useful question to answer when individuals are evaluating whether this makes sense. So I pointed out the issue. I didn’t say this is a bad idea.

[Gunnar_Zarncke]

Depends on the level of emergency. I have a mild case of asthma and if I catch it at a time the medical system is overwhelmed I think I would choose this. Measuring blood oxygen levels is relatively easy: I already got a 20€ blood oxymeter. If it goes up it is enough oxygen?

[Davidmanheim]

You can overdose on O2 as well, so you need to be careful. And if you are sick enough to need oxygen, especially if you need it while sleeping or are otherwise too sick to reliably monitor yourself, you need someone else there monitoring you.

[jimmy]

Unless you’re underwater or in a hyperbaric chamber, oxygen toxicity isn’t really a big concern, and a cheap oxygen concentrator like the one described above can’t get you close to where problems start. Even if you had a better oxygen concentrator, it doesn’t take any fancy training to add oxygen until 92% saturation or whatever.

[Davidmanheim]

Yes, a unit that can only do 5L/​minute at 30% probably isn’t dangerous—but I’d still ask a doctor what treatment protocol to use and how to monitor.

[Gunnar_Zarncke]

Agree. This is definitely not intended as a replacement for proper care.

[Dagon]

Is “counterfactual” the right word for this? I might recommend “potential” or “future” (or just leave out the modifier: “can we save lives”)? Also, this seems like something that an individual can unilaterally do, so “can I save lives” or “can you save lives” might be a clearer question.

That reformulation would make the next steps on answering clear: figure out the intermediate things that would lead to life-saving, an if they exist and have fairly low risk, then your answer is probably yes.

How would you know when to use it, on whom? How would you know when to stop using it and get to a real ICU? How would you know what maintenance/​cleaning is required?

[abergal]

I rewrote the question—I think I meant ‘counterfactual’ in that this isn’t a super promising idea if in fact we are just taking medical supplies from one group of people and transferring them to another.

I don’t know anything about maintenance/​cleaning, was thinking it would be in particular useful if we straight up run out of ICU space—i.e., there is no alternative to go to an ICU. (Maybe this is a super unlikely class of scenarios?)