As pressure grows to reopen economy, a scramble to make nasal swabs for coronavirus testing leads to 3D printers

Each day, New Jersey does between 7,000 and 9,000 Covid-19 tests at the state’s testing sites. Gov. Phil Murphy says that number must at least double before the state loosens lockdowns.

Some health experts say the U.S. may have to do millions of tests — as many as 20 million to 30 million — per day.

That will take many more nasal swabs — a simple, but critical tool that’s in short supply.

A group of hospitals and companies is turning to 3D printers to ramp up production. Researchers at University of South Florida Health, a Tampa-based medical school, and Northwell Health, New York’s largest health-care provider, teamed up to develop a 3D-printed swab that they can make at hospitals. They tested the design and produced the swabs with Formlabs, a 3D printing company that plans to make hundreds of thousands of them.

The swabs are used for the most common type of Covid-19 test. The stick, which has a bristled end, goes deep into a person’s nasal cavity and collects a sample that’s tested for the coronavirus. 

The thousands of additional swabs could help alleviate some of the supply chain struggles that have slowed efforts for widespread testing. State governors and health experts say increased testing will allow them to better track the coronavirus’ spread, so they can decide how and when to safely reopen businesses.

On Sunday, President Donald Trump said he would use the Defense Production Act to increase manufacturing of swabs to at least 20 million per month. He made the announcement the same day several governors spoke out about shortages of key supplies, including reagents and swabs.

Summer Decker, USF Health’s director of 3D clinical applications, said 3D-printed swabs give hospitals another option and helps to empower them. By making swabs on-site, hospitals don’t have to worry about when the next shipment will arrive. Instead, the hospital can play a greater role in speeding along the high-volume testing that’d give the public more confidence to go back out into the world.

“It’s such a critical component because there’s a lot of pressure for us to start reopening things and for life to get back to normal,” she said. “The only way we can do that is by figuring out how many people are sick.”

During the pandemic, Northwell Health has gotten about 25% of the swabs that it’s ordered for its hospitals in New York City, Long Island and Westchester, said Todd Goldstein, its director of 3D design and innovation. The health-care system has not run out of the swabs, but he said staying stocked has gotten more difficult as demand grows.

“You literally have the entire world trying to get these test swabs — all at the same time,” he said.

He said Northwell Health now makes 5,000 swabs per day for its hospitals with 3D printers. It plans to scale up to 7,500 or 8,000 per day.

At USF Health, some doctors use 3D printers to make models of hearts or organs to prepare for surgery or educate patients, Decker said. In mid-March, the medical school’s dean emailed and asked if the 3D printers could help address the nation’s swab shortage.

Decker and her team got to work in the lab. They enlisted the help of Northwell Health.

The researchers zeroed in on printers and materials already cleared by the Food and Drug Administration. They examined a typical swab to figure out how to make a similar one with resins, a liquid plastic that hardens. They asked infectious disease doctors to narrow down about a dozen designs — and even tested the swabs on themselves.

She said they compared the 3D-printed swab against the ones made in a typical factory: Was it comfortable enough for patients? Could it collect a large enough sample? Could it hold the virus for 24-hours or even days, if there’s a back-up of testing at a lab?

In the hard-hit New York City area, thousands of patients who came to Northwell Health’s hospitals for testing helped accelerate clinical trials. Within two days, Goldstein said it completed testing. It’s already submitted its findings to the New England Journal of Medicine, he said. 

Both hospitals now make thousands of the 3D printed swabs to have additional supply. Decker said USF Health now makes about 10,000 swabs per week for its teaching hospital, Tampa General Hospital, and the hospital’s affiliated clinics.

USF Health and Northwell Health worked with Formlabs, a company that makes its 3D printers and materials, to test the design and ramp up production.

The Boston area-based company has 550 employees. Its clients range from Fortune 500 companies and major hospitals to small dentist’s offices.

“They came to us and said ‘Can you help us with this?,'” said Max Lobovsky, the company’s CEO and cofounder of Formlabs. “‘Can you help us refine the design and get the most out of the printer?'”

Formlabs has started making the swabs at its resin plant in Ohio, which is about 25,000 square feet. It has 200 printers stacked floor to ceiling on racks. It has 25 employees, but he said the company plans to hire more.

He said it is making “tens of thousands” of swabs, but plans to increase to 100,000 per day. So far, he said it’s sold about 50,000 swabs to hospital systems and government agencies.

The past few weeks have been hectic and surreal as the company pivots to a product that’s become critical during the pandemic, he said. White House trade adviser, Peter Navarro, called Formlabs to ask about the production of the 3D-printed swabs.

In an interview with Fox News, Navarro spoke about Formlabs and said the company is an example of how ”the new economy is going to be flexible and innovative.”

Lobovsky said he hopes the swabs change how people think of 3D printing. He said they illuminate how the technology makes it possible to quickly manufacture on-site and on-demand, rather than needing to manufacture and ship goods thousands of miles away.

“It’s going to be a seminal moment for 3D printing well into the future,” he said

Still, Formlabs isn’t expecting to make a profit on the swabs, Lobovsky said. It hopes to break even. Right now, it plans to charge $2 for each swab, but would like to get that down to $1 over time, which is closer to the price of typical swabs.

Other tech and 3D printing companies plan to make similar swabs, too, including EnvisionTEC and HP. Lobovsky said several dozen Formlabs’ clients across the world are making the swabs as well, including many dental labs that have lost their core business.

For Brooklyn-based Voodoo Manufacturing, making swabs has kept the factory open and workers on the payroll, said Jonathan Schwartz, its co-founder and chief product officer.

The company, which has 19 employees, typically makes dental aligners and other 3D printed items. It now makes 50,000 swabs per week, and it plans to double that, he said.

“As soon as we started to see demand decline and started to realize how impactful the coronavirus was going to be on our business and our way of life, we started to think about how do we keep the company alive,” he said. “We were in adapt or die mode.”

In early March, Schwartz said clients began cancelling orders. New York ordered all nonessential businesses to close their doors.

 ”If we wanted to keep the lights on, we needed to find a way to be essential.”

One of Voodoo’s factories now makes protective face shields. The other factory makes swabs.