To Answer Dire Shortages, This Healthcare Team Designed, 3D-Printed, and Tested Their Own COVID-19 Swabs in One Week

Last Wednesday, Todd Goldstein was working on other projects. Then physicians in the New York-based hospital system where he works, hard hit by a surge in COVID-19 cases, told him they were worried about running out of supplies.

Specifically, they needed more nasal test swabs. A nasopharyngeal swab for COVID-19 is no ordinary Q-tip. These specialty swabs cannot be made of cotton, nor have wood handles. They must be long and skinny to fit up behind the nose into the upper part of the throat.

Goldstein, director of 3D Design and Innovation at Northwell Health, a network of 23 hospitals and 800 outpatient facilities, thought, "Well, we can make that." He quickly organized a collaboration with Summer Decker and Jonathan Ford of the University of South Florida, and 3D-printing manufacturer Formlabs. In one week, the group designed, made, tested, and are now distributing 3D-printed COVID-19 test swabs.

Northwell's eight 3D printers are now printing about 2,000 swabs a day. Add in Massachusetts-based Formlab's factory of 250 3D printers, which the company has now dedicated to the effort, and Goldstein estimates they could ramp up to one million swabs per day if the need is great enough.

Photo: Northwell Health Todd Goldstein

"This has been the worst-case scenario for hospitals all across the world," says Goldstein. "We all want the same exact stuff and in huge quantities."

Before COVID-19, there wasn't a ton of demand for these swabs except for the occasional flu check, says Goldstein. Now, healthcare workers will swab millions of people within weeks, and the supply shortage has begun. In Iceland, for example, authorities say COVID-19 testing is now limited by a lack of test swabs. To make matters worse, one of the main specialty swab manufacturers, Copan Diagnostics, is based in Italy, the epicenter of an outbreak. The company has asked customers and distributors to ration orders, according to NPR.

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When Goldstein first heard of the swab shortage, he turned to Formlabs, which supplies Northwell's 3D printers, specifically to source the raw material for the job-a biocompatible resin typically used to make dental guides that is safe to use in noses and throats. As chance would have it, last November Formlabs acquired their Ohio-based supplier of that resin and therefore maintains a steady supply of the material, according to Jeff Boehm, a spokesperson for the company.

Formlabs also proposed a sterilization protocol that could be used to prepare the printed swabs for medical use. "We're not reinventing the wheel. We were able to use what we had in our toolbox to create these swabs," says Goldstein.

Photo: Formlabs

By Friday, Goldstein's Northwell team had designed six variations of swabs, as had their partners at the University of South Florida, Tampa. Together, the teams narrowed the options down to one design, shaped like a tiny wire bristle brush.

Unlike the Northwell team, whose research facility is closed due to the citywide outbreak, the Tampa-based team had an open wet lab to work in. Over the weekend, while Goldstein tested the swab's mechanical properties, the Tampa team performed the necessary benchwork, testing to make sure the swab worked correctly, picking up appropriate amounts of mucus, cells, and coronavirus.

The swabs worked, so on Tuesday and Wednesday this week, Goldstein printed more and dropped them off to clinics within the Northwell network, asking physicians to use the 3D printed swabs along with standard swabs on suspected COVID-19 patients and give him feedback.

Photo: Formlabs

On Friday, medical staff reported back that the swabs worked reliably, so on Saturday morning the team began printing full-blast, says Goldstein. Northwell has six automated Form 3D printers, able to operate 24/7 with minimal oversight, plus two stand alone machines that require frequent manual intervention. Under normal circumstances, the printers are used to make things like anatomical models, surgical guides, and the first amphibious prosthetic leg.

The swabs have FDA Class I exempt status, so they can be made and distributed to medical centers. "Our hospitals need these now," says Goldstein. "If we have enough swabs here and other hospitals around us don't have enough, we're happy to send some to them. We're all in the same boat. If we have extra resources, we're going to give them to you."

The team plans to release the design for anyone with a Formlabs printer to print, he adds. "Any single dental lab can start making these swabs tomorrow if they wanted to, and help out their local hospital."