Amazon CEO Jeff Bezos’s 2013 announcement that the company would use drones for package delivery surprised many people, who questioned the viability of such an endeavor. In fact, drones in one form or another, including hot air balloons and kites (commonly referred to as unmanned aerial vehicles [UAVs]), have been used since the 1800s, primarily in various military operations but also in the assessment of damage caused by disasters. For example, photographer George Lawrence used kites to fly a 49-lb camera over San Francisco to record the devastation of the 1906 earthquake.
Drones delivered care packages in the aftermath of the 2010 Haitian earthquake and were deployed in various disasters, such as the category 5 cyclone that struck the islands of Vanuatu, the Nepal earthquake, and Superstorm Sandy. None of these flights were in a medical delivery capacity.
In 2014, a medical drone delivery of medication was undertaken by Deutsche PostDHL AG from Norddeich, Germany to Juist, a remote, car-free island in the North Sea. The drone flew for approximately 12 km off the German coast and landed on the island. The same year Doctors Without Borders used drones to transport dummy tuberculosis (TB) test samples from a remote village to the city of Kerema, Papua New Guinea. The country has a significant TB burden and an increasing burden of multidrug-resistant TB, as well as inaccessible roads and generally poor weather conditions that moor transport boats 5 months of the year.
Medical drone delivery is more problematic in the United States. Because American airspace is so complex and busy, the Federal Aviation Administration (FAA) is taking what it calls “an incremental approach” to safely integrate drones. The FAA continues to demand that drones be controlled by a human pilot and stay within that pilot’s sight line; these regulations forestall implementation of a large-scale drone delivery fleet. The FAA also has established a no-fly zone, which lies between 400 and 500 vertical feet, to ensure that drones remain distinct on radar from human-piloted aircraft.
Even with such limitations, the first government-approved medical drone delivery in the United States occurred on July 17, 2015. Flirtey, a private company, partnered with the National Aeronautics and Space Administration to fly a drone carrying medicine to a small pop-up clinic in rural Virginia run by the Remote Area Medical program. It made three trips in 30 minutes and carried 10 lb of medicine.
Flirtey CEO Matthew Sweeny noted that the airport from which Flirtey flew its drone remained open to planes landing during the drone flight, and observers watched the runways and communicated at regular intervals with the control tower. “The reason that’s important is because it shows drones can operate safely around other aircrafts. I think now that we’ve shown this can be done safely and reliably, others will follow,” Sweeny said.
US-based Matternet has partnered with UNICEF to deliver HIV testing kits and decrease the time consumed testing infants living in rural areas of the African nation of Malawi using drones. Ten percent of Malawians have HIV, one of the highest rates in the world. UAVs would pick up sample batches from local healthcare facilities and deliver them to specialist laboratories. Only eight such laboratories exist in Malawi. At present, it can take almost 2 months to transport samples from a healthcare facility to a laboratory and for the results to be returned. UNICEF estimates that if the drone flights are cost-effective and prove more efficient than the diesel motorbikes used currently, the drones would be able to carry up to 250 tests at once.
This July, Zipline International, in partnership with the Rwandan government, will begin drone delivery of blood and drugs across that country. Hospitals can order blood or medicine by text message and have it delivered within 30 minutes. Each drone can carry an approximately 3-lb parachute-equipped cardboard box and can travel for more than 75 miles on a single battery charge. The drones navigate using GPS and Rwanda’s cellular network.
A patent awarded to Google on April 5 outlines a device that can deploy a drone based on a specific medical emergency carrying specific medical equipment. Users need only press a button to call a drone.
Although the applications are potentially endless, including the delivery of automated defibrillators and the introduction of microdrones that could replace invasive surgery by traveling to cancerous tumors and releasing chemotherapy only where required, the first real-world application of UAVs will likely be in disaster medicine. The logistics of transporting hemostatic supplies to, for example, people injured in mass shootings or an earthquake is more problematic than the supply itself. Dr Cornelius A. Thiels of the Mayo Clinic notes that, “"Blood is unique because it’s expensive and expires—platelets and thawed plasma last just 5 days—and the supply is very limited. In our region, the smallest critical access hospitals stock just two to six units of red cells and no fresh frozen plasma or platelets. In medium-sized hospitals, a single patient with massive bleeding can easily deplete the blood supply, and even larger hospitals can run low on certain blood types.”
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