Covid 19 and MacGyver

Now, we use the verb “to  MacGyver ”, to make or repair something, using whatever items are at hand.  Since the COVID-19 pandemic began, health workers globally have been concerned about inadequate supplies of personal protective equipment, ventilators and other essential items of medical care.

So many have created workarounds to fill the perceived gap between what they have and what they need.

Those of us who grew up in the 1980s remember the fictional crime-fighting hero Angus “Mac” MacGyver. He could seemingly create anything to get him out of a sticky situation using common household objects such as a magnifying glass and some duct tape.

Now, we use the verb “to MacGyver”, to make or repair something, using whatever items are at hand.

MacGyvering in health care was rife before the pandemic. But according to images of homemade gizmos on social media, COVID-19 has spurred health workers to make even more equipment using an array of small, common, interlocking devices at their disposal.

Curbing the ‘MacGyver bias’

But there are risks as well as potential benefits of this approach.

Last year, my colleagues and I wrote about the “MacGyver bias”. This cognitive bias means that people who create and use homemade devices are likely to have an emotional connection to their inventions.

It’s related to the better-known “IKEA effect” related to the extra connection we have with flatpack furniture we’ve put together ourselves.

With the MacGyver bias, clinician-inventors might not see the pitfalls and dangers in using their creations. They may downplay the risks and overestimate the benefits. Many of these inventions have also been created and introduced with little or no proof they work or are safe.

How could we find a balance?

If regulatory requirements stifle innovation, lives might be lost from a lack of potential new inventions.

Clearly a compromise is needed that doesn’t involve the full and lengthy regulatory process, yet still maintains a rigorous, independent assessment.

This could be a stopgap on the way to full approval, particularly in time-pressured situations such as a pandemic, when even imperfect solutions might be needed.

So what would this process look like?

We commonly use mock-ups of equipment or clinical spaces when educating health professionals. These simulation labs are now finding a new purpose, to test devices and processes before implementing them.

This means we can anticipate many problems before the new device comes close to a patient. By using a structured process, we can find solutions and test them objectively, away from the patient, without harm. This way, we can fail frequently, rapidly and safely to find the ideas (and devices) we might want to actually use.

The COVID-19 pandemic poses difficult questions about how we might deal with innovation in medicine. However, it also provides us with a catalyst to improve safety and implement change