Mechanical ventilators (MVs) played a critical role during the coronavirus disease 2019 (COVID-19) pandemic, providing respiratory support for critically ill patients and reducing mortality. However, the global scale of the pandemic led to significant ventilator shortages, necessitating various strategies to manage MV supply and optimize resource allocation. Real-time tracking systems in health command and control centers emerged as essential tools for monitoring and distributing ventilators efficiently. This study employed a mixed-method approach, incorporating the experience of the National Health Command Center (NHCC) in Saudi Arabia and a narrative review of strategies used to address MV shortages during the COVID-19 pandemic. Several solutions were implemented to meet the increased demand for ventilators, including optimizing high-flow nasal cannulas and using modified single ventilators. Ethical considerations in ventilator allocation highlight the need for a coordinated, multi-sectoral approach to prevent discrimination and maintain public trust. In Saudi Arabia, the NHCC faced substantial logistical challenges in providing respiratory support devices for intensive care units under unprecedented pressure. A successful response was achieved through a live tracking information system, which streamlined medical supply chain logistics and improved resource allocation. These efforts resulted in increased ventilator availability, cost savings, effective redistribution of resources, national self-sufficiency, and the ability to export ventilators during critical periods. A comprehensive, country-level strategy is essential for the effective stockpiling and management of MVs. A permanent, centralized ventilator management database would enhance real-time monitoring, optimize resource utilization, and improve preparedness for future public health emergencies.

Keywords: Mechanical Ventilator, pandemic, Emergency Health Services, delivery of health care, public health