Healthcare Hygiene magazine April 2020 | Page 28

COVID-19’s Impact on Healthcare: Disruption of the Supply Chain and the PPE Shortage By Kelly M. Pyrek D espite personal protective equipment (PPE) availability being so critical in normal utilization and in outbreak scenarios, about 80 percent of PPE comes from Asia, where many nations have stopped exports due to the COVID-19 pandemic. Government officials and health authorities are working with distributors to prevent hoarding of gowns, gloves, face shields and face masks, and are encouraging healthcare systems and institutions to initiate conservation protocols to stretch PPE supplies. “Supply chain organizations, no matter how prepared, experienced significant disruptions from the massive and growing impact of COVID-19,” acknowledges Li Ern Chen, MD, a physician advisor on the board of the Association for Healthcare Resource & Materials Management (AHRMM). “They are currently focused on procuring and distributing PPE across their organizations. This challenge is increasing daily as supply chains fight to keep up with the needs of the clinical world. We are also seeing price-gouging, which coupled with a global shortage of necessary supplies, has made value analysis obsolete in dealing with this virus. Meanwhile, as elective surgeries are being delayed to allow hospitals to focus resources on the COVID-19 outbreak in their communities, orders for those supplies will plummet.” In mid-March, Premier Inc. released survey results finding that 86 percent of U.S. hospitals and healthcare systems are concerned about their supply of face masks and other articles of PPE as the global spread of COVID-19 strains the supply chain. According to Premier’s purchasing data, U.S. hospitals and healthcare systems typically buy 22 million N95 face masks a year. However, during the months of January and February 2020, demand for N95s surged, up 400 percent and 585 percent, respectively, largely fueled by a heavy flu season and forward buying in anticipation of a coronavirus outbreak in the United States. The levels of demand suggest a minimum consumption rate of 56 million masks in 2020, nearly a three-fold increase in demand when compared to a typical year. According to data collected by Premier from distributors, most healthcare facilities currently receive just 44 percent of the N95s and 82 percent of the surgical masks they order. Domestic and near-shore suppliers of PPE have increased production and are on track to produce an estimated 60 million masks this year. However, reaching that production level will take between 30 days and 60 days. Because of the domestic backorders and the sharp reduction of imported goods, 36 percent of respondents to the Premier survey are preparing for broad-scale PPE shortages, and 54 percent have initiated PPE conservation protocols to stretch the supplies on hand. In addition, 46 percent of 28 respondents say they are worried about how long current supplies will last. “Sitting at the center of healthcare, helping manage more than $61 billion in healthcare spend, Premier serves as an early warning system for the supply chain,” said Michael J. Alkire, president of Premier, Inc., in a statement. “We have provided these survey results to the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) to help them better understand the current situation and prepare our nation’s response to coronavirus. We also continue to provide daily updates to our members, as well as assistance We encourage in obtaining necessary supplies on an all hospitals and as-needed basis. Because this situation is rapidly evolving, we encourage healthcare systems to all hospitals and healthcare systems initiate conservation to initiate conservation protocols to protocols to protect protect stock on hand and refrain from stock on hand and panic-buying that can further strain the supply chain.” refrain from panic- About 80 percent of all PPE man- buying that can ufactured globally comes from Asia, where nations such as China, Taiwan, further strain the Thailand, India and South Korea have all supply chain.” stopped exporting products, a situation — Michael J. Alkire expected to continue through April, if not longer. While masks are expected to be in short supply for some time, Premier’s S2S Global direct sourcing company is ramping up inventory on hand for disposable protective apparel such as isolation gowns and gloves in an- ticipation of increased member demand. Many PPE “Many PPE supplies are heavily back- ordered and global shortages exist for supplies are heavily specific products such as N95 masks,” backordered and global said David A. Hargraves, Premier’s senior vice president of supply chain services in shortages exist for a statement. “So far, our members have specific products such as been able to work with manufacturers N95 masks.” and distributors to mitigate many issues. — David A. Hargraves But supply is unquestionably strained and health systems are going to extraordinary lengths to provide essential healthcare for their communities. Our data shows Premier members have at least two weeks of supply on hand, but that’s only if we assume current utilization rates. That number will quickly balloon if we have a domestic outbreak of coronavirus, as the Department april 2020 • www.healthcarehygienemagazine.com