The truest test to date of healthcare PPE procurement infrastructure worldwide?

The COVID-19 Pandemic has been the truest test to date of healthcare infrastructure worldwide. Simultaneous outbreaks have strained supply lines between nations as each struggles to contain their infections. Those reliant on the import of healthcare supplies have suffered dramatically from difficulties in ramping up production to meet the sudden extremes in demand, especially apparent in the affluent United States.

Despite several months of opportunity to improve PPE availability, and a lull in cases after a nationwide shutdown, shortages continue to plague healthcare facilities. The US government must increase its involvement in facilitating this process of acquisition and distribution; else, the hoops healthcare managers have to jump through to protect their workers will continue to be a deadly obstacle to the nation’s frontline.

The hoops healthcare managers have to jump through to protect their workers will continue to be a deadly obstacle to the nation’s frontlines.

As of April 2020, The United States was only able to domestically manufacture about 17% of the PPE needed throughout the country per month. The result has been independent businesses and healthcare providers competing with local and state governments to access PPE from the decentralized global market. This has led to a “wild-west” situation fraught with fraud and difficulties.

The federal government’s engagement during this PPE crisis

The federal government has stepped in as a regulator. Governments are investigating and prosecuting cases of illegal price gouging and even confiscating shipments of PPE. In one case covered in the New England Journal of Medicine, a hospital executive was able to purchase a consignment of KN95 masks from China disguised in food service trucks. The Department of Homeland Security threatened to confiscate the shipment but stood down after pleas from a state representative. While that shipment was saved, the federal government has successfully confiscated many other PPE shipments and attempted to distribute them evenly.

Unfortunately, distribution has been inefficient, and some hospitals have an excess PPE while others remain in dire need. The CDC has offered some guidance for healthcare providers in managing this imbalance of equipment in an effort to alleviate additional stress on already strained healthcare facilities. Additionally, there have been many instances of PPE in disaster-stockpiles being expired, potentially rendering them ineffective.

Unfortunately, there have been instances of PPE in disaster-stockpiles being expired, potentially rendering them ineffective.

Government had no actionable answer for PPE hoarding?

While the SARS-CoV-2 virus ravaged Chinese production of PPE, The United States had no fail-safe for resultant shortages of supplies needed to protect healthcare workers in the heat of a pandemic. China produced half of the world’s face mask supply before factories started closing. As supply plummeted, governments like the US had no answer for dramatic hoarding of PPE and price gouging.

Before the pandemic, no emphasis was put on domestic production or regulation of vital PPE supplies; independent healthcare systems and businesses operated on a buy-as-you-go basis. There have been some successes, however. Many factories and suppliers of other goods and services have converted to the production of some forms of PPE and are working with state and local governments to supply healthcare workers in need. Legislation has been put in place to reserve N95 mask purchases for health care purposes. Perhaps equally important, the efforts of every-day citizens in manufacturing and wearing cloth face masks.

As PPE medical supplies plummeted, governments like the U.S. had no actionable answer for the dramatic hoarding of PPE and price gouging.

Spotlight on fatal flaws in PPE supple chain

The COVID-19 pandemic and the now apparent threat of similar crises have highlighted some fatal flaws in US supply chains. The US has increasingly taken domestic production for granted and sacrificed American jobs and security for cheap imports and corporate profit. It is imperative the US government begins taking steps towards ensuring stability in the price and production of vital goods such as PPE and other disaster supplies.

In some areas hit the hardest with PPE shortages, healthcare workers have been forced to use garbage bags and extra clothing as protective coverings.

The establishment of a centralized “clearinghouse” is a crucial step pioneered by other services accustomed to disaster-level demand spikes. The lack of adequate protective gear for healthcare workers during this pandemic has been an ethical disaster. In some areas hit the hardest with PPE shortages, healthcare workers have been forced to use garbage bags and extra clothing as protective coverings. The establishment of stable domestic supply chains and the regulation of vital manufacturing will be critical in protecting the country from the ill-effects of future pandemics and national emergencies.