Hot spots of pandemic activity were quickly running out of supplies

As the COVID-19 pandemic heated up in early 2020, it was quickly made apparent that PPE acquisition was going to be a problem – a big problem. Facilities that had previously used an established supplier for daily operations were suddenly needing a much larger reserve of PPE supplies. Fear was rampant, and facilities were anxious to get their hands on as much stock as they could manage. Meanwhile, “hot spots” of pandemic activity were quickly running out of supplies, putting lives at risk.

Fear was rampant, and facilities were anxious to get their hands on as much stock as they could manage.

On March 13, 2020, President Trump declared a nationwide emergency and invoked the Stafford Act. As part of that process, the national stockpile of PPE was made available for distribution. Unfortunately, that stockpile was not sufficient to meet current need.

Contingency plans were developed and begun:

  • Supplies pulled from non-medical businesses, such as construction, hair and nail salons, farming, and manufacturing.
  • Private companies ramped up production as much as possible
  • Import of supplies from non-affected countries
  • Increasing the federal micro-purchase threshold
  • Lowering the simplified acquisition threshold for Federal entities.

In the rush to acquire supplies by private entities, states, and the federal government, a lot of competition developed quickly. In a high-stakes game of competing federal governments around the world, individual states, large companies, and small clinics – the small businesses rarely stood a chance. Price gouging was rampant, shipping delayed, and counterfeit and inferior products flooded the market.

Confusion about HOW to purchase supplies, and from where, was everywhere.

In the rush to acquire supplies by private entities, states, and the federal government, a lot of competition developed quickly.

Federal Procurement

Many federal commodity goods are purchased each year by using the “reverse auction” process, where vendors are vetted and then given access to the Federal market. The government places an order, and then vendors compete by bidding to fill the order. PPE was NOT included in this process for fear of issues with product quality. Did these acquisition restrictions impede PPE procurement?

These reverse auctions are online and can be closed quickly – sometimes as soon as 24 hours. The process has been successfully used for other emergency supplies. It is also favorable for small businesses and vendors in multiple locations.

State and Private Entity Procurement

Each state, large healthcare organization, and tribal entity has a different process for purchasing supplies. By rule of thumb, the larger the organization, the more complex the purchasing process is – and therefore slower. FEMA provided coordination of distribution of federally procured supplies, and collecting data regarding testing, cases, and PPE delivered. The gap between PPE needed and that supplied by FEMA was large, and individuals were left to scramble for supplies, shopping the internet for sources.

The gap between PPE needed and that supplied by FEMA was large, and individuals were left to scramble for supplies, shopping the internet for sources.

Most organizations were not agile enough to adapt quickly to new processes for procurement. Purchasing quickly from a website that may be sold out within minutes or hours was not in the plan! Horror stories of very inferior products, products that never arrived, scams, and ridiculously inflated prices were common.

As the pandemic has worn on, suppliers have had a chance to increase production and some shortages have resolved. However, this semblance of balance in the market has taken months to attain, at the expense of a lot of preventable infections.

Proposed Solutions

In hindsight, the glaring lack of preparedness can lead to future improvements. Since the federal government already has a system in place that is replicable and proven, many believe that this is the option that makes the most sense for procurement. FEMA can then dispense supplies and deal with payments from states and organizations in due time, but without delaying the actual supplies in hand.

With the lack of a cohesive federal purchasing program, private organizations have worked to fill this need. HealthEquip is only one example of a private marketplace for vetting vendors, purchasing, distribution, and donor management. Where there is a need, the market will often fill it, which reinforces the need for a single national source for PPE acquisition.