The coronavirus has placed demands on the medical supply system in a whole new way. If federal stockpiles do not move down to the state level soon, it could become extremely difficult to allocate supplies to areas that desperately need them. The public is making it harder for medical personnel to locate certain supplies. Consumers are purchasing personal protective equipment, N95 respirators, and testing kits for home use while hospitals are going without. They are even being asked to donate N95 respirators from their garage or attics. Some hospitals and medical centers are so strapped for medical gear that they are asking for homemade masks.
According to Derrick Williams, Executive Director of Logistics at Indiana University Health, stated that his team started taking action as soon as they saw China’s coronavirus rates increasing back in the middle of January. Williams stated that his team views the coronavirus as they do Ebola, and they made the choice to designate their team to allocation services. His team set up Incident Command Systems at their 17 hospitals to distribute critical supplies. His goal was to prevent hospital workers from pulling wanted supplies and be able to request items that were outside of their normal usage, as long as they were on the allocation list. Items that become more in demand as supplies decreased were added to the list. Items that are commonly on the list include respirators, face shields, isolation gowns, and gloves.
Williams’ team controls all of these supplies manually. He stated that although the items are ramping up in China (where they obtain most of their supplies), nothing seems to be flowing out at this time. IU Health has also canceled non-essential surgeries to keep their supplies intact and reserve them for the COVID-19 pandemic. Like many other healthcare systems, IU added telehealth options to their services. Patients can elect to video chat with a healthcare provider to reduce the number of patients coming into medical offices and exposing others. Lastly, IU is only allowing healthcare workers one N95 mask per shift. Williams stated that his workers are stocked for now, but he indicated that this might change as the pandemic worsens and the need for alternative gear rises.
Getting N95 Masks To Healthcare Workers
One of the biggest challenges healthcare centers face is obtaining proper amounts of N95 masks for workers. IU Health normally keeps six weeks of supplies on hand. During flu season, they stock up to eight weeks. However, the timing of COVID-19 could not have been worse as many healthcare centers struggle to keep enough supplies on hand during the cold and flu season anyway. According to IU Health, their staff uses 14,000 N95 masks per month. The problem is that many distributors rely on China to supply their masks, and the country has been keeping them for domestic use. Williams stated that China is not sending out any masks, and it’s hurting the supply system here in the United States. IU Health estimated that they will receive more supplies in May or June, but the stock might not be enough to support them, even if they send lower amounts than usual. As a result, the 17 hospitals associated with IU Health will suffer. Williams stated that he has been told they will receive anywhere from 45% to 90% of their normal N95 mask order, based on projected models. If the number of patients surges to 30%, then IU Health could run out of masks when they need them the most.
Because of this, IU Health is seeking alternative solutions. This includes the N99 mask, which is typically used in construction and is more expensive than the N95. Luckily, the FDA has loosened its restrictions on what type of masks can be worn by medical professionals. They are now allowing industrial respirators in healthcare settings, as long as the N95 is unavailable. IU and other healthcare centers are asking for N95 donations and calls are pouring in from the community. IU received a donation of 30,000 masks. Healthcare units are also getting masks from the state’s supply, but so far, they have not received help from the federal government. Researchers believe this will eventually trickle down through the state.
IU Health is working with Indiana’s Chinese communities and groups to help procure masks directly from China. However, the masks need to be FDA certified, and this can slow down the process. Typically, IU pays $0.50 per mask. Currently, local vendors are selling them for up to $8 per mask. Williams stated that the price gouging has been outrageous. He stated that his healthcare team needs masks, but can’t afford to pay these outrageous amounts because they need hundreds of thousands of them. Vendors are also raising the price of other essential items, such as face shields and gowns. Williams stated that they get hundreds of emails per day indicating that vendors have these items in stock, but the prices are more than affordable.
Stocking Supplies At The State Level
Hospitals and other medical centers are trying to get much needed supplies as they can. However, according to Ruthanne Sudderth, senior vice president of communications and public affairs for Michigan Health and Hospital Association (MHA), a lot of these supplies are being pushed toward national stockpiles. This means that hospitals don’t always have access to them. Before receiving stockpile supplies, hospitals and health centers have to report their needs to the state and then the state dispatches them. This strategy does not fare well during a pandemic as supplies are needed immediately and there is no time to go through the state.
Sudderth stated that the lack of coordination for pandemic supplies is affecting the state's ability to get the supplies that are needed. Therefore, they are pushing back on the federal government to speed up the process. States are not seeing as much support as they would like. For example, Michigan hospitals have a long list of orders on back order. This includes gowns, gloves, and respirators. Sudderth stated they are doing what they can to increase supplies, but it’s not happening fast enough. As a result, the MHA has asked private manufacturers to start making supplies for now. Hospitals also struggle to get the testing kits they need. Williams stated that the state won’t cover half of what they need.
Aside from personal protection supplies, Sudderth stated that the MHA also needs ventilators and testing kits. She indicated that hospital staff is having to cub swabs in half to prolong their supply. They are also using FDA-approved alternative supplies for testing. The FDA is easing up on modification enforcements for ventilators. They are also allowing hospitals to use them in different settings. However, many healthcare systems still don’t have the number of ventilators they need and are looking into used equipment to fill the gap.