Navigating Healthcare Supply Shortages During the COVID-19 Pandemic

Abstract

The powerful infectivity of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to over 1 million infections worldwide and forced more than half the world's population to live under stay-at-home orders.To respond to this deadly infection, healthcare workers desperately need personal protective equipment, medical supplies such as ventilators, and pharmaceuticals.However, virtually every country in the world is seeing severe shortages of these healthcare supplies at a time of maximal need.As cardiologists, we have the opportunity to see how we can change our clinical practices to respond to these healthcare supply shortages.To determine how we can approach these important issues, we first need to understand how healthcare supplies are delivered and how coronavirus disease 2019 (COVID-19) has disrupted this system.The provision of healthcare supplies occurs because of a robust international supply chain that provides timely delivery to healthcare systems around the world. 1 Supply chains consist of producers of raw materials, manufacturing factories, transportation systems, and distribution networks. 2Disruptions to these supply chain networks have occurred in the past, but they have been single deletions such as losing a source of raw material, an isolated factory closing, or turmoil in a single country. 2 Because the supply chains are international and matrixed, they are usually self-healing in response to these isolated incidents.Supply chains also work to optimize alignment between the volume of healthcare supplies delivered and the demand in healthcare facilities.Because of this supply chain optimization, most healthcare systems and even entire nations keep only a modest inventory of healthcare supplies in anticipation of future demand. 2oday, however, the COVID-19 pandemic has disrupted the healthcare supply chain worldwide.Shortages of raw materials are universal which have led to dramatic increases in prices.For example, the price of isopropyl alcohol used in hand sanitizers has gone up from ≈$1000 to $3160 per metric ton. 3 Infections in Lombardy, Italy, surrounded one of the key worldwide factories that produce nasopharyngeal swabs to test for the SARS-CoV-2 virus. 4The pandemic has disrupted transportation networks with the shutting down of international flights worldwide and restrictions in cross-border travel and shipping.Sixty-eight countries have limited the export of their personal protective equipment supplies to other countries further breaking down the distribution networks of the international supply chain. 5Since the pandemic has impacted virtually every country worldwide, there are no unaffected reservoirs of industrial activity to draw from.This supply chain disruption would have been normally challenging, but an explosion in the demand for healthcare supplies has made the situation much worse.Patients with COVID-19 requiring hospitalization must be placed in infectious isolation with extensive use of personal protective equipment.One estimate showed that a COVID-19 patient's 24-hour intensive care would require 36 pairs

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