January 19, 2021

Editorial

By: Elizabeth Wood
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The rollout of COVID-19 vaccines starting in December 2020 was the one bright spot in an otherwise tragic year with a rapidly rising death toll currently over 385,000. Distribution of the 20 million doses promised by year end was thwarted by problems such as lack of coordination and lack of confidence in vaccine safety. Fortunately, healthcare workers are at the head of the line as vaccines become available. But the relentless spread of disease, slow pace of distribution, and reluctance of many people to get vaccinated suggest that COVID-19 isn’t going away anytime soon.

 

Ongoing supply chain challenges

Vaccine availability and distribution is the latest example of supply chain bottlenecks disrupting the healthcare industry over the past year.


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Data collected by the Bureau of Labor Statistics from July through September 2020 showed that 64% of healthcare businesses had experienced supply shortages. And a fall 2020 survey of infection preventionists revealed that many US healthcare facilities had implemented personal protective equipment (PPE) crisis standards of care.

The online survey, conducted by the Association for Infection Control and Epidemiology between October 22 and November 5, 2020, included responses from 1,083 infection preventionists. Of those, 73% cited implementation of PPE crisis standards of care for respirators, 68.7% for masks, and 75.8% for face shields or eye protection. As such, 75.9% said staff were allowed to reuse respirators either five times or as many times as possible before getting a new one, and 73.6% cited the same criteria for reuse of masks.

California, the current epicenter of the pandemic, passed laws in the fall of 2020 requiring public and private healthcare employers to ensure an adequate supply of PPE “to any employees who provide direct patient care, or who provide services that directly support patient care in a general acute-care hospital.” One of the laws states that general acute-care hospitals that fail to stockpile a 3-month supply of PPE by April 1 will face fines of $25,000.

It’s not clear how that requirement can be met because the global supply chain continues to be disrupted. Despite assurances from the US Health and Human Services department about availability of supplies from the Strategic National Stockpile, many healthcare facilities have not gotten what they need.

Results of an in-depth investigation by the Associated Press and FRONTLINE, reported in early October, shed light on actions taken throughout much of 2020 that contributed to the supply crisis and endangerment of healthcare workers. Such reporting helps to explain what has happened over the past year, and we can only hope that similar mistakes won’t be repeated in the future.

 

Innovative solutions

Lessons learned at some facilities may be helpful to leaders trying to meet both current and future supply needs.

Sentara Healthcare, a 12-hospital system serving Virginia and North Carolina, did not experience patient surges but did have trouble stockpiling supplies. After the Federal Emergency Management Agency reprioritized Sentara’s supply deliveries to other locations, Sentara partnered with some retired Navy Seals, who ferried supplies from China.

Sentara also used 3D printing to bolster its supply of ventilators, sterilized and reused existing PPE, and streamlined interactions with patients to reduce PPE usage. Leaders have set up a warehouse specifically for PPE stockpiles to ensure preparation for any future shortages.

For Winona Health, a 49-bed facility in Winona, Minnesota, a proactive approach to planning and communication was essential to avoid a surge. Leaders there did regular testing at nursing homes and other congregate living facilities, which helped them anticipate potential influxes of patients. They also set up weekly calls to exchange information with these facilities, and they developed educational videos to enhance awareness of the importance of public health measures.

Redeployments and a financial Rescue Program enabled University Medical Center Health System to avoid layoffs and furloughs of staff in 2020. The system has 4,600 employees serving patients at 62 locations in Texas and New Mexico.

A three-part plan was implemented to cross-train both clinical and non-clinical staff. Those who were not redeployed received 75% of their pay—an expense that came to just over $29,000. Leaders there were committed to retaining staff rather than having to recruit and train new staff, which is ultimately more costly.

A more in-depth look at ways to better anticipate demand and develop supply chain resiliency is offered in this issue (“Supply chain strategies shift to meet pandemic-induced demands,” cover story).

It will take resiliency of all kinds—physical, emotional, and professional—to endure still more months of hardship until the coronavirus can be contained. But hang in there. Vaccines are en route, and the US Department of Health and Human Services has allocated more than $3 billion to help states expand vaccine distribution. The more people who are vaccinated, the better the chances for regaining some semblance of normalcy. ✥

 

References

Associated Press. US medical supply chains failed, and COVID deaths followed. October 6, 2020. https://apnews.com/article/virus-outbreak-pandemics-ap-top-news-global-trade-fresno-4354f8e8026cf8135b74fa19f0d0f048.

 

Blackman M. Guide your hospital successfully through the COVID-19 crisis: 4 strategies. HealthLeaders Media. December 10, 2020. https://www.healthleadersmedia.com/welcome-ad?toURL=/strategy/guide-your-hospital-successfully-through-covid-19-crisis-4-strategies.

 

https://apic.org/news/national-survey-shows-healthcare-facilities-implementing-ppe-crisis-standards-of-care/.

 

https://www.hhs.gov/about/news/2021/01/06/hhs-announces-22-billion-in-funding-to-support-expanded-testing-vaccination-distribution.html.

 

https://www.lcwlegal.com/news/ab-2537-and-sb-275-impose-requirements-on-general-acute-care-hospital-employers-and-other-healthcare-employers-regarding-personal-protective-equipment.

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