Flu Season Has Exposed Life-Threatening Flaws in Medical Supply Chains


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Flu season within the U.S. usually peaks in February, however this 12 months’s outbreak is already one of many worst on report. As of Jan. 6, 20 kids have died from the flu, and general mortality attributable to the flu is already double that of final 12 months’s.

One cause the flu is so extreme this season is that the dominant pressure is H3N2, which has a powerful means to mutate and is especially aggressive in opposition to Individuals over 50.

Making the menace worse is the truth that many of the IV saline luggage utilized in widespread medical therapies and procedures – together with extreme circumstances of the flu – are made in Puerto Rico, which remains to be reeling from Hurricane Maria. Hospitals in some areas across the nation which might be working at or above capability due to the flu are rapidly working low on saline, resorting to time-consuming and probably harmful therapies of sufferers.

The IV saline scarcity is unlikely to trigger a life-threatening breakdown of medical therapies. However the scarcity does expose a harmful flaw within the medical provide chains that everybody depends on to counter illness outbreaks or bioterrorism. Many several types of vital medical gear and medicines both come from overseas or depend on a single producer.

International Provide Chains

Globalization has modified the way in which we produce, transport and retailer virtually something, together with medicines and medical provides. Now that it’s cheap to move items, many could be simply produced overseas at considerably decrease prices. In practically all circumstances, that advantages producers and shoppers alike.

For the medical trade, roughly 80 % of all prescription drugs utilized by Individuals are produced abroad. Nearly all of this manufacturing takes place in China and India.

Forty-three % of saline within the U.S. comes from Puerto Rico. The U.S. was already working beneath optimum ranges of saline when Hurricane Maria hit.

Fast transportation of products additionally permits most industries to depend on “simply in time” deliveries. Which means items arrive solely shortly earlier than they’re wanted, slightly than arriving in giant shipments.

In most conditions, and for many items, that causes few points. Nonetheless, when there’s an inadequate stockpile, supply delays could be life-threatening. A lot of our hospitals obtain shipments of important prescription drugs thrice a day.

Sad Coincidences

As researchers finding out how nations can put together for illness and disasters, it’s clear to us that the IV saline scarcity is simply the tip of a big iceberg.

There are two methods the “simply in time” system could be disrupted: an sudden surge in demand or a delay in supply. On this case, each occurred concurrently. The U.S. is coping with an unusually potent pressure of the flu, whereas Hurricane Maria introduced manufacturing in Puerto Rico to a grinding halt. If solely one of many two had occurred, it’s unlikely the U.S. would have skilled a scarcity.

Now, hospitals overrun with flu sufferers have to show to alternate options to IV saline. One is an IV push process, through which medicines are manually “pushed” into the IV line. This may be lethal if not finished appropriately.

Within the case of IV saline, the simultaneous prevalence of each demand and delay was unintended. Sadly, it’s not solely potential that such confluence will happen sooner or later – it’s doubtless. Within the case of pandemics or organic warfare, there’ll doubtless be each a surge in demand for vital items and a simultaneous disruption of manufacturing and supply.

If a pandemic illness severely affected China or India, the place giant shares of medicines come from, manufacturing could possibly be knocked out or slowed. That would go away the remainder of the world susceptible to the illness’s unfold, as a result of there could be no provide of essential medicines to fight it. The 1918 influenza pandemic triggered disruptions that prevented coal from being delivered to the northeastern U.S. That left some with out warmth within the top of winter, inflicting individuals to freeze to demise and compounding the lethal pandemic.

At this time, such a breakdown may go away hospitals and different essential infrastructure with out electrical energy. If the unfold of the illness is intentional, as in circumstances of bioterrorism or bio-warfare, adversaries may goal international provides of essential therapies.

Getting ready for Issues

The destruction in Puerto Rico and the influence it has had on the availability of small IV saline luggage in American hospitals is a warning. This time, it’s IV saline. Subsequent time, it is likely to be electrical energy to run intensive care models or important antibiotics to deal with infections.

International provide chains are an enormous puzzle, however public well being and emergency preparedness officers must, at a minimal, perceive each hyperlink within the chain of important items. With no thorough understanding of the availability chain, it’s tough to preempt issues that would come up in occasions of emergency. Hospitals and different essential infrastructure, reminiscent of energy vegetation and the transportation trade, might need to diversify their suppliers of important items and encourage these suppliers to not focus manufacturing in a single space, particularly to not an space susceptible to pure catastrophe. A last, however way more expensive, choice is to make sure we are able to produce most of those items domestically in occasions of emergency.

In our view, the answer depends upon a partnership between authorities and trade. Federal, state and native governments have to change procedures, however non-public corporations concerned within the manufacturing and supply of important items should plan forward for emergencies.

The ConversationIf these weaknesses in our international provide chains usually are not addressed, particularly as they pertains to medical provides, prescription drugs and different important items, we’re headed for catastrophe.


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