Medical supply chain crisis
The United States is at a defining moment in its frontline health systems' response to the coronavirus outbreak. America has a lead federal organization that can fix the medical supply chain crisis and support our nation's medical systems. Why hasn't it been called into action?
As a professor of supply chain risk management, I have had deepening concerns about the abilities of our national supply chains to respond to the six-month inventory disruptions and transport volatility that can accompany such contagions.
As a former nurse who had engaged in medical logistics, I was left speechless when my family member, a physician, told me of being issued a pair of N95 masks meant for one-time use. His employer, one of the finest health systems in the country, advised him not to expect any more "in the foreseeable future." Without them, his surgical team had to cover patients' faces in Saran Wrap, poking a hole in the mouth area for intubation to try and block any virus aerosol. This supply failure is a shocking vulnerability our doctors and nurses must live (or die) with each day now.
The federal emergency stockpile of medical equipment and supplies reportedly is nearly depleted, leaving the Trump administration and states to compete for the supplies in a global marketplace and be exposed to price-gouging and profiteering.
Consider the projected ventilator shortage: About a week ago while experts predicted as many as one million U.S. patients would need the machines, there were 16,600 units in the federal government's strategic stockpile, in addition the roughly 160,000 units in the U.S. medical system.
The stakes to bolster and surge the U.S. medical system have never been higher. Yet, no organization of the U.S. government has stepped forward with the necessary global scale, network of key supplier relationships and mass volume procurement/distribution systems to effectively help save our medical supply chains from extreme disruption.
FEMA, the COVID-19 response coordinator, has shown significant deficiencies in scaling logistics capability in the past, failing to manage complex and massive crossborder flows of critical medical goods, as when Hurricane Maria hit Puerto Rico in 2017. The federal government must mobilize the Defense Logistics Agency (DLA), the supply chain command center for the Department of Defense. With its authority and incredible scale of operations, the DLA can help save our collapsing medical and essential goods supply chains.
This agency provides more than $37 billion in goods and services annually, employs some 26,000 civilian and military personnel, and manages nine supply chains and roughly five million items. It maintains networks of key suppliers, including large original equipment manufacturers (OEMs) such as Boeing and 3M. Its operations and global network of distribution centers reach into most states and 28 countries, allowing it to support disaster response and humanitarian relief efforts at home and abroad.
It is uniquely positioned with a history of supporting other federal agencies, and state and local governments, with uniforms, food, fuel and more. Its customer base includes many of the agencies at the front lines of the coronavirus crisis - FEMA, the Department of Health and Human Services and the Department of Agriculture School Lunch Program.
The DLA has the capacity to aggressively and urgently commandeer critical supplies across the globe through huge volume buys and aggressive supplier management, particularly with their key OEMs. It has the distribution systems to deliver these critical goods to the front lines of the coronavirus war here in the United States. Yet, the
DLA has been outright reserved in its coronavirus response for example by announcing requests for information from possible suppliers of protective gear, not actual proposals to fund and acquire supply.
Amazingly, Secretary of Defense Mark Esper made no mention of the DLA recently as he discussed DOD contributions (National Guard deployments, collaborative vaccine research and opening strategic reserves) to the coronavirus fight.
On its way to becoming widely acknowledged as the best in the world in managing a national pandemic response, Singapore faced a similar defining moment when the 2003 SARS contagion started to overrun its medical systems. The solution: Singapore's armed forces was organized at scale to launch a web-based system, equivalent to a community needs board, so hospitals could directly upload inventory requirements in real time; only the military could procure and deliver mass volumes of critical life-saving goods directly to hospitals in time. Its army logistics group also led both the conversion of shipping containers to isolation rooms and the organized use of the taxicab system for supporting transport of food and medical supplies to households.
Like Singapore in the 2003 SARS crisis, America already has such a point-ofthe-spear national supply chain operation - the DLA. As it has done in other wars, the DLA is fully equipped for mass volume purchasing; and it has the market leverage worldwide to successfully procure, allocate and deliver urgent supplies to our health care front lines. It is the high- caliber weapon we urgently need in this war against the coronavirus.