Supply chain for medical supplies facing unprecedented challenge
Manufacturers face hurdles in efforts to retool production lines
When the European Union followed Taiwan’s lead and banned export of all personal protective equipment last week, it sent Canadian hospitals, governments and businesses scrambling to fill the void.
Hospitals in Toronto and southwestern Ontario had relied on one 3M plant in the United Kingdom for masks, and the EU ban (which still applies to the U.K., despite Brexit) shut down that source, according to executives at two southern Ontario hospitals.
“The U.K. plant under the European Union, they will not give North America the masks,” said Premier Doug Ford during his daily press conference Tuesday. “So, we’re doing everything we can to make sure we have a supply on hand.”
In response to questions from the Star, 3M did not address the issue of the U.K. plant.
“At this time, 3M does not manufacture N95 respirators in any facility in Canada. We have, however, doubled the amount of N95 respirators brought into the country during the first three months of 2020,” said 3M Canada president Penny Wise in an statement.
While some breweries and distilleries have been able to rapidly convert their equipment to produce hand sanitizer, it’s not going to be as easy for companies to switch to making face shields, respirators and ventilators, said Guillaume Laverdure, president of Medicom, a manufacturer of infection control products based in Montreal. “You have some products which are not specifically difficult to make, but the capacity is limited,” said Laverdure, who has been approached by several companies looking to tap into Medicom’s production expertise.
Garment industry insiders also point to medical grade certification as a potentially insurmountable barrier to quickly converting plants to manufacture specialized items like masks and respirators.
The overwhelming majority of the world’s supply of personal protective equipment (PPE), which health-care workers rely on, is made in China and Southeast Asia, and because the coronavirus pandemic started there, the supply was redirected to local needs months ago.
Taiwan imposed an export ban on all PPE in January and China’s government has been purchasing virtually all local production of PPE before it can be exported, severely hampering Canada’s access to N95 masks and other items. When the EU implemented its ban on all PPE exports on March 15, Canada went from concerned to desperate.
The federal government has started distributing PPE from the national emergency strategic stockpile to the provinces and territories, Eric Morrissette, a spokesperson for the Public Health Agency of Canada, told the Star.
Calls went out earlier this week from both the federal and provincial governments to local businesses seeking any lingering supplies of PPE that can be commandeered for medical use.
Universities, tattoo parlours, dental offices, hair salons and non-emergency medical facilities, including fertility and plastic surgery clinics, all have inventories of PPE that could be pressed into use.
While both calls received massive responses, they may not be enough to face the expected surge in coronavirus cases in the months ahead.
Currently, hospitals are not reporting any shortages. But stockpiles are expected to last only another two weeks and resupply is uncertain, said Mitze Mourinho, president of the Michael Garron Hospital Foundation.
This leaves Canada with no option other than producing new supplies, quickly, and in unconventional ways.
Last week, Prime Minister Justin Trudeau announced federal aid for Canadian manufacturers of PPE to “massively scale up” production. There will also be federal support for companies looking to retool their production lines to make medical supplies.
Getting a production line rolling “takes months and months of capacity investment,” Medicom’s Laverdure said.
Auto parts manufacturers, including Ontario-based Martinrae International, said last week that they will work with governments to retool factories for PPE production, though they cited the need for technical guidance.
Beyond know-how, there is also the question of securing enough raw materials — the plastic and paper products, as well as the specialized impermeable fabrics necessary to make masks and gowns.
“Without the material itself, you could add 50 factories to make mass (amounts of PPE) in Canada tomorrow, and they won’t be able to run,” said Laverdure.
Bob Kirke, executive director of the Canadian Apparel Federation, said the real issue preventing Canadian manufacturing from producing PPE is certification, which cannot be quickly achieved in non-certified plants.
“There are very big challenges to converting factories from making T-shirts to making certified medical garments,” Kirke said. “There are certifications for a reason: You don’t want blood or other liquids to go through the fabric.”
While in the face of a looming crisis the U.S. Food and Drug Administration has relaxed standards so that non-compliant masks can be used, no similar change has been made in Canada, said Kirke.
“We know we can’t do a 100 per cent compliant mask, but could we make one that is adequate for some purposes,” such as use by patients in waiting rooms, said Kirke.
Relaxed standards would free hospitals from having to worry about the legal implications of using non-conforming supplies.
“Is it time for Health Canada to relax some of the requirements to allow for a greater supply?” asked Kirke.
This week, several North American auto manufacturers announced they would start producing PPE to meet the unprecedented demand.
On Monday, Fiat Chrysler said it would begin manufacturing one million protective face masks per month and donating them to police, paramedics, firefighters and hospital workers.
Asked where the masks were going to be produced, company spokesperson Kevin Frazier told the Star the first plant to be converted is in China.
While the company is evaluating other plants, Frazier said he would not speculate on any difficulties in getting the masks out of China to the North American market.
Ford Motor Co. announced Tuesday that it would convert local plants in Michigan to produce respirators and face shields in partnership with 3M.
The company said it could produce 75,000 face shields this week, before scaling up to 100,000 a week by April.
Ford said it would also work with General Electric to increase production of ventilators and use in-house 3D printing technology to make respirator masks.
“We’re talking about producing hundreds of thousands of these ventilators in the future,”
Ford CEO Jim Hackett said in an interview with CBS. “The problem is that the lines that have been in place produce hundreds or thousands. We’re talking about needing hundreds of thousands.”
It will take time to reach this level of production volume, Hackett said.
“We’re talking about early June where we don’t think it is a problem, but between now and June, it is about ramping up.”
Luxury parka maker Canada Goose announced Wednesday that it would start making scrubs and patient gowns at its facilities in Toronto and Winnipeg next week.
The initial run will be 10,000 units, with the potential to expand production to other facilities if needed, the company said in a statement. The gowns will be donated to local hospitals.
While it remains to be seen if the initiative from individual businesses will meet the expected surge of infections, the COVID-19 crisis has exposed a long-term weakness in Canada’s preparedness.
“The main issue is how do we make sure that every single country in the long term has a local supply source that they can rely on,” said Medicom’s Laverdure, who noted his company was founded in 1988 to meet the shortage of latex gloves amid the AIDS epidemic.
“We understand manufacturing locally may not be the cheapest option. There is always a cheaper option somewhere (else). But there is a price to pay to have guaranteed local supply,” he said.
“It’s not all about lean inventory and low cost,” he said. “Yes, it’s more expensive than buying from China. But it serves a purpose. I hope everybody would remember that.”
“Is it time for Health Canada to relax some of the requirements to allow for a greater supply?” BOB KIRKE EXECUTIVE DIRECTOR, CANADIAN APPAREL FEDERATION