Report: Supply Chain Is Achilles Heel in Pandemic Preparedness

WASHINGTON — Strengthening the supply chain and letting companies communicate more freely are two of the ideas in a report from the Healthcare Leadership Council and other organizations about how to respond to future pandemics and other public health disasters.

“Any public health emergency requires effective collaboration at all levels of government,” said Mark McClellan, MD, PhD, founding director of the Duke-Margolis Center for Health Policy, during an online press conference announcing the report. “We need to complement each other rather than operate on separate tracks that are not well coordinated.” He noted that the report had “significant input from agencies with disaster response responsibilities.” Participants included a number of health insurers, nonprofit groups, trade associations, drugmakers, universities, the federal government, and healthcare providers.

The report’s recommendations include:

• Launching a standing disaster preparedness group, appointed by and working with the White House, which includes private sector expertise in production capacity, supply chain and distribution, data exchange, financing, and acute care delivery.
• Modernizing the healthcare supply chain through digitalization, automation, and predictive analytics, with standardized approaches for allocating resources based on need and equity to prevent bidding wars between states and healthcare providers.
• Creating measures to ensure health equity and address disparities
• Improving economic resilience with strategic incentives such as no-interest loans, federally guaranteed purchase commitments, and geographic diversification of production for critical medical products.
• Building a 21st-century public health early warning system that will use all available electronic health records and public health data collection.
• Passing legislation and writing regulations to create rapid response capabilities in areas such as medical licensure portability, telehealth accessibility, and swift access to stockpiles of personal protective equipment.
• Making it easier for private industry and government to share data by updating antitrust laws, enacting strong privacy protections, and ensuring broad access to the data.

Regarding the call for easing antitrust laws during a public health emergency, McClellan told MedPage Today that although antitrust law serves critical purposes in normal circumstances, “when we’re in the middle of a public health emergency, we’re way far away from that kind of system.”

Antitrust rules that would prohibit the government and private corporations from sharing information, for example, about how much more diagnostic testing or equipment or personal protective equipment is needed might be among those rules that would need to be waived. “Manufacturers need to know that they have a place in ramping up to meet that production. So normally information that wouldn’t be shared needs to be shared with the federal government … With that information it’s possible to figure out when we need to invoke the Defense Production Act” to fill a gap, McClellan said.

Hart Brown, senior vice president at R3 Continuum, a Minneapolis consulting firm specializing in helping companies recover from pandemics, natural disasters, and workplace violence, said in an email that he found the report overly broad. “There is little that leads to actionable items or … advice for implementation,” he said, adding that “these events can lead to long-duration, non-geographic crisis events. That means services may be needed to be delivered everywhere for a long time. That is very different from a tornado, hurricane, shooting, or major traffic accident.”

Brown listed three immediate concerns for public- and private-sector organizations in public health emergencies: minimizing health risk to staff, patients, contractors, consultants, and visitors; minimizing the risk of premises becoming a node of transmission; and ensuring that risk-based scenario plans are in place should staff be infected, be a close contact, on leave of absence, or quarantined.

Organizations also will need to take on more responsibility for forecasting and modeling, as well as for conducting contact tracing, Brown said. “Models and forecasts need to be specific to the area the healthcare system services … and be delivered in a manner the private sector can use for decision-making to reduce the numbers of patients arriving to the healthcare location.”