Thursday, March 12, 2020 | 2 a.m.
Panic over a potential novel coronavirus outbreak in Southern Nevada has driven residents to wipe out stocks of nonperishable food items, water and household supplies from local stores in preparation for the worst-case scenario of forced quarantines.
The virus is having a more dramatic disruption to another, more vital supply chain: ones carrying crucial medical supplies.
Local efforts
The medical supply crisis has prompted some in the community, like the Nevada Chinese Association, the Law Offices of Erik K. Chen and Oasis Global Partners (an international private equity firm with headquarters in Las Vegas) to use their relationships in Asia to organize the delivery of medical supplies to cities such as Huangshi, Huanggang and Wuhan. They quickly realized it was a feat easier said than done, however, says Aloysius Lo, a partner with Oasis Global Partners.
One issue, Lo says, is that many of the domestic suppliers to whom they have reached out are running out of some of the more crucial supplies amid panic over the global epidemic, which has resulted in quite a few back orders. “My biggest takeaway is that the medical supply chain here is so inefficient, if we ever had a major outbreak in Canada or the United States, there’s no way the medical supply chain could keep up,” Lo said.
The World Health Organization warns that shortages of personal protective gear are putting health workers at risk, particularly in the Hubei province in China, where medical staff on the frontlines are running out of such supplies as gloves, medical masks, respirators, gowns and goggles. Many have resorted to wearing raincoats and garbage bags.
At press time, the virus had infected more than 113,000 people, killing 4,000 since it was first identified in December. It has since spread to more than 104 countries and territories around the world. There were at least 754 patients identified in the United States with the illness at press time, including two presumptive case in Southern Nevada.
Last week, Tedros Adhanom Ghebreyesus, the WHO’s director general, said about 89 million medical masks, 76 million examination gloves and 1.6 million goggles are needed globally for health care workers to respond to the outbreak.
“Shortages are leaving doctors, nurses and other frontline health care workers dangerously ill-equipped,” Ghebreyesus told reporters. “The [health organization] has shipped nearly half a million sets of personal protective equipment to 27 countries, but supplies are rapidly depleting.”
Much of the supplies and protective medical gear are produced in China, which concerns Dr. Michael Gardner, vice dean of clinical affairs at the UNLV School of Medicine, since that could slow down both the production of supplies and the ability of agencies here to get them.
Gardner, who manages clinical activities for approximately 160 faculty physicians, 260 residents and 25 fellows throughout 17 clinic locations, says most hospitals and medical facilities get their supplies from a middleman who gathers product from different companies in bulk. He says they rely heavily on source material disproportionately produced in China. China ranked first in the world for countries that exported medical devices in 2018, according to the Federal Drug Administration.
Gardner says that while the United States hasn’t seen a significant decline in medical supplies yet, he worries about the production of items like masks and gowns in China if the shutdown continues.
“When you have only a few sources of where you get your supplies, you become very dependent on those sources,” he says.
Las Vegas-area hospitals and clinics haven’t faced a shortage yet, but Gardner says his friends and colleagues on the East Coast and in the Northeast tell him they are running out of surgical gowns and masks, causing them to alter surgery schedules.
“It’s not a major crisis yet, [but] we are starting to feel the effects,” he says.
The importance of protecting medical staff is greater than ever, Gardner says. He believes this particular strain of the coronavirus mirrors another pandemic from more than 100 years ago—the 1918 influenza pandemic, aka the Spanish Flu, which resulted in the worldwide deaths of 17 to 50 million people, many of whom were doctors and medical providers.
“There was a shortage of caregivers because they were dying at a higher rate than the population at large,” he says. “We need to make sure we protect them, so available medical supplies on the frontlines really is necessary.”
There have been reports in both China and the United States of people buying out face masks from stores and online retailers. Some are buying them in bulk and selling them online at inflated prices. Gardner urges against citizens stockpiling face masks, which could ultimately lead to a global shortage.
“If you don’t have symptoms and you’re not working in a situation where you’re in a health care environment or where people are sick, it becomes more fashion statement than preventive measure,” he says. “It doesn’t have any positive public health benefits.”
The world’s drug supply is also a concern, with 72% of active pharmaceutical ingredients produced outside the United States. A large number of those facilities are in China, according to the FDA. Active pharmaceutical ingredients, or APIs, allow drugs to achieve their intended effect (think acetaminophen in drugs like Tylenol that treat aches and pains).
The FDA recently announced that it would step up monitoring of the drug supply chain in the event of shortages. Since January, the government organization has been in touch with nearly 200 manufacturers of “human drugs” to remind them how to alert officials of any anticipated supply shortages, FDA Commissioner Stephen Hahn said in a statement posted on the agency’s website. He also said they’re asking manufacturers to evaluate their entire supply chain, including ingredients manufactured in China.
“Also, as part of our efforts, the FDA has identified about 20 other drugs, which solely source their active pharmaceutical ingredients or finished drug products from China,” he said. “We have been in contact with those firms to assess whether they face any drug-shortage risks due to the outbreak. None of these firms have reported any shortage to date. Also, these drugs are considered noncritical drugs.”
This story appeared in Las Vegas Weekly.
