Health services company Vizient and several providers told Congress that more transparency is needed in the personal protective equipment supply chain to help ensure front-line workers have the supplies needed to combat the COVID-19 pandemic.
The Senate Finance Committee held a hearing on how to improve the supply chain on Thursday. Several witnesses detailed problems finding new suppliers at the onset of the pandemic as supplies dwindled, issues facing the Strategic National Stockpile and concerns reusing and reprocessing PPE.
“Normally our hospitals, which represent 50% of acute care centers in the country, would move 15 million N-95 masks in a year. Most recently our count for this year alone is up to half a billion,” said Cathy Denning, group senior vice president of sourcing operations, analytics and Center of Excellence for Vizient, at the hearing.
The PPE supply chain has been wracked by not only unprecedented demand but also manufacturing problems at overseas companies. The issues have led some hospital systems to search for vital supplies outside of their normal vendors.
UC Health in Cincinnati found its own problems when a partnership of local hospitals tried to reach out to new suppliers.
“We learned there were many scams and promises of large quantities of supplies coming in from outside of the U.S.,” said Rob Wiehe, senor vice president and chief supply chain and logistics officer for the system, at the hearing. “These scams involved large sums of money being placed into escrow or cash in advance for goods that did not materialize.”
The system mitigated risk by placing orders among various vendors versus trying to rely on a singular large purchase, but that came with its own obstacles.
“The majority of the product we successfully sourced came from China or other Asian-pacific countries,” Wiehe said. “During our vetting process we found a significant number of the FDA and third-party testing certificates received from potential suppliers were not able to be authenticated or verified.”
Denning said that the supply chain needs to be improved in three ways: transparency, redundancy and verification.
She told senators that the domestic footprint of PPE manufacturing needs to be greatly improved and there needs to be transparency among suppliers.
Vizient asks suppliers to provide information on the manufacturing, raw materials and other information on the supplies. It also wants information on the movement from the manufacturing facility to the end hospital.
“We’ve had a very hard time getting that information,” she said.
But transparency does not just need to come from suppliers, but also the federal government, several witnesses said. Wiehe said that transparency among the Strategic National Stockpile “has to be improved.”
He noted that goods from the stockpile arrived at his facility unannounced and at sporadic times.
“We have to understand what is forthcoming and how we can rely upon it,” Wiehe added.
Dennings recommended the stockpile—which includes ventilators, PPE and several critical drugs—should have at least 90 days of supplies of key items.
As supply chain constraints continue to crimp hospital supplies, most systems have employed the controversial strategy of reprocessing single-use PPE such as N95 masks.
This strategy got major pushback from the American Nurses Association (ANA), which testified at the hearing that Congress should work with the Food and Drug Administration on how to expeditiously research the effectiveness of several reprocessing methods.
“PPE is not being provided in the quantity or quality that is required for nurses to safely care for patients,” said Ernest Grant, M.D., president of the ANA, in his opening statement.
He pointed to an ANA survey from May that found 79% of respondents are required or encourage to reuse single-use PPE.
“More than half of these respondents said they feel unsafe using decontaminated respirators,” Grant added.