Mar 29, 2020 - Health

Fixing America's broken coronavirus supply chain

Polowczyk speaks at a coronavirus briefing at the White House, March 23. Photo: Brendan Smialowski/AFP via Getty Images

The senior Navy officer now in charge of fixing America's coronavirus supply chain is trying to fill the most urgent needs: ventilators and personal protective gear. But barely a week into his role at the Federal Emergency Management Agency, he's still trying to establish what's in the pipeline and where it is.

Driving the news: "Today, I, as leader of FEMA's supply chain task force, am blind to where all the product is," Rear Adm. John Polowczyk tells Axios.

Why it matters: Polowczyk hears the calls from Congress, governors and medical equipment suppliers who want the federal government to nationalize the supply chain using the Defense Production Act — but he argues that's not the right move this far into the crisis.

  • "They want me to do all the buying, all the distributing, and all the allocation," he says.
  • But the nation's medical supply chain consists of six or seven major distributors with 600–700 distribution nodes around the country.
  • "I'm not going to re-create that," he said. "I'm looking to break down barriers ... to help them feed product where it needs to go."

What's happening: Instead, Polowczyk says, FEMA is collecting inventory data from all those companies and weaving disparate information systems together "to illuminate their supply chains down to their distribution networks and potentially down to the hospital level."

  • The priority now is New York and California, he said, but demand is increasing in places like Louisiana, Chicago, Detroit, Washington and Florida.

The big picture: With more than 150 countries affected by the global pandemic, worldwide demand for medical equipment is exploding, but supplies are limited and often hindered by virus-related shipping problems.

  • "The thought that we're going to buy our way out of this right now is not possible," Polowczyk says.

What he's saying: Polowczyk told Axios the crisis has to be managed on four fronts.

1. Preservation: Hospitals need to stretch existing supplies as much as possible.

  • That means health care workers will need to conserve and even reuse masks and other protective gear, following guidelines from the Centers for Disease Control and Prevention.
  • FEMA is working with hospitals to set up sterilization operations using UV light, bleach or heat treatments so that masks and gowns can be turned in, sanitized and reused. "Do I want that doctor to use a dirty mask? No, that's why we have to operationalize it."
  • That will require a "cultural flip for the medical community."
  • "Instead of treating it as a 70-cent disposable, treat it as a $100 mask and gown and face shield."

2. Acceleration: FEMA needs to assist by clearing bottlenecks and speeding deliveries.

  • The emergency airlifts that kicked off this week are one dramatic example, with a flight from Shanghai that arrived in New York this morning carrying supplies like gloves, N95 masks, surgical masks, gowns, hand sanitizer units and thermometers.
  • FEMA is also chasing leads, in the U.S. and overseas, to identify potential suppliers of protective gear, but not all can deliver. "For every 10 of those leads, maybe one pans out."
  • FEMA staffers also need to visit warehouses and open boxes "to make sure it's not sawdust."
  • Ventilator companies like GE Healthcare, Philips and Hamilton Medical already are sharply increasing production, as are Honeywell and 3M, which make respirator masks.

3. Expansion: New manufacturers need to step up to produce medical supplies.

  • The Trump administration already has enlisted help from the auto industry.
  • Many other companies have volunteered, but it takes time to figure out what they can produce or how they can partner with others.
  • FEMA is working with approximately 130 such leads, said Polowczyk. "Every one of those has a story."
  • Lining up new manufacturers will take several weeks or longer, he said. "You can't just make masks in volume in a matter of days."

4. Reallocation: FEMA needs a better understanding of what's available, where it is and where it needs to go.

  • "You can't run a supply chain without business IT and business intelligence," which is why Polowczyk is trying to merge all the data from distributors.

The bottom line: The shortages are daunting. But in Polowczyk's view, all four efforts "when combined together, should get us through this phase, this wave, of COVID-19."

Go deeper: Inside the start of the great virus airlift

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U.S. coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

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