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Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies

  • 1Infection Control/Hospital Epidemiology, Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 2Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 3University of Michigan Health System, Ann Arbor
  • 4Center for Global Development, Washington, DC
  • 5INSEAD, Fontainebleau, France
  • 6Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts

Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across the US have reported substantial personal protective equipment (PPE) shortages, compromising their ability to keep health care professionals safe while treating increasing numbers of patients.1 Gloves, face masks, N95 respirators, powered air-purifying respirators, eye protection, and gowns are central to transmission-based precautions. Initial delays in COVID-19 testing increased PPE use, further intensifying demand.

Consequently, some health care professionals have resorted to directly sourcing PPE from personal networks. Infection prevention teams across the country have focused on supply conservation with extended use and reuse protocols. These teams have also collaborated with others (engineers, the maker community, local businesses, and community volunteers) to create new forms of PPE, including respirators and eye protection. At the same time, reports suggest there are overseas suppliers with sizable quantities of PPE who want to supply US health care systems, but logistic issues related to quality, payment terms, and air cargo capacity are among the barriers.

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    1 Comment for this article
    Big Data-driven personal protective equipment stockpiling framework under Universal Healthcare for Disease Control and Prevention in the COV
    Kevin Sheng-Kai Ma, DDS, MSc |
    Big data analytics has improved healthcare by analyzing electronic medical records, socio-demographic information, and environmental factors [1]; moreover, its tracking roles in emerging infectious diseases including the coronavirus pandemic have been discussed [2]. In countries with single-payer universal healthcare systems (UHS), claimed data of payers could be an abundant source for analytics. On the other hand, compulsory social distancing, coupled with mass masking, has been widely adopted as strategy for non-specific symptoms at early stage COVID-19 [3]. We propose that analytics based on proper concatenation of databases may prevent supply shortages for personal protective equipment (PPEs).

    Taking Taiwan as
    an example, cloud computing-based healthcare databases within the UHS has alleviated the integration between primary care providers and hospitals, as well as reduced the cost of tracking procedure. Applying the same logistics to PPE allocation would allow PPE providers to manage the distribution of surgical masks on a real-time basis, and recognize the mask holders per insurance or passport number [4]. With the help of data analysis, combining artificial intelligence and cloud technology, public health policy-making could be practicable. Thus when it comes to the implementation cost of epidemic prevention policies, Taiwan authorities adopt low stringent level strategies compared with other high income countries, but still have achieved epidemic control in the early outbreak [5].

    After the 2003 severe acute respiratory syndrome outbreak, Taiwan CDC (TCDC) started transferring registered real-time infectious disease data to this established monitoring system, where PPE stockpiling platform was practiced. Therefore, prior to the official recognition of COVID-19 outbreak [2], PPE databases were subsequently concatenated by UHS to manage resource allocation and logistics when several cases were identified. Establishment of this application programming interface for mask-selling pharmacies under UHS required data transfers as well as managerial issues including governance and ownership, which interdepartmental communication was efficient within UHS. Specifically, the tracking system expands the healthcare informatics system that pharmacists are familiar with, which user friendly interfaces for these PPE providers and consumers help expedite processes in an efficient manner [4]. UHS and TCDC have also promoted the system to increase the distribution channels, which government offices may also allot masks to lessen the burden on healthcare providers.

    Since masks alone aren’t effective without combining infection-control measures [6], we recommend to utilize such integrative platform for the maintenance of more PPE stockpiles, including critical infection-control equipments, so as to reduce iatrogenic COVID-19 exposure.


    [1] Kevin Vigilante, Steve Escaravage, and Mike McConnell. Big Data and the Intelligence Community — Lessons for Health Care. N Engl J Med 2019; 380:1888-1890
    [2] C. Jason Wang, Chun Y. Ng, Robert H. Brook. Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. JAMA. 2020; 323(14): 1341-1342.
    [3] Megan L. Ranney, Valerie Griffeth, and Ashish K. Jha. Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covi