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| Essential Drug Supplies for Virus Patients Are Running Low | Essential Drug Supplies for Virus Patients Are Running Low |
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| Across the country, as hospitals confront a harrowing surge in coronavirus cases, they are also beginning to report shortages of critical medications — especially those desperately needed to ease the disease’s assault on patients’ respiratory systems. | Across the country, as hospitals confront a harrowing surge in coronavirus cases, they are also beginning to report shortages of critical medications — especially those desperately needed to ease the disease’s assault on patients’ respiratory systems. |
| The most commonly reported shortages include drugs that are used to keep patients’ airways open, antibiotics, antivirals and sedatives. They are all part of a standard cocktail of medications that help patients on mechanical ventilators, control secondary lung infections, reduce fevers, manage pain and resuscitate those who go into cardiac arrest. | The most commonly reported shortages include drugs that are used to keep patients’ airways open, antibiotics, antivirals and sedatives. They are all part of a standard cocktail of medications that help patients on mechanical ventilators, control secondary lung infections, reduce fevers, manage pain and resuscitate those who go into cardiac arrest. |
| Demand for these drugs significantly increased in March as the pandemic took hold in the United States. Orders for antibiotics like azithromycin and antiviral medicines like ribavirin nearly tripled. Medicines used for sedation and pain management, including fentanyl, midazolam and propofol, increased by 100 percent, 70 percent and 60 percent respectively. | Demand for these drugs significantly increased in March as the pandemic took hold in the United States. Orders for antibiotics like azithromycin and antiviral medicines like ribavirin nearly tripled. Medicines used for sedation and pain management, including fentanyl, midazolam and propofol, increased by 100 percent, 70 percent and 60 percent respectively. |
| Demand for albuterol, a common asthma inhaler medication, has also risen significantly, given its importance in easing the breathing of patients with severe infection. | Demand for albuterol, a common asthma inhaler medication, has also risen significantly, given its importance in easing the breathing of patients with severe infection. |
| At the same time, the rate at which these prescriptions are filled and shipped to hospitals has dropped considerably, down by half to more than three-fourths in the last month, according to data collected by Premier Inc., a health care improvement company that provides group purchasing, analytics, consulting and various services to more than 4,000 hospitals and approximately 175,000 other providers in the United States. | At the same time, the rate at which these prescriptions are filled and shipped to hospitals has dropped considerably, down by half to more than three-fourths in the last month, according to data collected by Premier Inc., a health care improvement company that provides group purchasing, analytics, consulting and various services to more than 4,000 hospitals and approximately 175,000 other providers in the United States. |
| “Just like we’re seeing shortages of other materials, like masks and ventilators, medications are right there in the mix of things that we don’t always have enough of on hand,” said Erin Fox, a drug shortage expert at the University of Utah. “So we were not prepared for this kind of surge.” | “Just like we’re seeing shortages of other materials, like masks and ventilators, medications are right there in the mix of things that we don’t always have enough of on hand,” said Erin Fox, a drug shortage expert at the University of Utah. “So we were not prepared for this kind of surge.” |
| Hospitals in particular are feeling the pinch in supplies. In a recent survey of 377 hospitals and 100 long-term care, home infusion and retail pharmacies, Premier found that drug shortages were pervasive in acute care settings, where 70 percent of respondents reported at least one shortage for coronavirus drugs. Among long-term care facilities, home care settings and retail pharmacies, 48 percent reported shortages. | Hospitals in particular are feeling the pinch in supplies. In a recent survey of 377 hospitals and 100 long-term care, home infusion and retail pharmacies, Premier found that drug shortages were pervasive in acute care settings, where 70 percent of respondents reported at least one shortage for coronavirus drugs. Among long-term care facilities, home care settings and retail pharmacies, 48 percent reported shortages. |
| Demand is even higher in coronavirus hot spots like New York, California and Washington. | Demand is even higher in coronavirus hot spots like New York, California and Washington. |
| A senior doctor at one large New York City hospital said the institution, like some others, was running low on the drugs they commonly use to induce anesthesia and then paralysis in patients on ventilators. “We’re running out of all the drugs,” the doctor said. “So we’re on second line, third line, fourth line medications. We’ve run out of the ability to monitor these people the way we conventionally monitor them. So we’re just sort of flying blind a little bit.” | A senior doctor at one large New York City hospital said the institution, like some others, was running low on the drugs they commonly use to induce anesthesia and then paralysis in patients on ventilators. “We’re running out of all the drugs,” the doctor said. “So we’re on second line, third line, fourth line medications. We’ve run out of the ability to monitor these people the way we conventionally monitor them. So we’re just sort of flying blind a little bit.” |
| Doctors at several hospitals have been using a combination of midazolam, hydromorphone and ketamine. Under normal circumstances, they would use propofol and fentanyl because they are short-acting, the doctor said. The others have a longer duration and that makes it harder for patients to emerge from sedation later. | Doctors at several hospitals have been using a combination of midazolam, hydromorphone and ketamine. Under normal circumstances, they would use propofol and fentanyl because they are short-acting, the doctor said. The others have a longer duration and that makes it harder for patients to emerge from sedation later. |
| And with the peak in cases and resource use still projected to be several weeks away, the run on these drugs only highlights weaknesses in the current supply chain. | And with the peak in cases and resource use still projected to be several weeks away, the run on these drugs only highlights weaknesses in the current supply chain. |
| “The pharmaceutical supply chain is one of just-in-time production,” Ms. Fox said. “Manufacturers tend to make just enough product, and they forecast out their manufacturing cycles based on how much they sold in the past. Nobody expects to sell, you know, 10 times the amount of something, and so nobody has that on hand.” | “The pharmaceutical supply chain is one of just-in-time production,” Ms. Fox said. “Manufacturers tend to make just enough product, and they forecast out their manufacturing cycles based on how much they sold in the past. Nobody expects to sell, you know, 10 times the amount of something, and so nobody has that on hand.” |
| Even before this crisis emerged, the Food and Drug Administration noted shortages of well over 100 drugs in the United States. And factory shutdowns in China, India and other countries may have exacerbated the shortage of some ingredients and generic drugs during the pandemic. | Even before this crisis emerged, the Food and Drug Administration noted shortages of well over 100 drugs in the United States. And factory shutdowns in China, India and other countries may have exacerbated the shortage of some ingredients and generic drugs during the pandemic. |
| “Out of 21 antibiotics that would be critical for treating secondary infections in Covid-19 patients, 18 antibiotics have greater than 80 percent of their supply coming out of either China, India or Italy — all places that have had production disruptions,” said Stephen Schondelmeyer, a professor at the University of Minnesota’s College of Pharmacy who is a co-leader of the Resilient Drug Supply Project, which aims to provide a detailed map of the supply chain for important drugs used in the United States. | “Out of 21 antibiotics that would be critical for treating secondary infections in Covid-19 patients, 18 antibiotics have greater than 80 percent of their supply coming out of either China, India or Italy — all places that have had production disruptions,” said Stephen Schondelmeyer, a professor at the University of Minnesota’s College of Pharmacy who is a co-leader of the Resilient Drug Supply Project, which aims to provide a detailed map of the supply chain for important drugs used in the United States. |
| Another factor that can affect the global supply chain is when countries ban export of certain drugs, either because of trade wars or because they want to ensure supply for their own citizens, Mr. Schondelmeyer said. India, for example, has put a ban on the exports of 26 drugs and drug ingredients, including hydroxychloroquine, an old malaria drug that is being used around the world as a potential treatment. | Another factor that can affect the global supply chain is when countries ban export of certain drugs, either because of trade wars or because they want to ensure supply for their own citizens, Mr. Schondelmeyer said. India, for example, has put a ban on the exports of 26 drugs and drug ingredients, including hydroxychloroquine, an old malaria drug that is being used around the world as a potential treatment. |
| “So, politics is beginning to lay into the supply chain issues,” Mr. Schondelmeyer said. | “So, politics is beginning to lay into the supply chain issues,” Mr. Schondelmeyer said. |
| The U.S. government could provide incentives to drug manufacturers to increase domestic production to solve some of the supply problems. But ramping up production may take two to three months and would not be able to fill immediate gaps, Mr. Schondelmeyer said. “It’s not a process where we could have the tablets next Friday.” | The U.S. government could provide incentives to drug manufacturers to increase domestic production to solve some of the supply problems. But ramping up production may take two to three months and would not be able to fill immediate gaps, Mr. Schondelmeyer said. “It’s not a process where we could have the tablets next Friday.” |
| Increasing production is also dependent on quotas for controlled substances and ingredients that are set by the Drug Enforcement Administration. On Tuesday, the American Hospital Association and four other medical groups sent a letter requesting that the D.E.A. temporarily increase quotas to add flexibility for domestic manufacturing, but the agency has not done so yet, Ms. Fox said. | Increasing production is also dependent on quotas for controlled substances and ingredients that are set by the Drug Enforcement Administration. On Tuesday, the American Hospital Association and four other medical groups sent a letter requesting that the D.E.A. temporarily increase quotas to add flexibility for domestic manufacturing, but the agency has not done so yet, Ms. Fox said. |
| Hospitals have to start looking for alternatives that work almost as well as the current standard treatments. | Hospitals have to start looking for alternatives that work almost as well as the current standard treatments. |
| “Many places are already shifting to using medications that we tried to avoid,” said Dr. Lewis J. Kaplan, president of the Society of Critical Care Medicine, a nonprofit involved in research and advocacy for patients. “We had cut down tremendously on the amount of benzodiazepines, which you may be familiar with as Ativan or Valium, because they may induce delirium, especially in people who are having trouble sleeping. But we’re now using those medications where our standard sedatives are running low.” | “Many places are already shifting to using medications that we tried to avoid,” said Dr. Lewis J. Kaplan, president of the Society of Critical Care Medicine, a nonprofit involved in research and advocacy for patients. “We had cut down tremendously on the amount of benzodiazepines, which you may be familiar with as Ativan or Valium, because they may induce delirium, especially in people who are having trouble sleeping. But we’re now using those medications where our standard sedatives are running low.” |
| Some hospitals are purchasing alternative antibiotics, crushing up pills instead of using IV fluids, and reducing nonessential surgeries and treatments to prioritize patients with coronavirus infections, Dr. Kaplan said. | Some hospitals are purchasing alternative antibiotics, crushing up pills instead of using IV fluids, and reducing nonessential surgeries and treatments to prioritize patients with coronavirus infections, Dr. Kaplan said. |
| “There isn’t a hard and fast rule,” he said. “It is, what do I have? Can this work for this patient? And do I need to ask someone about whether or not the drugs that are mixing are reasonably safe?” | “There isn’t a hard and fast rule,” he said. “It is, what do I have? Can this work for this patient? And do I need to ask someone about whether or not the drugs that are mixing are reasonably safe?” |
| Updated June 12, 2020 | Updated June 12, 2020 |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| One change that has further strained drug supplies is a switch to buying albuterol inhalers for individual patients rather than using nebulizers, a shift that doctors hope will decrease the spread of the virus through the air. But that move heightens the problem of depleting supplies for people with asthma and chronic obstructive pulmonary disease, who routinely rely on the inhalers and have been encouraged to buy 90-day supplies of their medicine. | One change that has further strained drug supplies is a switch to buying albuterol inhalers for individual patients rather than using nebulizers, a shift that doctors hope will decrease the spread of the virus through the air. But that move heightens the problem of depleting supplies for people with asthma and chronic obstructive pulmonary disease, who routinely rely on the inhalers and have been encouraged to buy 90-day supplies of their medicine. |
| “In general, that’s good advice up front,” Mr. Schondelmeyer said. “But with drugs like albuterol, we’re not going to be able to sustain that because we’re already on short supply.” | “In general, that’s good advice up front,” Mr. Schondelmeyer said. “But with drugs like albuterol, we’re not going to be able to sustain that because we’re already on short supply.” |
| Two pharmaceutical companies that make albuterol inhalers — GlaxoSmithKline and Teva Pharmaceuticals — have said they are facing unprecedented demand but did not have any supply chain issues at the moment. Kelley Dougherty, a spokeswoman for Teva Pharmaceuticals, said the company was “producing as much albuterol as possible as quickly as possible.” | Two pharmaceutical companies that make albuterol inhalers — GlaxoSmithKline and Teva Pharmaceuticals — have said they are facing unprecedented demand but did not have any supply chain issues at the moment. Kelley Dougherty, a spokeswoman for Teva Pharmaceuticals, said the company was “producing as much albuterol as possible as quickly as possible.” |
| Pfizer, which makes several versions of the sedative midazolam, also noted that its distribution network continues to operate without significant disruption. “For many of these critical medicines, we have ample supply. For some, the unprecedented surge in demand for these products is limiting our ability to fully satisfy customer orders in the short-term,” said Kimberly Bencker, a spokeswoman for the company. | Pfizer, which makes several versions of the sedative midazolam, also noted that its distribution network continues to operate without significant disruption. “For many of these critical medicines, we have ample supply. For some, the unprecedented surge in demand for these products is limiting our ability to fully satisfy customer orders in the short-term,” said Kimberly Bencker, a spokeswoman for the company. |
| Pharmacy benefit managers, such as CVS Caremark, are also trying to balance the growing interest in prescription medications for the coronavirus response with the needs of patients who take them for chronic conditions like asthma, H.I.V., rheumatoid arthritis and lupus. | Pharmacy benefit managers, such as CVS Caremark, are also trying to balance the growing interest in prescription medications for the coronavirus response with the needs of patients who take them for chronic conditions like asthma, H.I.V., rheumatoid arthritis and lupus. |
| “Our goal is to limit stockpiling of medication that could result in future shortages and gaps in care,” said Mike DeAngelis, a spokesman for CVS. Retail pharmacies are following state dispensing guidelines, and limiting the dispensing for coronavirus treatments to a 10-day supply in states without set recommendations, Mr. DeAngelis said. People who already take these medications for approved uses will be able to bypass any new quantity limits agreed to by their plan sponsor. | “Our goal is to limit stockpiling of medication that could result in future shortages and gaps in care,” said Mike DeAngelis, a spokesman for CVS. Retail pharmacies are following state dispensing guidelines, and limiting the dispensing for coronavirus treatments to a 10-day supply in states without set recommendations, Mr. DeAngelis said. People who already take these medications for approved uses will be able to bypass any new quantity limits agreed to by their plan sponsor. |
| Experts still advise that patients avoid hoarding medications because the regional shortages could soon turn into national shortages as coronavirus infections continue to spread. | Experts still advise that patients avoid hoarding medications because the regional shortages could soon turn into national shortages as coronavirus infections continue to spread. |
| While the pandemic has sparked innovations in mechanical breathing machines, and some medical supplies can be sourced from the national stockpile, drugs are not as easy to replace. “If you get past a peak in a certain area, you could move resources like ventilators somewhere else, but drugs are consumables,” Mr. Schondelmeyer said. “They’re gone once they’re used.” | While the pandemic has sparked innovations in mechanical breathing machines, and some medical supplies can be sourced from the national stockpile, drugs are not as easy to replace. “If you get past a peak in a certain area, you could move resources like ventilators somewhere else, but drugs are consumables,” Mr. Schondelmeyer said. “They’re gone once they’re used.” |
| Transparency in the available supply chain data could help prevent drug shortages in the future. Pharmaceutical companies, wholesalers and suppliers typically know where the raw materials for drugs are sourced and which countries manufacture which parts of a drug, as well as which factories could take over if production needs to be scaled up. But each company keeps this data confidential, and even the F.D.A. does not have a systematic way to look across drug production and supply chain capabilities. | Transparency in the available supply chain data could help prevent drug shortages in the future. Pharmaceutical companies, wholesalers and suppliers typically know where the raw materials for drugs are sourced and which countries manufacture which parts of a drug, as well as which factories could take over if production needs to be scaled up. But each company keeps this data confidential, and even the F.D.A. does not have a systematic way to look across drug production and supply chain capabilities. |
| “We need to make this at least somewhat more transparent and begin to look for ways to plan for and identify where we have vulnerabilities and where we should be changing policy,” Mr. Schondelmeyer said. “Right now, we’re trying to build that bridge as we’re walking across it.” | “We need to make this at least somewhat more transparent and begin to look for ways to plan for and identify where we have vulnerabilities and where we should be changing policy,” Mr. Schondelmeyer said. “Right now, we’re trying to build that bridge as we’re walking across it.” |
| William K. Rashbaum contributed reporting. | William K. Rashbaum contributed reporting. |