Securing personal protective equipment for frontline health care workers is forcing administrators to develop a new set of operating skills.
Dr. Andrew W. Artenstein, who heads Baystate Health’s command center for COVID-19, described his experiences attempting to acquire N95 facemasks and related gear for workers to the New England Journal of Medicine on Friday.
In the past, getting needed facemasks and supplies probably took Artenstein all the time it takes to sign a requisition form. He signed, someone passed it on to Accounting where a check was cut, things happened and stuff showed up.
“As a chief physician executive, I rarely get involved in my health system’s supply-chain activities,” he told the journal. “The COVID-19 pandemic has changed that.”
Now, Artenstein and all of his co-workers have a much bigger role and a much bigger stake in making sure PPE are available. One of the first things they need to do is figure out where in the world to find the equipment.
According to the Los Angleles Times, at one point a deal involving a load of 250,000 triple-ply face masks with N95 respirators came up on Artenstein’s radar. He had learned from an acquaintance of a friend of one of his co-workers a supplier was willing to take $5 per mask — five times the normal price. Still, even at that rate the masks were a bargain in lives saved.
The first step was to make sure the alleged broker was, indeed, capable of getting the materials and in the quantities needed. It took hours to vet the supplier who, as it tuned out, was a player at the level Artenstein needed
Samples of the Chinese-made masks were sent via over-night express and were exactly what the Springfield health workers needed. Now, they had to find a way to get the pallets of masks to Springfield without losing it to the federal government or some other state.
Earlier deals had disappeared, Artenstein said when prohibitive counteroffers from other states or the brawn of the Department of Veterans Affairs meant the supplies were not coming to Springfield.
Despite all the planning, just hours before the scheduled handover of the product, the Baystate group learned they would only get a quarter of what they ordered. The deal had to continue because the masks were desperately needed. Not enough masks was better than no masks at all.
Finally, Artenstein and his group met with the supplier in a warehouse and watched as pallets of the materials were unloaded. A final quality check made sure they were as advertised and the load was packed into the two tractor-trailer rigs bound for Massachusetts.
Just then, two FBI agents walked into the warehouse. The short supply of PPE around the world has created a very lucrative black market for medical gear, and the agents wanted to know who was moving such a large quantity of masks.
A credential check and much cajoling worked for the group and the agents released the shipment. While the FBI was done with him, to his horror Artenstein found out the Department of Homeland Security was sniffing around the buy and they were looking into redirecting the masks to federal use.
A fast call to congressmen who could help finally convinced DHS this particular shipment was more trouble than it was worth. The two trucks pulled out of the warehouse and on their respective ways.
Artenstein kept looking over his shoulder until both trucks pulled into Springfield and all the pallets were safely locked in a Baystate storage facility.
“Did I foresee, as a health-system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organization would ever be faced with such a set of circumstances? Of course not,” Artenstein said. “This is the unfortunate reality we face in the time of COVID-19.”
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