An article in the Wall Street Journal details concerns about the supply chain for various drugs should a flu pandemic occur.
In the event of a pandemic flu outbreak, that chain is almost certain to break. Thousands of drug-company workers in the U.S. and elsewhere could be sickened, prompting factories to close. Truck routes could be blocked and borders may be closed, particularly perilous at a time when 80 percent of raw materials for U.S. drugs come from abroad. The likely result: shortages of important medicines -- such as insulin, blood products or the anesthetics used in surgery -- quite apart from any shortages of medicine to treat the flu itself.
The Journal notes that the widely embraced "just-in-time" business practice -- keeping minimal inventories and delivering products just when needed -- is at odds with the "just in case" rationale behind preparedness planning.
"Most if not all of the medical products or protective-device companies in this country are operating almost at full capacity," says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "That's the reality of today's economy: just-in-time delivery with no surge capacity."
The Journal says the severe acute respiratory syndrome (SARS) outbreak in 2003 in Canada offers a case in point.
When SARS hit, the country's largest nurses' union complained about a shortage of N95 masks after much of the existing supply was shipped to Asia, where the disease hit hardest.
These masks protect against contracting flu by filtering out at least 95 percent of certain airborne materials during normal breathing. Some nurses in Canada had to use less-protective masks when caring for SARS patients. Others were rationing the supply.
The main companies that manufacture the masks - 3M Co. and Kimberly-Clark Corp. - had to scramble to meet the sudden demand because, like many companies, they didn't have an existing stockpile.
The outbreak was relatively brief and limited in location - a minor blip compared with what would likely happen with pandemic flu.
Dr. Osterholm has proposed a national initiative to identify critical items and ensure their supply during a pandemic.
High on his list of "critical products" are tools for fighting flu itself, such as face masks, ventilators to help the sickest patients survive and syringes to administer a vaccine if one becomes available.
Dr. Osterholm, who also is associate director of the Department of Homeland Security's National Center for Food Protection and Defense, says the country also needs reliable supplies of food and water, the ability to keep heat working in northern climates and medical products for non-flu-related illnesses. The U.S. has 105,000 ventilators, most of which at any given time are in use. The federal stockpile of medical products has about 4,500 more. In a pandemic, tens of thousands more would be needed.
Source: Wall Street Journal, January 12, 2006. (The Journal is a paid subscription site, but this article happened to be carried in the Pittsburgh Post-Gazette, also.)