Abstract
COVID-19 has made hospitals face the challenge of inadequate personal protective equipment (PPE) supply to guarantee the safety of medical workers. This problem should be examined from two perspectives: scientific and analytical ones. From the scientific perspective, it is necessary to address the questions on the nature of physiological, pathological, and epidemiological issues and on the types of PPE that can prevent the worsening of the epidemiological situation. From the analytical perspective, the questions to address are about economic issues related to the problem and the role of supply chains. Solutions presented in academic literature include ensuring that local supply chains are developed, and staff is provided with efficient PPE.
Introduction
The pandemic situation in the world that is associated with the spread of COVID-19 has led to the development of a specific problem related to the shortage of Personal Protective Equipment (PPE) supply in hospitals. While discussing this problem from the scientific perspective, it is important to focus on the following research question (Level 1): What are the anatomical, physiological, pathological, or epidemiological issues? This inquiry should be supported by one more research question (Level 2): What are the alternative sources or types of PPE that can contribute to preventing the worsening of the epidemiological situation? This topic should also be investigated from an analytical perspective. The main research question (Level 1) to address is the following one: What are the economic issues involved? To collect more information on this problem, it is also necessary to formulate the additional research question (Level 2): How can economic issues influence PPE supply chains? Although currently, the PPE supply issue in US hospitals and worldwide seems to be partially addressed, there is still a need for finding effective ways of responding to the situation to reduce its negative epidemiological effects.
Scientific Perspective of Inquiry
Anatomical, Physiological, Pathological, and Epidemiological Issues
PPE in the form of face masks, respirators, face shields, gloves, and gowns is traditionally used in clinical settings to prevent the transmission of infections to protect both medical workers and patients. If there is not enough PPE in a hospital, the risks of spreading infectious diseases increase significantly. In the situation of the COVID-19 pandemic, the usage of PPE is critical for the medical staff to stop the spread of the disease in clinical settings and guarantee individual safety (Livingston et al., 2020). If there is inadequate access to different types of PPE, healthcare providers face significant physiological and pathological threats of being infected. The risks of transmitting COVID-19 are significant because patients in hospitals are vulnerable to infections. When referring to the example of COVID-19, it is important to note that the infection is spread due to contact and droplet transmission, and in many cases, airborne transmission (Ip et al., 2020). PPE is critically important to protect medical workers and avoid being infected with the coronavirus. From the epidemiological perspective, the shortage of PPE in hospitals can negatively affect the further spread of the infection among patients.
Alternative Sources of PPE
Recent literature on the problem of PPE supply in hospitals presents researchers’ and practitioners’ opinions and results of studies on the availability of alternative sources of different types of PPE to prevent the further worsening of the epidemiological situation. The key solutions discussed in the literature include new approaches to sterilization and disinfection of PPE, the use of robots when it is possible, and the minimization of contacts with patients, among others. The key focus is on reusing PPE when it is guaranteed that the equipment is sterilized and on repurposing different protective items. Researchers and practitioners proposed to use different types of face masks to protect eyes, noses, and mouths (Rajak, 2020). Furthermore, alternative sources of face shields and gowns are also discussed in the literature (for example, sports eye protectors and helmets, plastic bags) (Burki, 2020). The ways of making PPE reusable and recyclable are also discussed in scholarly articles as effective approaches to contribute to making protective devices more accessible for healthcare professionals.
Mathematical/Analytical Perspective of Inquiry
Economic Issues Related to the Problem
The coronavirus pandemic has resulted in a variety of economic issues associated with the usage of PPE in hospitals. The key problem is linked to the necessity of spending more resources on personal protective equipment and finding new sources of these items to be used in remote areas. According to Ranney et al. (2020), the administration in hospitals in the United States and worldwide faced the economic burden associated with the necessity of addressing the shortage of PPE because the prices for masks, gloves, and shields increased significantly. As it is stated by Burki (2020), “the price of surgical masks had increased sixfold, the price of N95 respirators had trebled, and the price of surgical gowns had doubled” (p. 785). These data are reported in comparison to the prices noted when the pandemic started. Thus, the development of the pandemic has led to critical economic problems related to guaranteeing adequate PPE supplies in hospitals.
It is important to note that hospitals and other healthcare facilities faced the challenge associated with not only overcoming the lack of protective equipment but also with its costs. Low supplies of PPE are observed even today, and one of the key economic barriers and challenges at this stage is the establishment of the production of masks and gloves, as well as other PPE locally (Rowan & Laffey, 2020). The stabilization of prices for PPE along with access to all types of protective devices is required to ensure that the spread of the infection in hospitals is prevented.
Economic Issues Influencing PPE Supply Chains
It is stated in the literature on the topic that one of the key economic issues associated with the PPE supply in hospitals is the lack of effective supply chains. Currently used supply chains for addressing healthcare facilities’ demands for protective equipment are not efficient. The problem is that the limited trade and transportation between cities and countries affect the PPE supply significantly. As a result, researchers and analysts propose alternative approaches to addressing the problem (Ranney et al., 2020). One of the offered solutions is the necessity of making supply chains shorter and based on local producers if it is possible. Before COVID-19, China produced about 20 million masks daily, but this number was not enough to address global needs when the pandemic started (Burki, 2020). Currently, the global supply chain based on PPE produced in China should be replaced with local supply chains even though China has increased the manufacturing of masks and gloves recently. Furthermore, the focus should be on supporting local factories in producing more PPE to be used in hospitals and other clinical settings without dependence on wider supply chains.
Governments in different regions of the world have focused on controlling PPE supply in hospitals concerning sponsoring the production and purchase of cost-efficient and environment-friendly PPE. The communication lines between different suppliers and representatives of medical organizations should also be improved to avoid the shortage of PPE. The reason is that the demand for masks and gloves will increase, as it is forecasted by Burki (2020), 2.2 billion masks, 1.1 billion gloves, and 8.8 million face shields will be used by the end of 2020. In this context, the potential solution to the problematic PPE supply in the United States and globally is the creation of local supply, the extension of supply using local resources and alternatives ways, and the effective management of supply, selecting reusable and easily distributed items (Ip et al., 2020). All these solutions are proposed in the currently available academic literature on the problem of PPE supply in hospitals concerning the analytical perspective and the economic aspect.
Conclusion
Many hospitals and other healthcare facilities worldwide have recently faced the challenge of inadequate PPE supply to be able to guarantee the safety of medical workers. This problem has been discussed from two perspectives: the scientific and analytical ones. From the scientific perspective, the two important research questions to answer are associated with the nature of anatomical, physiological, pathological, or epidemiological issues related to the problem and the types of PPE that can prevent the worsening of the epidemiological situation. The research indicates that the focus should be on providing all the staff with PPE that can be offered in the form of common masks, gloves, gowns, etcetera, as well as non-traditional devices to protect healthcare providers’ faces and bodies.
From the analytical and economic perspective, the questions are posed regarding the economic issues involved in the problem and the role of supply chains. It has been found that the prices of PPE represent a significant economic burden for hospitals. However, one should note that more attention should be paid to refocusing on locally-based supply chains to guarantee easy access to PPE without depending on global supply chains as it was before the pandemic.
References
Burki, T. (2020). Global shortage of personal protective equipment. The Lancet Infectious Diseases, 20(7), 785-786.
Ip, V., Özelsel, T. J., Sondekoppam, R. V., & Tsui, B. C. (2020). VID-19 pandemic: The 3R’s (reduce, refine, and replace) of personal protective equipment (PPE) sustainability. Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, 1-2.
Livingston, E., Desai, A., & Berkwits, M. (2020). Sourcing personal protective equipment during the COVID-19 pandemic. JAMA, 323(19), 1912-1914.
Rajak, K. (2020). COVID-19 crisis prompting innovation in addressing personal protective equipment shortage. Journal of Patan Academy of Health Sciences, 7(1), 69-72.
Ranney, M. L., Griffeth, V., & Jha, A. K. (2020). Critical supply shortages—The need for ventilators and personal protective equipment during the Covid-19 pandemic. New England Journal of Medicine, 382(18), e41.
Rowan, N. J., & Laffey, J. G. (2020). Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic–Case study from the Republic of Ireland. Science of the Total Environment, 725, 138532.