Yesterday, scientists and supply chain experts participated in an /r/AskScience AMA, sharing the following:
"Since March, clinical microbiology laboratories have faced shortages of testing supplies, including SARS-CoV-2 molecular test reagents. Due to the growing demand and need for COVID-19 testing, production of supplies required to test for other infectious diseases has dwindled. This has led to a ripple effect of shortages and is causing a major delay in testing for common infections, such as urinary tract infections, sexually-transmitted infections including chlamydia and gonorrhea, gastroenteritis and cystic fibrosis."
You can review their findings here.
In surveying labs, their findings show:
-73% have a shortage of commercial testing kits for SARS-CoV-2
-65% of labs have a shortage of non-COVID-19 testing supplies for detection of routine bacteria (including the bacteria causing strep throat, pneumonia, bronchitis and urinary tract infections )
-70.8% of labs have a shortage of supplies for molecular detection of sexually transmitted infections
-17.6% have a shortage of supplies for mycobacteria testing (including testing for tuberculosis (TB), Buruli ulcer, and pulmonary nontuberculous mycobacterial disease)
-50% of labs have a shortage of supplies for routine fungal testing (ranging from superficial, localized skin conditions to deeper tissue infections to serious lung, blood (septicemia) or systemic diseases)
But this isn't just about lab supplies and equipment. There are also major logistical, labor, data and other shortages, issues or needs at the moment, right at a critical point before we head into a winter that will likely be a very dark time in the COVID era. And this is occurring after early failures at the expense of patients, with no improvements since.
Others are calling for Supply-Chain Collaboration, but will that really work without a coordinated national response? These shortages have yet to be fixed.
The AMA included:
-Dr. Amanda Harrington - PhD, D(ABMM) - Director, Clinical Microbiology Laboratory; Associate Professor and Vice Chair for Clinical Pathology; Department of Pathology and Laboratory Medicine, Loyola University Chicago
-Dr. Melissa MIller, Ph.D - D(ABMM), F(AAM) - Professor, Pathology & Laboratory Medicine; Director, Clinical Molecular Microbiology Laboratory; Director, Clinical Microbiology Laboratory, University of North Carolina School of Medicine
-Sherri Goodlove - Vice President, Marketing, Association for Supply Chain Management
-Peter A. Bolstorff, CSCP, SCOR-P - Executive Vice President, Corporate Development, Association for Supply Chain Management
-Dr. Susan Butler-Wu, PhD, D(ABMM), SM(ASCP) - Associate Professor of Clinical Pathology, Keck School of Medicine, University of Southern California, and Director of Clinical Microbiology at LAC+USC Medical Center.
Some of the most honest but disheartening responses in the AMA:
-Question: Back in the spring, non medical labs at our institution and many others donated reagents and supplies to support testing efforts. Is this type of contribution still ongoing, or has the supply chain as a whole just been altered? Is there a way to do this redistribution more systematically?
-Answer:
There have been and continue to be emergency response supply chain actions at local and state levels. Those actions benefit the population in those areas directly affected but because the actions are done mostly outside the 'the system', transparency and collaboration are difficult at best.
There has been a concerted effort to report an aggregated view of testing supplies from manufacturers but there is no end-to-end plan that coordinates the source, make and deliver processes nationally or even regionally. We've seen only incremental improvement since May and we are still wasting 60% of test capacity due to shortages.
Question: I'm curious about geographic trends. Are some regions/states/countries more affected by supply shortages than others?
Answer:
Every country developed or evolved it's own supply chain strategy in support of its COVID-19 response including testing capacity. Anecdotally, we have global stakeholders that have stated that coordinated response, public support and transparent data have led to significantly better impact.
Question: Why haven¡¯t rapid tests become more available? Does money have something to do with it?
Answer:
From a supply chain point of view -- getting to FDA approval for the test is a milestone but being able to effectively plan, source, make at scale, and deliver at scale is a nearly equal challenge. The pandemic is bringing to light that successful impact at the patient level requires a tight sync between both the development and supply chain teams.
Our next challenge will be the end-to-end COVID-19 vaccine supply chain and the impact it will have on COVID testing requirements. Stress testing critical care supply chains will be 'a thing' in the next 6 months.
If you're a member of a clinical microbiology lab and would like to get involved in data collection efforts, you can email the team for details.
posted by deludingmyself at 8:59 AM on October 28, 2020 [1 favorite]