Scaling up operations during Covid-19 with technology
It's no secret that the pandemic has uprooted every cornerstone of our day-to-day life. Consequently, the spread of COVID-19 has required our global healthcare network to rethink operational strategies to meet the crisis' demands. With the pandemic overwhelming healthcare systems – locally, nationally and globally– the global healthcare network had to rapidly respond to the challenges and upscale their healthcare capabilities to meet the pandemic's unprecedented demands.
As a manufacturer of key medical equipment, the global pandemic has obviously placed Marathon Medical in a position to help healthcare professionals and their patients in a time of extreme need. However, in a practical sense, it also posed a significant logistical and business challenge: how could we scale our operations quickly enough to meet the need, without either diminishing the quality of these vital products or putting our business in future jeopardy.
This was a challenge facing healthcare suppliers across the globe. Hospitals were running out of ventilators and had to turn away patients due to lack of supplies. Due to this increased demand, analysts predict that the medical supplies market size will reach $100 billion by 2021, a 13.4 per cent increase from 2019.
For us, seamlessly scaling business efforts was necessary at the onset of the pandemic to rapidly increase our production of the most critical items, such as surface disinfectants and ventilators, to the broader medical community.
This obviously posed significant challenges for Marathon Medical, but also for healthcare providers who still needed certainty around the delivery – and future availability – of vital medical equipment.
To tackle this unprecedented challenge, we needed to be nimble enough to pivot support for our customers, which required us to forecast the demand for equipment and supplies, manage inventory effectively and distribute rapidly. This business challenge was only further compounded by the unwavering need to keep up with demand without compromising or reducing quality and safety.
To do this, we placed a significant focus on resource planning and leaned heavily on our cloud-based business management software. We worked in partnership with Sage before the pandemic to help optimize our business, but having ready access to the key data needed to make informed decisions and rapidly scaling our operations has been critical over the past seven months.
Not only did it help us ensure we could develop and deliver the supplies needed to meet the increased demand, but on the distribution side we are able to supply the right number of products, forecast demands and provide accurate, up-to-date information.
It’s this ability to plan – and adjust quickly as needed – which has helped us service the most extensive integrated health care system in the United States, The Veterans Health Administration (VHA), without skipping a beat. It’s also one of the reasons why the federal government was relying on us to provide over $27 million worth of medical syringes, vials and needles to administer a billion COVID-19 vaccines, when one becomes available.
In addition to scaling to meet the immediate global crisis, it was also important that we weren’t making decisions that put our business future at risk or could impact our ability to continue delivering the equipment our existing customers still needed. In this regard, being confident in financial software to automate and streamline invoice and bill collection, minimizing record-keeping redundancies and errors, as well as quantify budget planning has been critical. This allowed us to remain focused on the present crisis and how we can help, while remaining confident that the future of our business remains solid.
Ultimately, technology is enabling us to meet our end of the contract with the Federal Government, and we are honored to be the medical equipment supplier for such an important, life-changing program. Our manufacturers also move us forward; it is their support and commitment to our align mission, and their technology in place to keep the supply chain moving, that enables us to provide excellent products to the broader healthcare community.
The challenges to vaccine distribution affecting everyone
While it is comforting to know that vaccines against COVID-19 are showing remarkable efficacy, the world still faces intractable challenges with vaccine distribution. Specifically, the sheer number of vaccines required and the complexity of global supply chains are sure to present problems we have neither experienced nor even imagined.
Current projections estimate that we could need 12-15 billion doses of vaccine, but the largest vaccine manufacturers produce less than half this volume in a year. To understand the scale of the problem, imagine stacking one billion pennies – you would have a stack that is 950 miles high. Now, think of that times ten. This is a massive problem that one nation can’t solve alone.
Even if we have a vaccine – can we make enough? Based on current projections, Pfizer expects to produce up to 1.3 billion doses this year. Moderna is working to expand its capacity to one billion units this year. Serum Institute of India, the world’s largest vaccine producer, is likely to produce 60% of the 3 billion doses committed by AstraZeneca, Johnson & Johnson and Sanofi. This leaves us about 7 billion doses short.
Expanding vaccine production for most regions in the world is complicated and time-consuming. Unlike many traditional manufacturing operations that can expand relatively quickly and with limited regulation, pharmaceutical production must meet current good manufacturing practice (CGMP) guidelines. So, not only does it take time to transition from R&D to commercial manufacturing, but it could also take an additional six months to achieve CGMP certification.
The problem becomes even more complex when considering the co-products required. Glass vials and syringes are just two of the most essential co-products needed to produce a vaccine. Last year, before COVID-19, global demand for glass vials was 12 billion. Even if it is safe to dispense ten doses per vial, there is certain to be significant pressure on world supply of the materials needed to package and distribute a vaccine.
It is imperative drug manufacturers and their raw material suppliers have clear visibility of production plans and raw material availability if there is any hope of optimizing scarce resources and maximising production yield.
It is widely known by now that temperature is a critical factor for the COVID-19 vaccine. Even the regions with the most developed logistics infrastructures and resources needed to support a cold-chain network are sure to struggle with distribution.
For the United States alone, State and local health agencies have determined distribution costs will exceed $8.4 billion, including $3 billion for workforce recruitment and training; $1.2 billion for cold-chain, $1 billion vaccination sites and $0.5 billion IT upgrades.
The complexity of the problem increases further when considering countries such as India that do not have cold-chain logistics networks that meet vaccine requirements. Despite India’s network of 28,000 cold-chain units, none are capable of transporting vaccines below -25°Celsius. While India’s Serum Institute has licensed to manufacture AstraZeneca’s vaccine, which can reportedly be stored in standard refrigerated environments, even a regular vaccine cold chain poses major challenges.
Furthermore, security will undoubtedly become a significant concern that global authorities must address with a coordinated solution. According to the Pharmaceutical Security Institute, theft and counterfeiting of pharmaceutical products rose nearly 70% over the past five years. As with any valuable and scarce product, counterfeits will emerge. Suppliers and producers are actively working on innovative approaches to limit black-market interference. Corning, for example, is equipping vials with black-light verification to curb counterfeiting.
Clearly, this is a global problem that will require an unprecedented level of collaboration and coordination.
Disconnected information systems
While it is unreasonable to expect every country around the world will suddenly adopt a standard technology that would provide immediate, accurate and available information for everyone, it is not unreasonable to think that we can align on a standard taxonomy that can serve as a Rosetta Stone for collaboration.
A shared view of the situation (inventory, raw materials, delivery, defects) will provide every nation with the necessary information to make life-saving decisions, such as resource pooling, stock allocations and population coverage.
By allowing one central authority, such as the World Health Organization, to organize and align global leaders to a single collaboration standard, such as GS1, and a standard sharing protocol, such as DSCSA, then every supply chain participant will have the ability to predict, plan and execute in a way that maximises global health.
Political influence and social equality
As if we don’t have enough stress and churn in today’s geopolitical environment, we must now include the challenge of “vaccine nationalism.” While this might not appear to be a supply chain problem, per se, it is a critical challenge that will hinge on supply chain capabilities.
In response to the critical supply issues the world experienced with SARS-CoV-2, the World Health Organization, Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) formed Covax: a coalition dedicated to equitable distribution of 2 billion doses of approved vaccines to its 172 member countries. Covax is currently facilitating a purchasing pool and has made commitments to buy massive quantities of approved vaccines when they become available.
However, several political powerhouse countries, such as the United States and Russia, are not participating. Instead, they are striking bilateral deals with drug manufacturers – essentially, competing with the rest of the world to secure a national supply. Allocating scarce resources is never easy, but when availability could mean the difference between life and death, it becomes almost impossible.
Global production, distribution and social equality present dependent yet conflicting realities that will demand global supply chains provide complete transparency and an immutable chain of custody imperative to vaccine distribution.
The technology is available today – we just need to use it. We have the ability to track every batch, pallet, box, vile and dose along the supply chain. We have the ability to know with absolute certainty that the vaccine is approved, where and when it was manufactured, how it was handled and whether it was compromised at any point in the supply chain. Modern blockchain technologies should be applied so that every nation, institution, regulator, doctor and patient can have confidence in knowing that they are making an impact in eradicating COVID-19.