The COVID-19 has had an unprecedented impact on America’s economy, organizations, communities and families.
But the med/surg industry did not sit idly by. Whether working from home or working with an extensive list of protocols and safeguards, the industry’s med/surg reps, warehouse workers, truck drivers and more rolled up their collective sleeves and went to extraordinary lengths.
The following is part one of a two-part series of stories that delve into different facets of the industry’s response to COVID-19, and how it has impacted the marketplace.
Medical Resources: Innovation amid a pandemic
Keep moving forward. That was the message Randy Reichenbach, general manager of Medical Resources, an IMCO member, wanted his team to keep in mind as they tried to keep up with the unprecedented demand for products amid the COVID-19 pandemic.
Everyone in healthcare was feeling the pressure, he said, especially on the provider side. And not just the frontline caregivers, but the purchasing departments trying to keep them well supplied, staff and caregivers at nursing homes and assisted living, as well as responders like EMS, police, National Guard and armed forces personnel. “Every time we started getting stressed, we’d take a step back and say ‘You know what? We’re not frontline providers and staff,” said Reichenbach. “We’re in a protected environment working to provide product where we can.’ So we’d look at it that way: ‘Okay, let’s keep moving forward.’”
Despite being short staffed and working through supply disruptions, Medical Resources continued to deliver product amid skyrocketing demands. Reichenbach said they would get a lot of calls wanting product at the last minute. For instance, one caller asked for 250 IV poles in two days. When told Medical Resources could probably do it in two weeks, they at first declined, but then would call back a day or so later saying they would take them. In another instance, a potential customer would ask Medical Resources to find 500 hospital beds, but wouldn’t have a Purchase Order ready. “It’s been crazy for us, and for our customers that are on the hospital side.”
However, the scene was markedly different at physician offices and surgery centers. “They weren’t doing anything,” he said. “They were closed down. So, businesses have had some ups and downs.”
Bringing new products to market
Reichenbach said they started running across so many situations where there weren’t any products available that Medical Resources decided to make its own in certain categories. Some of the products Medical Resources came to market with included stainless-steel hand washing stations, plexiglass dividers where healthcare providers had intake to separate staff from patients and staff from staff, and room dividers. They worked with a group from the University of Cincinnati and Procter & Gamble to develop a ventilator, and got involved in the design of a first responder respirator.
“I think you’re going to see a lot of manufacturers, distributors and other people step up with these kinds of initiatives,” said Reichenbach.
Reichenbach said their customer base has shifted to sources outside of healthcare as a result of COVID-19. “We’re getting calls from hotels, casinos, cruise ship companies, interior design groups, grocery – all looking at how they can have cleaner facilities,” he said. Many organizations are wanting to move away from open offices back to closed office settings.
They’re also inquiring about innovative infection prevention solutions. “Ultraviolet cleaning is a hot topic,” said Reichenbach. “We’ve put out about $800,000 of quotes in the last two weeks on just UV cleaning.” Medical Resources has also received many calls from healthcare and private sector businesses and manufacturers about CuVerro Antimicrobial Copper, a solid surface that continuously kills 99.9% harmful bacteria when cleaned regularly, according to studies.
Sidebar:
Infection prevention should remain ‘a big deal’
Reichenbach said there are a lot of lessons the industry has learned from COVID-19, especially the importance of proper infection control. Healthcare providers should be implementing increased hand washing, enhanced terminal cleans, disinfectants and PPE, plus new ones to mitigate HAIs and to decrease cross infection. “That’s a really big deal. I hope it’s not one of those things where when this goes away everyone forgets about it.”
Previous to COVID-19, proper infection prevention had been hit or miss at hospitals and healthcare facilities. “Over the years, I’ve seen a lot of hospitals that are really clean and well-managed. But, I’ve also seen a lot that weren’t. And I think we’ll see a really big push too increase the amount of cleanliness in hospitals and nursing homes.”
McKesson: Answering the call
On Friday, March 21, 2020, Tad Strong, vice president of global supplier operations, McKesson Medical-Surgical, received a phone call from his boss, Andy Birken, who wanted to talk about a project through the Federal Emergency Management Agency (FEMA) called Project Airbridge. The federal government was reaching out to suppliers, delivery companies and other healthcare stakeholders for their help in getting critical personal protective equipment (PPE) to the United States more quickly.
That one call extended through the entire weekend, resulting in a massive mobilization that would put
McKesson’s capabilities to the test as it began putting together the requirements for Project Airbridge. Strong’s team (in the United States and China) quickly received notification that McKesson was asked to participate in Project Airbridge and was told its first flight was scheduled to depart in a matter of days.
Shifting modes
Now engaged in the massive effort to quickly get critical PPE to the U.S. and then to the frontline healthcare workers, McKesson shifted its global supply chain operations from ocean (sea) freight to air freight for PPE products in less than a week.
Strong’s team created a bridge line with Radiant Global Logistics (FEMA’s agent for all aircraft) and FEMA to discuss daily operations and planning for all FEMA flights carrying McKesson supplies. The team identified key external supply chain partners to provide support between McKesson and its PPE suppliers. “They assisted our efforts by helping us move freight within China and Malaysia from the factories to the airports,” Strong said. “These supply chain partners also provided warehousing and load planning for the FEMA aircraft. We immediately shifted from our standard transportation process and started transporting product to multiple staging areas and airports to expedite air freight departure to the United States.”
McKesson added additional internal resources to support all the extra work required for a successful operation. Strong said staff was temporarily brought in to manage the communications and reporting for the entire project, and McKesson’s internal U.S. Customs brokerage team quickly jumped in to help with the clearance of all product arriving in the United States.
Through the coordinated effort, as of June 1, McKesson has accelerated the supply chain delivery time for over 405 million eaches of a variety of PPE products, including gloves (nitrile, latex, and vinyl), gowns, coveralls, masks (N95, procedure, and surgical), face shields, thermometry, and respiratory items.
Once the products arrived in the United States, McKesson teams were able to efficiently distribute the PPE to the nation’s frontline healthcare providers in the COVID-19 hot zones, as well as other areas and providers throughout the United States. “The expedited arrival of the PPE has played a big part in bridging the demand gap by using air freight, getting critical supplies to the U.S. in 2 to 3 days verses 30 to 40 days,” said Strong. “The PPE items help protect our health care providers on the front lines and better equip them while they attend to the American people.”
The project has been incredibly rewarding, Strong said. “As I stated earlier, McKesson was able to work closely with FEMA and other government agencies, supply chain partners, our global suppliers, and many others to more rapidly bring much-needed PPE to the frontline healthcare workers to battle the COVID-19 pandemic,” said Strong. “It has been amazing to see a large organization like McKesson be so nimble and I am proud to be a part of the team.”
Personally, Strong’s daughter is an RN in a hospital in Birmingham, Alabama, and she has expressed the challenges of getting PPE in her hospital. “I know the efforts of McKesson and the other participants of Project Airbridge directly have played a big part in changing that.”
Sidebar
No shortage of obstacles
Tad Strong, vice president of global supplier operations, McKesson Medical-Surgical highlighted several challenges his team faced while participating in Project Airbridge:
- “We were asked to change our standard ocean container freight supply chain strategy to an air freight strategy in 5 days.”
- “We were challenged with providing enough product to fill a 747 every other day. As a reference, a 747 (400) holds roughly 5-6, 40-foot sea containers of products. Getting all of the required product to the departing airports with all the congestion led to changing flight schedules and 10-hour delays in receiving product from our suppliers.”
- “We asked all our PPE global supplier partners to provide product daily instead of a bi-weekly production schedule.”
- “Regulations that involved Chinese customs clearance for PPE products were revised multiple times just in the month of April. This caused delays in product leaving the country and many added hours of additional paperwork for the suppliers and distributors trying to clear the product for flights bound to the United States.”
CME: Plan, Procure and Install Three Alternate COVID-19 Hospitals in Three Weeks
On March 30, 2020, CME Corp. (CME), a national full-service equipment distributor and NDC member, got a call from David Schnell, branch preparedness chief at the Rhode Island Emergency Management Agency, asking if CME would be interested in working with him on three different alternate hospitals treating COVID-19 patients in and around the Providence, Rhode Island area. The state needed to have properly equipped multiple alternate hospital sites up and running in a compressed timeframe.
“Even though CME was working hard on many other critical COVID-19 projects across the country, we could not refuse the chance to help our home state of Rhode Island with their COVID-19 preparedness plan,” said Normand Chevrette, president, CME.
The project involved planning, sourcing, receiving, staging, warehousing, assembling and delivering 15,893 items from 55 manufacturers to three sites in Providence, Cranston and North Kingston, Rhode Island. The entire project added 1,385 beds designated for low-acuity COVID-19 patients managed by two large IDNs. Over five government agencies, two hospital systems, a project management team, an equipment planning group, a construction company, Rhode Island Disaster Medical Assistance Team (RIDMAT) and CME all collaborated in the planning and execution of the project. Government agencies included the National Guard, Office of the Governor, the Rhode Island Department of Health, the Rhode Island Emergency Management Agency, the Department of Defense and local municipalities
From March 30 to April 1, CME assessed sites with the National Guard and project management team. The CME government team then reviewed equipment lists with operations and clinic staff from two local hospitals responsible for operating the three new facilities. On April 2 and 3, CME sourced all items and began procurement. From April 6 to April 14, products were received at CME’s Warwick warehouse where they were staged, assembled and prepared for delivery. By April 15, products began to be delivered to the three sites in 50-plus trucks by more than 20 CME installer and technical services teammates.
Obstacles to overcome
Challenges abounded. The most critical equipment needed for COVID-19 temporary facilities was in short supply or had long lead times, said Cindy Juhas, chief strategy officer, CME. The timeline was tight – CME was tasked to find equipment that could be delivered within a two-week timeframe. For example, the state needed 1,500 beds/mattresses, 1,200 commodes and 2,000 privacy curtains (3.6 miles of curtain). Equipment lists had to be created in a short timeframe.
Logistics, too, posed a challenge. The state of Rhode Island could provide no storage space for new equipment and had insufficient human resources to provide staging, assembly, installation and delivery direct to the rooms. Two of the three facilities required the assembled equipment delivered in a three-day period, including a weekend.
And, having so many federal, state and local agencies trying to accomplish the same goals with different operating and management systems provided additional complications.
Fortunately, CME maintains an up-to-date quick ship list that was utilized to find much of the equipment needed. Certain items had to be sourced from multiple vendors to get the large numbers needed. “CME created a team focused specifically on this project, including our government sales team and several other key teammates who called to get confirmation of product availability and ship dates from over 50 manufacturers,” said Cindy Juhas, chief strategy officer, CME.
CME made available the warehouse space and provided necessary staff to receive, inspect, stage, assemble and prepare for delivery. CME also opened its warehouse on a Saturday for the National Guard Commander and the Branch Preparedness Chief of the Rhode Island Emergency Management Agency to inspect portions of the received product. Over 20 CME teammates loaded trucks and delivered product over two and a half days, including a weekend.
Responsive and understanding
The project was primarily managed by an equipment planning group with direction from the Rhode Island Emergency Management Agency and the Rhode Island National Guard. “All parties involved had to be patient, flexible and timely in their response,” said Juhas.
The project was a success. Over 90% of the items were delivered within the timeframe presented. “Immediately upon being assigned the task of being on the Medical Surge Team, I thought about a local company in Warwick, CME Corp,” said Schnell. “Upon speaking to the CME staff, I knew I made the right call. They were responsive, understanding the urgency of the situation, and ready and willing to assist!”
Owens & Minor: In This Together
To acknowledge and thank teammates for their extraordinary efforts during the COVID-19 pandemic, Owens & Minor recently launched “In This Together,” a campaign to internally spotlight the people handling increased warehouse, manufacturing, and hospital on-site needs. As a second phase to the campaign, the company is also externally recognizing individual contributors for the same dedication. Owens & Minor highlighted several team members through social media channels using the #InThisTogether hashtag so others could follow and recognize their commitment. The following teammates are a few of those the company thanked for their hard work.
Lianne Owens is a warehouse coordinator that went above and beyond in Owens & Minor’s New York Distribution Center to support customers and their patients. “She is well-known by her teammates for her positivity and willingness to lend a helping hand,” the company said in a LinkedIn spotlight.
Matt Osborne is a warehouse specialist who volunteered to come in hours earlier than his scheduled start time to pick, process, and load freight going out to a customer’s COVID-19 warehouse that was not only servicing the customer, but an additional two hospitals.
Carol Timm is a safety & training coordinator who took on extra cleaning and inspecting duties and made sure that Personal Protective Equipment was available to keep all teammates safe.
Henry Schein: Extraordinary levels of commitment
By Stanley Bergman, Chairman of the Board and CEO, Henry Schein, Inc.
Editor’s note: In a letter to Henry Schein team members, Stanley M. Bergman, Chairman of the Board and CEO, Henry Schein, Inc., offered some perspective on the challenges created by COVID-19, as well as how the company has rallied to meet the needs of the nation’s caregivers.
History has repeatedly shown us that during exceptional times, heroes rise to the challenge of the day. We see heroes in the healthcare professionals – doctors, dentists, physician assistants, nurses, emergency medical technicians, dental hygienists, dental assistants, and so many more – battling the virus on the front lines of the pandemic. These healthcare professionals and those working in essential services who deliver products and keep the shelves filled so the rest of us can receive necessary food and medicine are heroes. Let’s not forget the millions of self-sacrificing heroes who sit in isolation as we collectively try to halt the spread of this dreadful disease.
Team Schein, of course, has our own heroes. Throughout our Company, we are seeing extraordinary levels of commitment, innovation, and teamwork – qualities that have distinguished Team Schein for decades. Because of Team Schein, our Company has rallied to handle these extraordinary challenges in an extraordinary way, and we will emerge from the COVID-19 crisis strong and well positioned to continue to be there to assist our customers providing high-quality care to patients.
DUKAL: Getting creative to solve widespread challenges
As the COVID-19 pandemic spread, the scope of work didn’t increase incrementally for manufacturers like DUKAL.
It exploded. “It was all hands-on deck for DUKAL employees,” said Travis Torre, director of logistics. “We started having daily COVID-19 pandemic meetings where every detail you can imagine was discussed and dissected over and over.”
This proved to be the catalyst for operations, sales, purchasing, customer service, marketing “and our amazing Shanghai office to execute the daily changes,” said Torre. Twelve-hour days became the norm with every department in constant collaboration.
Internally, DUKAL’s management team had the foresight to invest in technology to make sure that every employee could work from home and still run our company. “The IT team worked overtime to get this done and it was no easy task,” Torre said. “There was some trepidation at first, unsure if we could pull this off seamlessly while continuing to run the business as we did in our office setting. I am proud to say that we succeeded, and as a result were able to help and continue to supply our customers with much needed medical products.”
There were many challenges that presented themselves, said Torre. On the purchasing/vendor side product costs skyrocketed for many reasons, such as lack of raw materials, and an unprecedented demand. Also, vendors were changing terms and asking for pre-payments along with higher cost products. “Additionally, air carriers were asking for 100% payment before the shipments even flew,” said Torre. “This could have put a strain on capital, but fortunately we started in a solid position having a sound company and a great CFO. This allowed us to navigate through this unprecedented challenge.”
The DUKAL team also encountered many logistical challenges. “Due to the dire need of PPE products and masks we have had to do over 100 air shipments at rates we have never seen before and hope to never see again,” Torre said. Finding and booking space with airlines was another obstacle. With the Wuhan airport closed, the Shanghai airport was “pretty much the only game in town,” he said. “We had to get creative with destination airports you would not logistically bring cargo to under normal circumstances. For example, there was a situation in which we had to deliver a critical shipment to a customer in New York. JFK airport was not the best choice at that time due to cost and flight scheduling. As a result, we ended up routing the shipment into Chicago’s O’Hare airport and then trucked it to New York.
“Early on if you were manufacturing or had vendors in the Hubei province it was almost impossible to find truckers to bring your cargo to Shanghai because of the restrictions and checkpoints,” Torre continued. “The Wuhan Port was closed and you could not use the Yangtze river feeder service for your containers to the Shanghai Port. However, having longtime positive relationships with vendors and our Shanghai office significantly decreased potential issues with our containers. We also paid a premium cost to use an ocean carrier with an established rail network in the United States that allowed our container cargo to reach its ultimate destination in shorter transit time.”
A desire to help others
DUKAL was able to navigate those challenges with the leadership and passion of the owner of DUKAL, Gerry LoDuca, Torre said. “Gerry’s love of this business, and desire for helping other people set the example for every DUKAL employee to follow.”
Torre said the DUKAL team grew as a company through this pandemic and learned more about each other and “what we can do with this company. Having smart, dedicated, and loyal employees is a recipe for success. As a group we were able to come up with many creative solutions to aid our customers.”
Also, Torre said they would not have been able to succeed without an amazing support system in their supply chain. “Much of our success is tied to our 3PL and freight forwarder/customs broker. We are very fortunate to have such a great logistical supply chain that worked around the clock for us. We would not have been successful without them.”
Taking care of DUKAL’s customers turned into a monumental challenge during the onset of the pandemic, Torre said. “DUKAL rose to that challenge, effectively helping our customers, to help our local communities through the acquisition and distribution of desperately needed medical supplies.”
Sidebar:
Lessons learned
Our industry will need to take a hard look at whom to go into partnership with, Travis Torre, director of logistics, DUKAL. “We need to ask the question, ‘Who did the right thing during the pandemic and who did not?’ When the dust settles, I believe our industry should consider off-shore vs. on-shore vs. near-shore options for critical products. DUKAL looks to be a leader in these discussions. We look forward to sharing our experiences with the industry to help shape the healthcare supply chain of the future.”
Hillrom territory manager:
Doing what needs to be done
The COVID-19 pandemic brought with it a new set of risks and considerations when calling on healthcare providers. What wasn’t in question, though, was that those customers would continue to need essential equipment to deliver care.
Prior to the pandemic, many CHC and IDN customers had placed orders with Hillrom for essential equipment that happened to need delivery under the new “stay-at-home” orders, said Andrew Rose, territory manager, primary care, for Hillrom in Los Angeles/Orange Counties.
Rose was determined to get those orders to customers. “I am a relatively healthy individual with no underlying issues that would make me fear COVID-19, and I took several precautions so that I didn’t bring anything home to family or friends,” he said.
His decision was bolstered from Hillrom’s organizational support, he said. The company did not make it mandatory to either stay at home completely, or to go into the field as normal, “so that allowed each sales rep the latitude to make safe and supportive decisions within their own territory,” Rose said. “That being said, Hillrom has been amazing at stepping up quickly and efficiently to provide us with any and all tools we could possibly need to be able to demo, sell, and support our products remotely using WebEx, Zoom, and Microsoft Teams. They have also provided special training courses on how to be a more effective sales/support rep using these tools, which has helped many of us become more comfortable doing many things remotely while still remaining effective.”
Finding a groove
Rose said the main challenge of serving customers in the new environment dealt with enhanced screening protocols. “But once you get into the groove of what is and isn’t allowable, it’s pretty simple to make things work as close to normal as possible.”
Selling was more difficult, as the focus had switched to immediate care and triage of the pandemic. “For that month and a half period, if it didn’t have something to do with the COVID-19 response, clinics didn’t really have time to discuss, which is understandable,” said Rose. “We have taken the approach to support where we can and help clinics purchase essential equipment that they need right now to help mitigate the problem.”
Rose said he simply followed safe protocols and stayed available to his clinics to offer help and support wherever he could. “Clinics have been extremely responsive and appreciative knowing that they continue to have support from the makers of some of their most important diagnostic equipment. I think this has helped show that Hillrom isn’t just a company out for the almighty dollar; that we are truly interested in making a difference in our communities and to do the right thing in this troubling time!”
Rose’s biggest takeaway from the pandemic is how quickly the “norm” can change. “You need to keep a cool head and roll with the reality that you’re facing. If we all just slow down and look at the big picture, I think we can collectively make good decisions and turn things around quicker than some in the TV media give us credit for.”
Quidel: Significant ramp up, significant contribution to the fight against COVID-19
The challenge was monumental, and crucial, to the frontline caregivers battling COVID-19. Almost overnight, demand for Quidel’s SARs COV-2 assays skyrocketed as hospital labs scrambled to have the appropriate testing in place at their facilities.
Quidel responded by adding a significant volume of SARs COV-2 assays across the United States, and did so in a significantly short window of time.
Working around the clock
Getting in a position to ship out the SARs COV-2 molecular tests first involved a combination of studies and approvals, said Mike Abney, senior vice president of distribution, Quidel. “We had to perform the quickest set of studies that we’ve ever attempted,” said Abney. “And we had work with the FDA to gain EUA approval with a highly accurate assay.”
Then came the massive ramp up in production. Quidel’s supply chain went from 0 to 1 million tests produced in the first 30 days, and then to 1 million per week going forward, Abney said. “We also enlisted Cardinal to help us with distribution, and to inform the hospital laboratory market about the assay and to pre-qualify customers who needed tests. So the last step was getting all of the item details and pricing set up in two systems.”
The most unique challenge involved the increase of Quidel’s buying level on swabs, and transport media by 10-20 times the normal rate. “This has been a big challenge for all diagnostic test manufacturers in 2020, but was especially important for Quidel because we aim to provide everything the customer needs to perform the test in every kit we ship out, swabs and transport media included,” said Abney. “The fact that we have been able to hold up against that standard thus far during the pandemic is something that we are very pleased with. This will remain an issue for our industry in some form for the rest of the year.”
The project turned out to be the largest ever tackled at Quidel from a demand perspective, said Abney. “The first quarter of 2020 completed a record U.S. respiratory season, and the COVID-19 pandemic started while Influenza A was still at its peak. While our teams were in the middle of working overtime and weekends to meet the highest demand ever for our line of flu assays, we threw this project at them with the shortest timeline imaginable.”
Quidel’s Jon Dailey, associate director, Supply Chain; Nate Chapman, associate director, Molecular Manufacturing; and Ron Lollar, senior director, Clinical, Regulatory & Scientific Affairs worked around the clock to launch, secure the supply chain, and agree with the regulatory agencies for the Lyra SARs COV-2 assay. Due to the work of these three individuals and their teams, Quidel took the brand over the 1 million test mark in less than 30 days.
“Every team at Quidel has people that have been working around the clock, seven days a week for the last couple of months,” said Abney. “In some cases the entire team has been doing so. Outside of the essential teams to manufacture the product, we had to do a lot of this on the phone and through video conference, which we had to adapt to quickly. We’re used to getting in a room in San Diego face to face and hashing things out. Many people on the team have commented ‘this is the hardest I’ve ever worked,’ but it’s been thrilling and motivating and we’re all happy to be a part of it.”
Sidebar:
Lessons learned
The most obvious lesson from the COVID-19 pandemic? We have all learned “you can’t be too ready for the unexpected,” said Abney. “Our CEO, Doug Bryant, pushed us to hire a few more talented people than we thought we needed, and to beef up manufacturing capacity beyond the level we thought we needed, and suddenly we required all of it and more to answer the call to produce more tests for the pandemic.”
Also, the value of Quidel’s distribution partnerships has never been higher than it is today, Abney said. “We could not achieve the level of customer communication and logistics required to execute what we are trying to accomplish over the next year without them.”