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Managing Supply Problems and Shifting Bottlenecks

Managing demand needs to be complemented with effective strategies for managing the supply of resources needed to care for patients — obviously, not an easy task when dealing with a highly contagious disease like Covid-19. But it is crucial since not doing so can trigger vicious cycles, as we are already seeing.

Covid-19 cases increase demand for tests and for staff. The increase in demand for tests initially results in test shortages (and thus testing backlogs). Staff needs protective gear both to perform tests and to treat patients. So, not surprisingly, increases in patient flow create shortages of masks and other Medical Equipment.

Shortages of both testing and protective equipment leave staff vulnerable to infection. In Italy, health care practitioners constitute 9% of all Covid-19 cases. In Spain, the figure is 14%. And there is now a significant infection rate among health care workers in the United States, according to reports in The New York Times and The Boston Globe. High rates of infection among health care workers not only make already bad staffing shortages worse, but they also can increase demand if infected staff become a vector for transmission to patients who do not have Covid-19. The key challenge in dealing with supply shortages is to break these vicious circles. There is no one way to do this, but applying some of the principles below should be helpful.

Dealing with acute shortages means identifying the root source of the shortage and focusing efforts there to expand or leverage available supply (which we discuss later). Because staff is a critical resource of almost every phase of health care delivery, protecting their health should be the number one priority. Increasing Ventilator production or creating new ICU beds is helpful only to the extent that there are staff available to operate that new equipment and care for the patients.

One way to save on big-ticket items is to avoid purchasing things that are available already for communal use at core or shared-research laboratories — Laboratory Equipment in which scientists can either book time on state-of-the-art equipment or pay staff to perform technically demanding experiments on their behalf.