From the Desk of Devendra Mishra

Executive Director  & Co-Founder, BSMA

The most apocalyptic crisis since the global influenza pandemic of 1918-1919 has led to over a million people infected and 70,000 lives lost to COVID-19 a century later. In the absence of a timely national response, the most severely afflicted States have been continually building a supply chain to save lives. Andrew Cuomo, the Governor of the State of New York of USA, has emerged as the Chief Supply Chain Officer, like the United States Army General Herbert Norman Schwarzkopf Jr. who planned and led Operation Desert Storm, defeating the Iraqi Army and liberating Kuwait in early 1991. This had been an exceptional deployment of supply chain management in terms of the air and ground logistics of soldiers, armaments, equipment and information.

The anatomy of the evolving supply chain has consisted of 1. Planning for the Surge, 2. Data Modeling for Prediction and Adaptation. 3. Integrated Health Information System, 4. Collaboration for Scale and Synergy, 5. Strategic Sourcing and Centralized Inventory Management, and 6. Planning for Restoration of the Economy.

PLANNING FOR THE SURGE

Andrew Cuomo was unambiguous in stating his mission to be “preparing our hospital system so it is not overwhelmed when the apex of the curve hits and ensuring people stay home so they don’t get the virus in the first place. We are following the mathematical projections of the experts and preparing for the main battle at the apex by procuring as much equipment as we can, increasing our hospital capacity and supporting hospital staff.” He set the goal of every hospital in the State to build 100% additional capacity of beds. Considering that there are about 200 hospitals in New York State, totaling 53,000 beds with 20,000 of those in New York City, the strategic objective was an impetus for a transformation of the supply chain. The unprecedented crisis was addressed with an unprecedented organizing endeavor.

DATA MODELING

Since the first COVID-19 case was confirmed in the state on March 1, computer models have refined their projections at universities and agencies with millions of new data points to provide the most educated guesses about how COVID-19 will spread or recede. No modern-day catastrophe has relied so heavily on mathematical modeling to make predictions, anticipate impacts and plan for worst-case scenarios than the Coronavirus pandemic.

STATE-WIDE HOSPITAL INFORMATION SYSTEM

After the State of New York recorded more than 100,000 COVID-19 cases and 1,500 deaths, Governor Cuomo launched an online portal to connect hospitals and healthcare facilities across the State. The plan merges them into one operating system with hospitals spread from Buffalo to NYC. Hospitals will be sharing staff, patients, and supplies for the foreseeable future, with Albany overseeing the distribution of resources. Data managed includes demand (patient registrations, treatment, recovery, deaths, etc.), assets (hospital facilities, ICU and regular beds,  equipment and tools), inventory of products and supplies (ventilators, masks, swabs, etc.), human resources (doctors, nurses and others), and hospital metadata. The team will be led by the State Department of Health and includes the Westchester, New York City and Long Island healthcare systems, the Greater New York Hospital Association and the Healthcare Association of New York State. The team will also work with FEMA and the federal government.

A new hospital network Central Coordinating Team will help facilitate a more coordinated and strategic approach among the state’s healthcare system. The coordinating team will help implement the statewide public-private hospital plan to share information, supplies, staff and patients among hospitals across the State. The team will be responsible for organizing upstate to downstate staffing; assisting Elmhurst Hospital and other stressed hospitals; setting patient thresholds for hospitals; organizing patient transfers to other hospitals and the USNS Comfort; coordinating State-City stockpiles and individual hospital stockpiles; and, facilitating staffing recruitment.

With nearly 80,000 healthcare workers who have volunteered to work on a temporary basis during the COVID-19 pandemic, the portal will prioritize the deployment of workers to hospitals with the greatest need.

Ironically, the opponents of Cuomo’s plans view the pioneering initiative as being on the verges of socializing the entire system. On the other hand, drawing from a page from the playbook for dealing with a natural disaster, has been a common practice of a State Regulatory Authority to impose an emergency, like what was recently done for Hurricane Katrina.

STRATEGIC PROCUREMENT TO BUILD CENTRALIZED STOCK

New York will partner with six other neighboring States (New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts) of the Northeast will buy critical coronavirus supplies, and Empire State officials will mandate hospitals statewide to stockpile at least 90 days’ worth of protective gear in preparation for a possible second wave of the contagion. The consortium of seven States will enter the marketplace together to buy some $5 billion of personal protective equipment, tests, ventilators and other equipment from companies and overseas suppliers. The seven states are already partnered to move towards a gradual reopening of their respective economies.

ECONOMY RESTORATION STRATEGY

Saving lives and restoration of livelihood is the current challenge of the nation while avoiding a second wave of the disease. Governor Cuomo announced the State’s 5,000 independent pharmacies can now start testing for COVID-19. Due to supply chain and testing equipment shortages, the state health department still prioritizes testing for people who need hospital care, though there has been an increased capacity to test for essential healthcare workers and first responders.

Consultants have been entrusted with the task of developing a science-based plan for the safe economic reopening of the region. McKinsey & Company is producing models on Coronavirus testing, infections and other key data points, that along with other research and expert opinions, will help underpin decisions on how and when to reopen the region’s economy. Deloitte is also involved in developing the regional plan.

The Governor laid out battle plans for a potential second wave as the virus’ first strike continued to kill hundreds of New Yorkers. Meanwhile, the Metropolitan Transportation Authority also announced Saturday that they will be checking employee temperatures at more than 70 rotating locations through their Temperature Brigade team.

FUTURE CANNOT WAIT, IT IS HERE!

The Coronavirus pandemic has made “supply chain” a household colloquial word which is clearly understood by one and all. The loss of lives leaves no choice but transform the supply chain for a quantum leap in resilience, rapid response and responsibility. The leadership of Governor Cuomo in supply chain execution has offered building blocks of a model for the country and the world. Innovations in the future will find their roots in some of these.

  • The pioneering initiative of the NY State to build a Hospital Information System will spread to the 50 States, finally resulting in a National Health Information System.
  • Data Gathering, Data Modeling and Visibility of diseases and patients have got an impetus to formulate acceptable norms for privacy of personal health information.
  • Linkage of CDC with similar organizations across the world is imperative for global healthcare because we have realized painfully how inter-connected human beings are. Social Media information will prove to be complimentary.
  • The morphing of drug development with clinical trials and commercialization has proved that necessity is the mother of invention.
  • Technology to enable distributed, remote healthcare will expand the niche of telemedicine where smart phones and IoT will be critical drivers.
  • Supply chain of Life Sciences will be reconfigured for significantly greater speed, agility, resilience and patient care.