PPE – The Most Frustrating
Letters of the Pandemic
June 2020 • DALLAS MEDICAL JOURNAL 5
Personal protective equipment
(PPE) has been ground zero for
DCMS members as it relates to
the COVID-19 pandemic that has
exploded across the United States. The
reasons for the shortage to the supply
chain are multifactorial. It many ways, the
shortage of PPE in the U.S. was a perfect,
predictable storm. For the past several
decades, the domestic manufacturing
of PPE items has declined while most of
that product development has shifted to
Asia, and China specifically. So when the
COVID-19 illness first broke out in Wuhan,
China, and grew rapidly, two phenomena
occurred that set in motion the massive
shortage of PPE across the rest of the
world, including the U.S.
The first bottleneck in the traditional
supply chain was the need for China to redirect
PPE to their own healthcare system
to care for the rapid spread of the disease
among a large segment of the dense,
urban population. It is unclear exactly how
many Chinese mainland residents were
ultimately infected with COVID-19, and how
many of those required medical care, but
based on anecdotal evidence, the outbreak
was severe and pervasive enough to shortstop
nearly all the PPE shipments out of
the country. This one action likely was the
most significant break in the supply chain
link and rippled across the rest of the
world.
The second issue that specifically
derailed U.S. physician access to PPE is
the method by which the Strategic National
Stockpile supplements state-based
Regional Advisory Councils (RACs) to
distribute PPE supplies. Given an already
troubled supply chain, for Texas (and
perhaps many other states), the policy
priority of the RACs was to prioritize PPE
shipments to hospitals first, then other
clinical facilities second, and lastly private
physicians, dentists, and first responders.
With the global supply chain rapidly coming
to a halt, this prioritization meant that
the few scant supplies that were being
sourced were immediately being shipped
to hospitals and there simply was nothing
left for the remainder of the providers.
Physicians across Texas immediately
began sounding the alarm bell when their
practice supply chain vendors no longer
could fulfill traditional orders. TMA and the
county medical societies went to work to
intervene in the state policy for distribution
of PPE in order to educate policy makers
on the need to divert some of the PPE
supplies to private practice physicians
so they could continue seeing patients
and perform in-office COVID-19 testing.
This was a critical argument by organized
medicine because doctors needed to be
part of the upstream solution to offering
COVID-19 testing in order to divert patients
from seeking tests at hospital emergency
departments, which were quickly filling with
actively sick COVID-19 patients.
In April 2020, the state RAC administrators
agreed to alter the prioritization system
and include private practice physicians
into the priority order for PPE supplies.
However, given the number of individual
doctors, the RACs partnered with DCMS
and other county medical societies to
function as the order fulfillment arm of the
process once bulk supplies were procured
by the RAC.
DCMS was pleased to partner with TMA
to lean in and develop a robust system for
physicians to enter their PPE needs into
an online PPE Portal. DCMS then worked
with the RAC to procure pallets of PPE
items each week based on the requests by
DCMS members, and then distribute those
items to individual physicians. Through
four weeks of the program (as of May 29),
DCMS has distributed over $450,000 and
210,00 pieces of PPE supply to DCMS
physicians.
Throughout the pandemic, DCMS has
been here for our members to assist
however we can as our physicians navigate
perhaps the most significant disruption
to their practices ever experienced. We
know that PPE supplies have a been a
major component of that disruption and
are pleased that we could offer value to
members during the most difficult days.
After COVID-19 subsides, you can continue
to count on DCMS to be here for you as
we all learn to serve the community going
forward.
Jon R. Roth, MS, CAE
DCMS EVP/CEO
D C M S E V P C E O
Jon R. Roth, MS, CAE