
COVID-19 Supply Chain Update - Reedx
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-supply-chain-update
======
jefftk
"Regarding personal protective equipment—surgical gowns, gloves, masks,
respirator protective devices, or other medical equipment designed to protect
the wearer from injury or the spread of infection or illness—the FDA has heard
reports of increased market demand and supply challenges for some of these
products. However, the FDA is currently not aware of specific widespread
shortages of medical devices, but we are aware of reports from CDC and other
U.S. partners of increased ordering of a range of human medical products
through distributors as some healthcare facilities in the U.S. are preparing
for potential needs if the outbreak becomes severe."

This is very weird: my understanding is that masks are sold out at standard
suppliers and have been for a while (though available at extremely high prices
from resellers). This seems like it is beyond "supply challenges" and into
being a "specific widespread shortage"?

~~~
mc32
I think they’re still in stock at _some_ Home Depots. At least last I checked.

In any case, an N95 mask is insufficient if you don’t cover eyes as well and
don’t use IPA70/Sporklenz or similar after touching any common surface. 10%
bleach should also work but it’s nastier (to skin and materials).

~~~
themodelplumber
> IPA70/Sporklenz

OK, searching on that term brings up an impressive number of PDF data sheets.

IPA70 seems to mean Isopropyl Alcohol, 70%.

Sporklenz no idea but it conjured up images of a European Homer Simpson
repping cleaning products as _Mr. Sporklenz._ (Herr Sporklenz?)

~~~
drewmol
Not sure about Sporklenz but yes IPA70 is referring to an Isopropyl Alcohol
solution of 70% isopropyl alcohol. Higher concentrations are also effective
but above 75% you risk burn or excessive drying upon direct skin contact.
FWIW, a 99% concentration will very quickly pick up atmospheric moisture and
stabilize closer to 96% in all but the most dry of environments.

~~~
dTal
50-70% IPA is actually a more effective disinfectant than 99%; the water helps
it penetrate cell walls, I'm told.

~~~
inferiorhuman
The water slows down the evaporation letting it linger long enough to be
useful (at least that's what I think I read). Either way, 70% is gentler on
skin. 90%+ is great for cleaning oily stains and whatnot.

------
citilife
This almost read like a bot wrote it...

> A manufacturer has alerted us to a shortage of a human drug that was
> recently added to the drug shortages list. The manufacturer just notified us
> that this shortage is related to a site affected by coronavirus. The
> shortage is due to an issue with manufacturing of an active pharmaceutical
> ingredient used in the drug. It is important to note that there are other
> alternatives that can be used by patients. We are working with the
> manufacturer as well as other manufacturers to mitigate the shortage. We
> will do everything possible to mitigate the shortage.

They don't name the manufacturer, the drug, or really much of anything.

~~~
frisco
This is called “Special English” aka “Simple English” or “Voice of America
English”. It is meant to be very clear and straightforward to understand to
minimize the possibility of miscommunication and make it so that non-experts
of all backgrounds can take away the important messages. Given how important
the medicine supply chain is to lots of people’s daily lives, I’m sure they
didn’t want this page to seem understandable only by the educated.

[https://en.m.wikipedia.org/wiki/Special_English](https://en.m.wikipedia.org/wiki/Special_English)

~~~
pyuser583
There is not enough of a drug, according to a drug maker. There aren’t enough
ingredients to make the drug. The missing ingredients are made at a place
affected by the coronavirus.

Fortunately, there are different types of drugs that can help. We are making
these other drugs available.

~~~
jiofih
This is not an improvement at all. Try to read the original at a slow pace, it
is very straightforward but still precise.

~~~
vehementi
> an issue with manufacturing of an active pharmaceutical ingredient used in
> the drug

is WAY WORSE than

> there aren't enough ingredients for the drug

~~~
roenxi
If they are trying to say there aren't enough ingredients to make the drug
then the second way is better. But that isn't the same as what the original
sentence said.

The phrase 'issue with manufacturing of' covers a much wider range of problems
than a shortage. Maybe they have tonnes of materials and they just need a
mechanic to fix the machine for example. No shortages of anything except
people in the right place at the right time.

------
someonehere
I stumbled on a daily supply chain sub over at reddit. r/supplychain which
gets a daily update from a user who pulls his data from across manufacturing,
shipping, and other sources. I recommend anyone interested in supply chain
detailed analysis, that’s where to go.

~~~
Zaskoda
I've been reading the updates there and have been making specific purchases as
a result. For example, I read about disruption to clothing manufacturing and
bought some summer shorts, pairs of boxers, and packages of socks - stuff I
was expecting to buy soon anyway.

------
jonahbenton
Really glad this was posted.

It is absolutely insane to be in the position where essential medical
equipment is not going to be available in the US because of COVID19 quarantine
in China.

What the absolute F are we paying US Pharma 1000% premiums for, if not in part
to maintain control over supply chain.

Shameful.

------
pkaye
Someone had posted this on Reddit today. Mentioned some of the drugs made in
China to be aware of.

[https://www.reddit.com/r/gout/comments/faym30/pharmaceutical...](https://www.reddit.com/r/gout/comments/faym30/pharmaceutical_supply_chain_concerns_allopurinol/)

------
ryanmercer
There is a good general daily thread in
[https://www.reddit.com/r/supplychain/](https://www.reddit.com/r/supplychain/)
that's a decent starting point each day for what's going on in the world of
supply chain/logistics.

~~~
dfsegoat
This is a little different. The FDA has an entire infrastructure setup around
Supply Chain security - basically to ensure critical medicines are always
available from SOMEONE. Not to spam on my comments, but see here:

[https://www.accessdata.fda.gov/scripts/drugshortages/](https://www.accessdata.fda.gov/scripts/drugshortages/)

~~~
TheSpiceIsLife
You’re message here and in your other comment is quite important.

There are quite a few people in this thread assuming the press release is all
the FDA has to say, and who appear to have made little effort to test that
assumption.

I guess this proves the point that the use of _Special English_ as per this
comment
[https://news.ycombinator.com/item?id=22445952](https://news.ycombinator.com/item?id=22445952)
is well warranted.

------
phyzome
« We are not aware of any reports at this time of human illnesses that suggest
COVID-19 can be transmitted by food or food packaging. »

Given the number of illnesses that can be transmitted by indirect contact,
including cases of sick food workers contaminating a supply, I feel like they
should indicate a little more caution in this section.

------
qrbLPHiKpiux
Relying on another nation like this for our critical supplies if a national
security threat that I'm surprised is even in operation like this, today.

China Rx is a very good book about this.

------
mark-r
Just make sure you're all stocked up on Forsythia.

(Oblique reference to the movie Contagion)

~~~
1001101
I was reminded of that when reading about a compound in licorice
(glycyrrhizin) that seem to be effective in reducing the replication of SARS,
(another coronavirus):

[https://www.ncbi.nlm.nih.gov/pubmed/12814717](https://www.ncbi.nlm.nih.gov/pubmed/12814717)
[https://www.nature.com/articles/news030609-16](https://www.nature.com/articles/news030609-16)
[https://en.wikipedia.org/wiki/Glycyrrhizin](https://en.wikipedia.org/wiki/Glycyrrhizin)

------
01100011
Just saw there's a community acquired case in Santa Clara county:

[https://www.mercurynews.com/2020/02/28/santa-clara-county-
an...](https://www.mercurynews.com/2020/02/28/santa-clara-county-announces-
new-coronavirus-case/)

------
jaakl
Making a basic mask to protect for “USA nuclear attack” was mandatory lesson
in all Soviet region schools. It takes less time and skills than whining about
supplies here. China has has won us by creation of total learned helplessness?

~~~
kragen
N95 masks are a pretty fine filter material and they seal pretty well while
minimally obstructing breathing; I think it would be hard to equal their
performance out of improvised materials, and perhaps more important, it would
be impossible to know whether you had succeeded. Would you like to share the
instructions you learned? Even if the result was less effective than an N95
mask, it might be useful.

------
Fomite
Things conspicuously not mentioned that always drives me nuts: Medical oxygen.

~~~
extrapickles
The main difference between industrial and medical oxygen is that for medical
oxygen the providence of the tank is tracked to make sure that it has only
been used to store oxygen, and hasn't been left unused for a long period of
time. With the massive need for various gasses and the cost in transporting
them long distances, most large metro areas have at least one air distillation
plant that produces them.

Pressure Swing Absorption oxygen generators have been getting cheaper, and
will separate oxygen from air as long as they have electrical power and
maintenance every few months. PSA is not suitable for all medical uses though
as it typically produces 90-95% oxygen and is not directly capable of
producing pure oxygen.

~~~
gpm
A quick search suggests that we produce 99% oxygen just by running it through
two stages of pressure swing absorption. Is that also not good enough for
hospitals? If so, what do we use for even purer oxygen.

~~~
Fomite
The issue is not _making_ the oxygen. It's distributing and delivering it.

------
dchasson
So they aren't predicting anything, are relying on manufacturers to self
report, already have surprise shortages, and are monitoring and mitigating?
These statutory authorities and responsibilities to assure blah blah blah,
that doesn't give permission to prepare or ramp up requirements?

"Implementing critical infrastructure monitoring" is giving out an email
address? Hmmm.

~~~
totalZero
They're doing their job. My view is that bureaucracy has its own doublespeak
for everything.

So when I see this:

> It is important to note that no law exists requiring medical device
> manufacturers to notify the FDA when they become aware of a circumstance,
> including discontinuation of a product, that could lead to a potential
> shortage, and manufacturers are not required to respond when the FDA
> requests information about potential supply chain disruption.

...in my head, I translate it to this:

> We welcome a law requiring medical device manufacturers to notify the FDA
> when they become aware of a potential shortage or discontinuation, and
> requiring manufacturers to respond when the FDA requests information about
> potential supply chain disruption.

