Avoiding a Repeat

To make sure that the United States does not find itself in the same situation of waves of pandemic, shortage of personal protective equipment, scarcity of ventilators, not enough medical technicians to operate the machinery, and on and on. In order to make sure that this does not happen again, the US should do the following:

Hospitals safety stocks. Following the 2008/2009 financial meltdown, the US institutes requirement for banks to carry higher reserves in order to avoid failures. Similarly, the US should include requirement for hospitals, as part of their license to operate, a requirement to carry a certain amount of extra inventory of certain emergency equipment and supplies. Just like banks, hospitals should be stress-tested to see if they can withstand pandemics. This inventory is the first line of defense.

National stockpile. Like the strategic petroleum reserves, the nation needs a centrally managed safety stock of certain emergency medical supplies. The US does have a national strategic stockpile of medical supplies but it is woefully inadequate. The stockpile was built and maintained by the Bush 43 administration. It was used several disasters, such as 9/11 and Katrina, but was adequately replenished following the use. The Obama administration depleted the stockpile during the H1N1, Ebola, and Zika various epidemics but failed to replenish it properly. The Trump administration made a bad situation worse by taking several unfortunate decisions such as disbanding the Security Council’s global health security office. It also decided to stop embedding an epidemiologist from the CDC with China’s CDC. A string of decisions over two administrations resulted in skimpy stockpile and no “canary in the mine.” A robust national stockpile should be the second line of defense in terms of medical supplies.

A medical national guard. It is not enough to have machinery if there are no technicians and other trained medical personnel to man them. The solution is a new organization of medical technicians and personnel who are trained but work only part time in hospitals. The model here is the national Guard which can provide reserve troops for a military campaign. The medical national reserve will provide trained personnel in cases of pandemics and other national disasters. It may be part of the Department of Homeland Security, possibly the Federal Emergency Management Administration, or a newly constituted pandemic preparedness organization. Member will train on new equipment regularly and work in hospitals one weekend a month (or as required by the hospitals), shadowing doctors, nurses, and technicians and helping where possible. In case of a pandemic the medical national guard can provide the trained personnel to operate the extra medical.

All of these ideas may require legislation with details and principles on how rules may be enforced, how supplies will be allocated, and how the medical national guard volunteers will be managed and compensated.

Yossi Sheffi is the Elisha Gray II professor of engineering and director of the Massachusetts Institute of Technology’s Center for Transportation and Logistics. He is the author of two books on supply-chain risk management, “The Resilient Enterprise” and “The Power of Resilience”