Domestic PPE production: More sustainable and good local jobs

President-elect Joe Biden has prioritized the domestic production of personal protective equipment (PPE) as vital to ensuring adequate access to these supplies in emergencies. Fortunately, there are real opportunities for local and regional PPE production to fill supply chain gaps as well as to create good manufacturing jobs.

Our Healthcare Anchor Network’s (HAN) just-released white paper, Reimagining Personal Protective Equipment (PPE) Supply Chains, calls for national leadership and health care sector collaboration to create PPE production capacity for American sourced and manufactured supplies. 

One exciting area of opportunity is to shift from disposable to reusable PPE production, which can help health systems facing shortages to better weather pandemics and other health emergencies. This is already currently recommended by the Center for Disease Control to help ensure adequate supply reserves and alleviate demand surges. However, despite these recommendations, reusable PPE (or PPE that can be cleaned and disinfected) still only accounts for 15 percent of the market. Instead, 61 percent of the market share is made up of disposable gowns, drapes and packs. Shifting from disposable to reusable PPE could also contribute to reducing energy consumption, greenhouse gas emissions, total water consumption and solid waste generation since they can be reused 80 to 100 times, which helps offset some of the costs of reusable over disposable PPE.

According to our research, America’s robust textile industry makes the country well-situated to pivot towards the production of reusable PPE.

Seventeen HAN member health systems’ senior supply chain executives and other leaders shared in the white paper the supply chain challenges that persist today, including the critical shortage of masks, gloves, respirators and raw materials needed to make medical gowns. The PPE supply chain began collapsing in January and February 2020 with the COVID-19 outbreak, and purchasing PPE became the “wild west” with levels of government and health systems competing for the dwindling equipment. Even after states began reopening, raw materials were unavailable at any price or experienced surge pricing of up to 1,000 percent. These challenges are expected to persist in certain supply categories into 2021 and maybe even 2022.

Given this unacceptable situation, we need public policy changes to address our nation’s continuing PPE challenges. We need to restructure how the Strategic National Stockpile is managed and consider instituting publicly funded, annual strategic stockpile drills that would ensure that a portion of supplies would rotate and be replenished consistently.

In addition, to spur and sustain local domestic PPE production, the government must provide incentives to local manufacturers and infrastructure. Our white paper includes examples of the market shifts in the PPE supply chain, showing that small and medium-sized enterprises can, and will, fill gaps in the PPE supply chain. However, economic conditions, supportive public policies and institutional demand must exist to make it happen. 

In one example of this shift, a doctor at HAN member CommonSpirit Health designed a new reusable surgical gown that is easier to mass-produce. The doctor joined with Precision Fabrics Group and a local non-profit, FABRIC (Fashion and Business Resource Innovation Center), to sew and produce these gowns. As of August 2020, FABRIC has created nearly 100 additional jobs at their Tempe, Arizona location and is supporting more than 200 new essential jobs throughout their combined factories. 

While this is an example of how local reusable PPE production can stimulate local job development, the pre-COVID-19 norm is the concentration of PPE production in a handful of large manufacturing corporations, and significant (60 to 70 percent) offshoring of manufacturing into Asia by American businesses — which has contributed to the supply chain instability. 

Hospitals in the U.S. spend nearly $500 billion a year on goods and services. Reimagining the PPE supply chain provides an opportunity for more health systems to support local, inclusive procurement and to create good manufacturing jobs with benefits for struggling local residents. We need bold leadership and commitments from health sector leaders in order to have significant impact. On Wednesday, Nov. 18, 42 HAN health system leaders will convene at the HAN Anchoring Resilience summit to catalyze this effort.

Our health care workers and patients must have access to medical supplies and equipment in times of emergencies and localizing domestic production of PPEs will help ensure access as well as create good manufacturing jobs. As the country heads into its “third wave” of COVID-19 with new peak case levels, we must have a national strategy of collaboration between federal, state, and local policy and the health care sector that solves our PPE supply challenges and helps us build a better system with more inclusive and sustainable local economies.                   

David Zuckerman is director of the Healthcare Anchor Network, which engages health systems in building more inclusive and sustainable local economies. Gary Cohen is president of Health Care Without Harm, which advocates for environmentally sustainable health practices.