Bad time to get sick: supply chains

One of the women in my breast cancer survivors’ Facebook group is under extreme stress because an ultrasound found a malignant 11 cm mass in her husband’s liver.

This is her post:

**Pet Scan today, at 7 am. Endoscopy took 3 days to schedule and we had to jump through hoops to get it for tomorrow. They initially wanted to schedule an office visit for June 10th! to review the procedure and then schedule it about 2 weeks later. It took dozens of phone calls and we had to play the CANCER CARD! We can't wait another 4 weeks to determine if this is a metastases from an Upper GI cancer! (This is week 5 of tests....another 4 weeks before another scan/biopsy to determine what cancer he has!!!!! We are absolutely NUTS and TERRIFIED!)**

**This whole system is broken. People who can’t navigate it or who don’t have an advocate to fight it, will probably die. Not only do they not have enough providers, schedulers,and appts, AND scheduling appts is a nightmare, they have a shortage on contrast. This imaging center canceled two appts, while I am waiting, saying they won’t get their shipment from China, until mid-July and telling people to call their doctors to figure out where they can go. More waiting for them!**

This problem is one result of supply chain problems.…

**Patients Face Long Delays for Imaging of Cancers and Other Diseases**

**Many U.S. hospitals are postponing scans used to diagnose diseases after a Covid lockdown in China hobbled the main U.S. supplier of an imaging chemical.**

**By Reed Abelson, The New York Times, May 26, 2022**

**A nationwide shortage of the imaging agents needed for a CT scan — the result of the recent lockdown in Shanghai to quell a Covid outbreak — has prompted hospitals to ration these tests except in emergencies...**

**An estimated 50 million exams with contrast agents are performed each year in the United States, and as many as half the nation’s hospitals are affected by the shortage. Some are reserving much of their supply on hand for use in emergency rooms — where quick, accurate assessments are most dire.**

**The shortage of a vital imaging agent is the latest example of the country’s vulnerability to disruptions in the global supply chain and its overreliance on a small number of manufacturers for such critical products. The Shanghai plant shuttered by the lockdown is operated by GE Healthcare, a unit of General Electric and one of two major suppliers of the iodinated contrast materials. The company supplies its dyes, Omnipaque and Visipaque, for the United States....Yet even though GE Healthcare said this week that the situation was improving now that the plant had reopened, the shortages and patient delays could persist well into the summer because of a lag in how quickly replenished supplies could be distributed....** [end quote]

Many people didn’t go for routine checkups during the Covid pandemic of 2020-2021, leading to an increase of more advanced cancers.

On a Macro scale, supply chains with very little redundancy (few suppliers, restricted distribution) are vulnerable to disruption. Who would have thought that baby formula or CT contrast media would suddenly become unavailable? It’s a matter of life and death for those who are affected. But if someone had asked last year whether baby formula was such a critical product that a shortage would lead to invoking the Defense Production Act, people would have laughed.

We take so much for granted. The vulnerability and fragility of our civilization is being revealed. Leaders of government and industry will seriously discuss bringing production back to the U.S. and developing multiple sources. But every move away from “just in time” and global sourcing will increase prices and lead to inflation.

On a personal scale – stay healthy! This is a bad time to get sick. It may be hard to schedule a diagnostic scan.



But every move away from “just in time” and global sourcing will increase prices and lead to inflation.

This has been my default reply for 6+ years to friends and relatives complaining about all the outsourcing. Yes, it’s good to bring stuff back here, like manufacturing. Yes it’s good to not rely so much on imports. Yes it’s good to have more jobs here. It all comes with a cost. I’m fine with that, I’m lucky to be able to afford it. Too many can’t.

As far as I’m concerned the inflation we are seeing today was inevitable, in one way or another, for one reason or another, due to one party or the other. It was bound to happen and is overdue. Fortunately unemployment is low, workers have clout, and wages are going up.

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The problem with “just in time” is low inventory. That leaves no backup supply for the unexpected delay.

Outsourcing can still work and be cost effective, but someone needs to carry some reserve inventory. And someone has to own it and finance it.

On a personal scale – stay healthy! This is a bad time to get sick. It may be hard to schedule a diagnostic scan.

I’m glad that I’ve been junk-food-free for the past 2 years. Both long-term risks (like heart attacks, strokes, and cancer) AND short-term risks (like COVID-19) are increased by unhealthy diets.

Given that it’s a bad time to get sick, I’m shocked that everyone is behaving as if the pandemic is over even though wastewater viral loads are close to those of the biggest pre-omicron surges. I’ll need a haircut soon. Unless there’s a sudden and steep drop in the wastewater viral load, I’m cutting my own hair again. Except during this past January (height of the first omicron surge), I haven’t done that since April 2021, before I was fully vaccinated.

The problem will just get worse. Shortages of everything and most importantly skilled doctors, nurses, technicians, etc. Anyone who has spent anytime in a hospital, hospice, doctor’s offices will know staffs are short and that is with trying to use as many immigrants as possible to fill positions.

The excessive hassles of paperwork and dealing with insurance companies more interested in maxing out profits than providing quality medical care ensures it will continue a downward path.

I have a well regarded gastro doctors but except for procedures it is nearly impossible to talk to him and instead you go through PAs, NPs, etc. At times that is fine but at least once a year it would be nice to sit and chat with the doctor to go over your care.

I’m not sure waiting 3 days for a procedure is that bad but I’m no doctor.

In MD many counties are hitting the “high” category according to the CDC and our place of work is going back to mandatory masking and virtual meetings. Personally I didn’t have any issues with the elimination of the masking but I thought it was foolish going back to in person meetings and conferences since you are just asking for trouble. One sick person can easily spread it to others and then those people take it back to their home offices. I’d say, live and learn but we know that seldom happens now.