[HN Gopher] COVID-19 Supply Chain Update
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COVID-19 Supply Chain Update
Author : Reedx
Score : 182 points
Date : 2020-02-28 19:38 UTC (3 hours ago)
(HTM) web link (www.fda.gov)
(TXT) w3m dump (www.fda.gov)
| rahan46g wrote:
| Hi
| andreygrehov wrote:
| tl;dr?
| jefftk wrote:
| "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"?
| reaperducer wrote:
| _my understanding is that masks are sold out at standard
| suppliers and have been for a while_
|
| Where I live it's hit-and-miss, but not as bad as it used to
| be.
|
| When this first started, masks were hard to come by because
| people were buying out stores to ship to relatives in China.
|
| Today I've been to three places, and two of them had masks. The
| third was out of hand sanitizer.
| scottlegrand2 wrote:
| Unavoidably slightly political but...
|
| I saw a shift in behavior following Trump's conference
| appointing Mike Pence as the effective coronavirus czar.
|
| Every morning there was a small stash of N95 masks at my
| local Home Depot until yesterday. Similarly I started seeing
| specific sorts of non-perishables disappearing from the
| shelves of Trader Joe's and Safeways. Where it goes next, I
| don't know. But I think the crowd has spoken on the subject
| already.
| airstrike wrote:
| Correlation, causation, etc.
| mc32 wrote:
| 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.
| themodelplumber wrote:
| > 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 wrote:
| 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.
| Scoundreller wrote:
| > 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.
|
| During a previous outbreak that led to hand sanitizer
| getting hard to find/expensive, I just dumped a bunch of
| 70% rubbing alcohol into my existing bottle once it gets
| half empty.
| milankragujevic wrote:
| https://www.sterislifesciences.com/products/surface-
| disinfec...
| themodelplumber wrote:
| > Spor-Klenz(r) Ready-to-Use Sterilant
|
| > cleanroom disinfectant, sterilant and sporicidal
| cleaner
|
| Ah...got it. Thank you.
|
| > Odor: Vinegar
|
| Ewww. Hope it's not too bad. I wouldn't want a strong
| vinegar smell in my clean room.
|
| Also interesting:
|
| "Spor-Klenz RTU sterilant was found to be effective
| against mouse hepatitis virus, minute virus of mice,
| murine norovirus, murine para influenza virus type 1
| (Sendai) and Human Immunodeficiency Virus (HIV-1) when
| tested according to EPA guidelines undiluted for 10
| minutes at 20degC (68degF) exposure. Spor-Klenz RTU
| sterilant was found to be effective against mouse
| parvovirus when tested according to EPA guidelines
| undiluted for 25 minutes at 20degC (68degF). Treated
| surfaces must remain completely immersed for 25 minutes."
| cwkoss wrote:
| That hyphenation makes a lot more sense, I was parsing it
| as 'spork-lenz'
| TeMPOraL wrote:
| Yup, me too. Something sounding like "spore cleanse"
| makes a lot more sense in this context than "spork lens".
| post_break wrote:
| 0 inventory at Home Depot, Lowes, Harbor Freight, etc. Hand
| sanitizer sold out at almost all retailers in the major city
| I live in too, I managed to snag some from a store people
| wouldn't think of (office depot). I have a few N95 masks, but
| I bought them ages ago and I'd be using them for painting or
| grinding metal, not the virus.
| Consultant32452 wrote:
| I'm guessing they mean "specific widespread shortage (at
| medical facilities)." Which is categorically different from a
| retail shortage at your local pharmacy or retail store.
| hanklazard wrote:
| I work in an outpatient medical office. Our office manager said
| that the major mask supplier that we use is rationing the
| number of boxes of masks that can be ordered, but still
| fulfilling orders. So while there may be a true shortage in
| medical facilities in the future, current shortages are in
| retail. Or at least that's my n=1 data point.
| Scoundreller wrote:
| Usually one gets put on "allocation", where you can only
| order amounts based on your historical ordering history.
|
| Sometimes it's 100%, other times it's less, depending on
| actual availability.
|
| Helps prevent stockpiling, but creates issues if your
| operation is bigger than it used to be.
| SargeZT wrote:
| I think they're referring to availability for medicine. My
| facility has zero issue ordering PPE at the moment; we order
| many thousands of boxes of gloves and masks and have no issue
| with that.
| alasdair_ wrote:
| I wonder how many boxes of masks "go missing" in a given
| month and if this will spike now that the resale price is so
| high.
| hanklazard wrote:
| We're starting to keep a more careful eye on inventory for
| that reason.
| ssully wrote:
| I am guessing they are speaking specifically about supplies to
| medical facilities, not the general public. The NYTimes ran an
| article recently [1] that makes it sound like the New York area
| has a hefty stockpile ready in the case of an outbreak.
|
| [1]: https://www.nytimes.com/2020/02/27/nyregion/new-york-
| coronav...
| hourislate wrote:
| Manufacturers have stop shipping Masks and other protective
| gear to retail. Everything is going to the the Healthcare
| Industry.
|
| HomeDepot will not get resupplied, Hospital down the street
| will get everything.
| mark-r wrote:
| Just make sure you're all stocked up on Forsythia.
|
| (Oblique reference to the movie Contagion)
| 1001101 wrote:
| 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.nature.com/articles/news030609-16
| https://en.wikipedia.org/wiki/Glycyrrhizin
| citilife wrote:
| 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.
| throwaway9878 wrote:
| California looks set to explode into another Italy scenario as
| local, human-to-human transmission now appears to be taking
| place in Solano County, where a woman now critically ill with
| the coronavirus previously exposed dozens of hospital workers
| in two hospitals. She was not tested for 11 days because the
| CDC's testing flow chart excludes the testing of people who
| contract the virus in America and who didn't visit China.
|
| The Governor of California stated yesterday that California has
| only around 200 test kits for the entire state. To this very
| day, there is virtually zero testing of anyone happening in the
| entire United States -- a fact that many people still are
| unable to believe (they remain in total denial). The SF
| Chronicle also confirms this story.
|
| According to a highly disturbing Wall Street Journal story
| (https://www.wsj.com/articles/whistleblower-says-federal-
| empl...) federal employees who ran the quarantine sites in
| California and elsewhere failed to wear proper protective
| equipment (PPE) and also weren't trained in how to handle
| people exposed to the virus. Most disturbingly, as the WSJ
| subhead says, "Employees weren't tested for virus before
| leaving California quarantine sites on commercial flights."
|
| I am astounded by the frequency of idiots in key decision
| making positions globally.
| orblivion wrote:
| > This almost read like a bot wrote it...
|
| Particularly with reference to "a human drug"
| Seenso wrote:
| > Particularly with reference to "a human drug"
|
| Veterinary drugs are a thing, and it appears the FDA
| regulates them, too:
|
| https://www.fda.gov/animal-veterinary/resources-you/fda-
| regu...
| [deleted]
| drugones wrote:
| Maybe in purpose to avoid drugs related panic purchases.
| rubber_duck wrote:
| Why publish anything then ?
| taywrobel wrote:
| Because otherwise once shortages begin they'll be accused
| of a "cover-up"?
| ydnaclementine wrote:
| So they can't say you they didn't tell you anything
| wyldfire wrote:
| Well, we know that there is a disruption and that as far as
| the FDA knows it's just the one report so far.
|
| In an administration that frequently gets involved in
| cover-ups, you can't fault the FDA for trying to disclose
| as much as they can without causing new problems.
|
| Plus the press release goes on to detail many other areas
| of FDA's regulatory domain that are also helpful.
| TheSpiceIsLife wrote:
| This this other comment (not mine) detailing these FDAs
| transparency re drug shortages:
|
| https://news.ycombinator.com/item?id=22445961
| zerkten wrote:
| This is what I'd expect having worked for ~10 years in
| pharma. These companies are very sensitive to announcements
| like these because they can be misinterpreted by the
| public/media. They'll be trying to find some alternative
| options and the details of the shortage will become evident
| from other sources eventually.
| [deleted]
| frisco wrote:
| 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
| inetknght wrote:
| I'm honestly _more_ concerned that the FDA is dumbing things
| down so much that smart people have trouble understanding it.
| sezna wrote:
| I didn't realize anybody here was having trouble
| understanding it. It looks like regular English but with no
| pronouns.
| BigJono wrote:
| I had a lot of trouble understanding it until I read it 5
| times. All the words just turn to soup in my brain as I
| read them... It's like the information density of the
| text isn't high enough to keep my attention or something.
| anigbrowl wrote:
| It might be special but it's not simple; it's vague and
| overly verbose, such that important information is buried and
| ambiguity is amplified.
| reaperducer wrote:
| I work for a health-related company, and to us it's called
| "Health literate."
|
| But, you're right- the idea is to write as plainly and
| clearly as possible so the largest number of people can
| understand.
|
| As for why the drug or manufacturer wasn't named, my guess is
| that it's so that there isn't a run on a particular
| medication causing unnecessary shortages.
| joezydeco wrote:
| Or price gouging by pharmacies that still have inventory?
| pyuser583 wrote:
| 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.
| [deleted]
| im3w1l wrote:
| Yeah wtf, the original was not easy at all to read. Also re
| your version I would use medicine instead of drug to avoid
| confusion.
| jiofih wrote:
| This is not an improvement at all. Try to read the original
| at a slow pace, it is very straightforward but still
| precise.
| vehementi wrote:
| > 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
| gizmo385 wrote:
| Is there anything similar in other languages? I would love to
| have a similar resource for my German learning.
| tomjakubowski wrote:
| I'm also interested in this question of "Special $LANG" for
| other languages. For German learners, DW has a daily
| podcast Langsam gesprochene Nachrichten ("News read
| slowly"), which I have found invaluable.
|
| https://m.dw.com/de/deutsch-lernen/nachrichten/s-8030
| yorwba wrote:
| The equivalent term is "leichte Sprache".
| https://en.wikipedia.org/wiki/Leichte_Sprache
|
| The websites of government agencies usually have a version
| in leichter Sprache, although it tends to be
| counterproductively hidden.
|
| The NDR offers news using leichte Sprache:
| https://www.ndr.de/fernsehen/service/leichte_sprache/
|
| Edit: or any of the other sites on this list:
| https://bpb.de/politik/grundfragen/politik-einfach-fuer-
| alle...
| teagee wrote:
| Linguistica 360 has news in slow ____ for a number of
| languages
|
| https://www.linguistica360.com/
| allovernow wrote:
| I'm glad to see this posted. When you dumb down the vast
| majority of media that your population consumes and make all
| of it essentially predigested, the average person becomes
| substantially less able to parse technical literature or
| think critically, because in the majority of the media they
| consume there is little required in the way of thinking.
|
| Making things accessable to the common denominator has a
| generally negative effect on society IMO. This is one major
| reason why our U.S. schools have been falling behind for
| decades - they are too focused on not leaving the poor
| performers behind, at the cost of limiting the achievement of
| those above the average.
| metalliqaz wrote:
| That's interesting, thanks.
|
| Non mobile link:
| https://en.wikipedia.org/wiki/Special_English
| dfsegoat wrote:
| FDA has an entire drug shortage database that is updated daily
| and publicly accessible. _There are tons of drug shortages at
| any given time_ , and most of them go back to API (Active Pharm
| Ingredients) - the raw active chemicals produced in bulk, that
| are then put into pills, injection solutions etc.
|
| You could probably figure it out from there. My guess is it
| would be irresponsible for them to name the Mfgr in the press
| release, particularly if it were a publicly traded company and
| people are going to jump to uninformed conclusions.
|
| https://www.accessdata.fda.gov/scripts/drugshortages/
|
| Supply chain security has also been a major focus at FDA over
| the last ~5 years, basically to ensure there are not "choke
| points" with respect to approved medicines:
|
| https://www.fda.gov/drugs/drug-supply-chain-security-act-dsc...
|
| So in general, I appreciate their transparency on this since
| they have been building up regs around this very type of issue
| for awhile.
| adrianmonk wrote:
| > _My guess is it would be irresponsible for them to name the
| Mfgr in the press release, particularly if it were a publicly
| traded company and people are going to jump to uninformed
| conclusions._
|
| Not only could it harm the company, it could be bad for
| patients. Naming it could cause a run
| (https://en.wikipedia.org/wiki/Market_run) on the drug, and
| if some people hoard it, there will be other people who are
| unable to get it.
| TeMPOraL wrote:
| And even worse than the hoarders: the sudden appearance of
| "entrepreneurs" smelling easy profit.
| adrianmonk wrote:
| Price gouging? Of drugs? _In the United States?_
| TeMPOraL wrote:
| Right. It's business as usual.
|
| I guess I'm grumpy today, after looking at the prices of
| respirators and antiseptics in Poland being already
| 10-20x the usual, and growing. And we don't even have a
| confirmed case just yet (doesn't stop the media from
| reporting a new "first case" every day for the past two
| weeks).
|
| Also this morning I've seen an ad on our local equivalent
| of Craigslist; somebody is trying to sell a pre-packaged
| web store for selling face masks, complete with a bunch
| of legit-sounding domains (using phrases "medical
| respirators", "anti coronavirus respirators", etc.) and
| three contracts to wholesalers of surgical masks, for
| roughly $1k total. Note: _surgical masks_. The ones that
| are worn to prevent accidental exchange of bodily fluids
| between patient and the surgeon. The ones that are
| completely ineffective against airborne viruses.
|
| I really feel that some people need to have cooperation
| and civil behavior beaten into them.
| DoreenMichele wrote:
| I deal with protecting myself medically daily. If you
| want to chat about your concerns, you are welcome to
| email me.
|
| Not medical advice per se. I'm not a doctor. I'm just
| someone continuing to rudely fail to die instead of going
| along with politely dying according to schedule so other
| people can feel like they are smart and know things.
|
| (This comment will self destruct in the near future.)
| TeMPOraL wrote:
| Thank you.
|
| Still, what can I say about my concerns? I'm scared. For
| myself, my wife, our infant, our families. In this island
| of emptiness in the middle of red dots the Europe is on
| COVID-19 maps, we're all just nervously waiting for the
| first real case. Personal protection goods are already
| gone, people are slowly realizing that maybe it's about
| time to start stockpiling food. We've stocked ourselves
| up with ~two weeks worth of long-life consumables. Going
| to extend it over the weekend to a month's reserve. Our
| infant already has 2+ months supply. I try to be calm,
| but it's getting harder.
|
| I don't know what I'm afraid more of at this point - of
| the virus, or of the quarantines and panic that will
| follow.
| tejtm wrote:
| They also have to tread a very fine line where these
| companies are "required" to self report important details
| that would damage a "brand". By not naming names they
| maintain the trust which increases the prospect of getting
| the important information we all need. (and that is not
| X.inc's next quarters earnings)
| Fomite wrote:
| Things conspicuously not mentioned that always drives me nuts:
| Medical oxygen.
| someonehere wrote:
| 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 wrote:
| 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.
| ryanmercer wrote:
| There is a good general daily thread in
| 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 wrote:
| 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/
| TheSpiceIsLife wrote:
| 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 is well
| warranted.
| qrbLPHiKpiux wrote:
| 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.
| pkaye wrote:
| 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...
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(page generated 2020-02-28 23:00 UTC)