Contents
Need Exploration and Identification
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in December 2019 in Wuhan, the capital of China’s Hubei province, and has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic. As of 14 April 2020, more than 1.94 million cases have been reported across 210 countries and territories, resulting in over 123,000 deaths (https://coronavirus.jhu.edu/map.html). The pandemic has resulted in travel restrictions and nationwide lockdowns in several countries. With the sudden surges in patient volume during the COVID-19 outbreak, closing of borders and restrictions on international shipping, and temporary shutdown of manufacturers for medical supplies, personal protective equipment (PPE), ventilators and associated consumables, as well as many other medical supplies have become a scarce resource.
This document details strategies to optimize supplies of hand-sanitizer during this crisis:
Existing Solutions
The SARS-COV-2 pandemic has created an increased demand for hand sanitizer at Penn State Milton S. Hershey Medical Center. In order to meet this demand PSHMC has been required to increase their order capacity from available suppliers. The market includes:
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Market Analysis
Presently, the current hand sanitizer market has been overwhelmed due to increased demand from the SARS-COV-2 pandemic. The breakdown in the hand sanitizer supply chain which has not been able to keep up with higher than average usage has led to shortages among the public consumer as well as for the healthcare provider.
Alternative Solutions
There are a number of solutions to meet the increased demand outside of regular supply chains. The common practice of using hand sanitizer when entering and exiting rooms is common practice though at this present time can be wasteful. Clinicians can be encouraged to use soap and water so as to save hand sanitizer supply for those tasks where soap and water is not available. Sink limitations in a clinical environment may be met through the usage of mobile, refillable sink stations.
Other alternatives include engineering hand-sanitizer within the community. Recognizing the increased demand at the beginning of the SARS-COV-2 pandemic the FDA lifted restrictions on who can manufacture hand-sanitizer. Alcohol distilleries and breweries have subsequently begun to re-tool their manufacturing for hand-sanitizer including locally in hershey.
https://parade.com/1011922/jerylbrunner/distilleries-making-hand-sanitizer/
http://www.tatteredflagbsw.com/emergency-hand-sanitizer
The EPA has published a series of requirements that must be met to ensure safe and effective hand sanitizer product which may be found here: https://www.fda.gov/media/136289/download
A recipe created by Memorial Sloan Kettering Cancer Center may be found here: https://masc.psu.edu/files/2020/03/ABHRmskManufactureProcedure.032020203.pdf
Concept Screening
Encouraging hand-washing is a deviation from normal clinical protocol for hand sanitization. To be effective clinically the FDA recommends a minimum of 20 second scrub with soap and water. Following this protocol has the potential to slow down clinic flow. Additionally, it is important to stress the need to follow FDA guidelines on how to wash hands, including length of time, to be effective.
Utilizing alternative manufacturers for hand-sanitizer requires the mix be both potent enough to destroy viruses and bacteria to be effective clinically. Creation of hand-sanitizer must meet FDA and EPA guidelines for both effectiveness and safety.
https://www.fda.gov/media/136289/download
Strategic Development
Utilization of existing supply chains is preferred and doing this in concert with increased hand-washing will lengthen the life of existing supply chains.
Creation of novel hand sanitizer will require steps to ensure safety and efficacy. This is achievable through following FDA and EPA guidelines as well as utilizing recipes that other institutions have published. The novel mixes can be tested for effectiveness on bacterial and viral culture to insure quality. Distribution of product will require obtaining containers to store and dispense product as current wall-mounted units are unlikely to be able to be modified for this purpose. Intellectual property concerns should be consulted with the institutional legal team.