Answering the Challenge of COVID-19 Pandemic Through Innovation and Ingenuity

Contributing to health system resilience during pandemics via purchasing and supply strategies: an exploratory system dynamics approach

BACKGROUND

Health systems worldwide struggled to obtain sufficient personal protective equipment (PPE) and ventilators during the COVID-19 pandemic due to global supply chain disruptions. Our study's aim was to create a proof-of-concept model that would simulate the effects of supply strategies under various scenarios, to ultimately help decision-makers decide on alternative supply strategies for future similar health system related crises.

METHODS

We developed a system dynamics model that linked a disease transmission model structure (susceptible, exposed, infectious, recovered (SEIR)) with a model for the availability of critical supplies in hospitals; thereby connecting care demand (patients' critical care in hospitals), with care supply (available critical equipment and supplies). To inform the model structure, we used data on critical decisions and events taking place surrounding purchase, supply, and availability of PPE and ventilators during the first phase of the COVID-19 pandemic within the English national health system. We used exploratory modelling and analysis to assess the effects of uncertainties on different supply strategies in the English health system under different scenarios. Strategies analysed were: (i) purchasing from the world market or (ii) through direct tender, (iii) stockpiling, (iv) domestic production, (v) supporting innovative supply strategies, or (vi) loaning ventilators from the private sector.

RESULTS

We found through our exploratory analysis that a long-lasting shortage in PPE and ventilators is likely to be apparent in various scenarios. When considering the worst-case scenario, our proof-of-concept model shows that purchasing PPE and ventilators from the world market or through direct tender have the greatest influence on reducing supply shortages, compared to producing domestically or through supporting innovative supply strategies. However, these supply strategies are affected most by delays in their shipment time or set-up.

CONCLUSION

We demonstrated that using a system dynamics and exploratory modelling approach can be helpful in identifying the purchasing and supply chain strategies that contribute to the preparedness and responsiveness of health systems during crises. Our results suggest that to improve health systems' resilience during pandemics or similar resource-constrained situations, purchasing and supply chain decision-makers can develop crisis frameworks that propose a plan of action and consequently accelerate and improve procurement processes and other governance processes during health-related crises; implement diverse supplier frameworks; and (re)consider stockpiling. This proof-of-concept model demonstrates the importance of including critical supply chain strategies as part of the preparedness and response activities to contribute to health system resilience.

Environmental and natural resource degradation in the wake of COVID-19 pandemic: a wake-up call

The study's objective is to examine the relationship between COVID-19 cases, environmental sustainability ratings, and mineral resource rents in a large cross section of 97 countries. The emergence of novel coronavirus 2019 (COVID-19) enlarges its magnitude across the international borders and damages social, economic, and environmental infrastructure with a high rate of human death tolls. The mineral resources are also devastated, which served as a primary raw input into the production system. The adverse effects of the COVID-19 pandemic on the environment and mineral resources are studied in a large panel of countries and found that mineral resource rents and population growth improve environmental sustainability rating (ESR). In contrast, an increase in coronavirus cases decreases the rating scale across countries. Further, mineral resources first decrease along with increased COVID-19 cases due to strict government policies, including the mandatory shutdown of economic institutions. Further, mineral resource rents increase later because of resuming economic activities in many parts of the world. The high rate of population growth is another important factor that negatively affects mineral resources across countries. Through impulse response and variance decomposition estimates, an exacerbated coronavirus cases and population growth would likely negatively affect ESR and mineral resources. In contrast, COVID-19 recovered cases will likely play a more significant role in securing mineral resources over time. Therefore, the global mineral resource conservation policies and improving ESR are highly needed during the COVID-19 to keep the significant economic gains in unprecedented times.