Russia’s invasion of Ukraine is being felt around the world, and the US health care system is not immune.
Russia and Ukraine are both powerhouses supplying certain products, including ammonium nitrate and natural gas. After refining, both produce two important gases for the health system: nitrous oxide, also known as laxative gas, and helium.
They are used in millions of ways every day. If these supplies are in short supply, they can make each root canal more painful and make each MRI much more expensive.
This disruption caused further unrest for the US healthcare system supply chain.
“It’s been a few years since the deficit we’re experiencing now, and so it’s no surprise to anyone,” said Wally Hopp, a professor at the University of Michigan who specializes in the medical supply chain.
Hoppe led a team called by the National Academy of Sciences, Engineering and Medicine to produce a report in March on supply safety for the American industry.
The government and the private sector could solve these problems soon, Hopp said. “But now they can only face a crisis with the health risks of Americans,” he added.
The years since the epidemic began have been marked by supply chain problems. The shortage of infant formula, which began after a factory in Michigan shut down due to pollution concerns, is the latest.
As a result of the closure of the Covid plant in Shanghai, where most of these products are produced, hospitals are experiencing a shortage of contrast pigments used in diagnostic scans.
As a result, hospitals in states ranging from New Jersey to Washington have restricted these scans to the most severe cases. And in the early days of the epidemic, the lack of personal protective equipment for frontline healthcare workers was a defining feature of Covid’s random and random response.
Such deficits are one of the most pressing issues for patient safety today, the safety agency, ECRI, said in its January Roundup of Top Safety Concerns of the Year. In the second place is the lack.
“Lack of product availability can lead to inability to treat patients and protect staff, which can lead to injury, illness or even death for both the patient and the physician,” the summary emphasizes. He noted that there are a number of key suppliers in many areas, which means that a problem in the far corners of the world could create a “domino effect” on the country’s healthcare system.
Its effects are being felt in body-scanning machines and other medical devices.
“Helium is a great material for heat dissipation,” said Bob Kercher, executive of Premier, a company that provides group purchasing services to suppliers. “It is used in large MRI and CT scans, to remove heat from the source.”
Hopp said helium supplies had been limited for some time and that the war had exacerbated the problem.
Russia is now sending relatively little natural gas to the West. It has managed to transport gas to those countries through pipelines instead of sending them to other countries in liquid form.
These decisions affect the supply of helium, since the conversion of natural gas to liquids means the removal of trace amounts of helium, the unintended consequence of reducing the amount of helium for use in the shipping industry through pipelines.
Other factors also negatively affect the supply: For example, a facility in Texas that produces helium shuts down due to security breaches.
All this together means higher costs for providers. Hopp says he estimates that the cost of helium per MRI machine in 2019 was about $ 34,000. “It’s definitely more now and it’s going to be more,” he said.
“Even I’ve seen speculation from the health system that the deficit could be severe enough to force them to shut down their MRI machines.”
David Fachini, director of radiology at Yale New Haven Hospital in Connecticut, said it was likely that community hospitals would be most affected. Finally, he suggests, manufacturers could build machines that do not require helium. But it’s “years away,” he said.
Helium is not the only gas in short supply. Nitrous oxide is primarily used in dental offices during surgery. About 40% of ammonium nitrate, a source of laughing gas, comes from Russia.
The premiere is “seeing price pressures, rising costs,” said Donna Kraft, a senior director. This can hurt dental offices, which usually receive an allowance based on regular use. Since the country has emerged from an epidemic shutdown, that baseline may be too small to practice or try to expand to serve more patients.
Also, Karcher warned, it would be difficult for the medical sector to secure rare gases. Providers may choose to purchase their products from higher bidders outside of healthcare.
ECRI says healthcare providers rely on a “just-in-time” inventory strategy, that is, to deliberately keep stocks low to avoid storage costs. That strategy makes sense when everything is calm. It is less sustainable when there is a large ground war and an epidemic.
Since these challenges are the product of a decision made a few years ago, and more needed to be done to address them quickly, short-term responses are “usually much less delayed,” Hopp said. “Once there is an ongoing supply shortage, the options available to the government are limited.”
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