Russia’s invasion of Ukraine is being felt worldwide, and the US health care system is not immune.
Russia and Ukraine both have the power to supply certain products এই in this case, ammonium nitrate and natural gas. These products, after refining, can produce two gases that are important to the healthcare system: nitrous oxide, also known as heterogeneous gas, and helium. They are used in millions of ways every day. And cramped supplies can make every root canal much more painful and make every MRI scan much more expensive.
The disruption represents further instability for the U.S. healthcare system’s supply chain.
“It’s been a few years since we’ve had the shortcomings we’re experiencing now, so it’s no surprise to anyone,” said Wally Hopp, a professor at the University of Michigan who specializes in medical supply chains. Hoppe led a team called by the National Academy of Sciences, Engineering and Medicine to provide a march report to secure supplies for the U.S. industry.
These issues can be addressed by the government and the private sector first, Hopp said. “But now they can only address the crisis with the health risks of American citizens,” he added.
The years since the epidemic began have been interrupted by supply chain problems. The shortage of infant formula – which began after a factory in Michigan shut down due to pollution concerns – is only the latest. Hospitals are facing a lack of contrast pigment used in diagnostic scans, the result of a covid lockdown at the Shanghai plant where most of it is produced. As a result, Washington state hospitals from New Jersey are trying to scan rations in the most severe cases. And in the early days of the epidemic, the lack of personal protective equipment for front-line healthcare workers was a defining feature of Covid’s unprepared and random response.
Such deficits are one of the most pressing patient-safety issues today, ECRI, a security agency, said in a January roundup of the year’s top safety concerns. The deficit is in second place. “The unavailability of the product may result in an inability to treat patients and protect staff, which can lead to injury, illness or even death for both the patient and the physician,” Roundup said. It noted that in many regions there are few key suppliers, which means that a problem in the far corners of the world could send Domino into the US healthcare system.
Its effects are being felt in body scanners and other medical machines.
“Helium is a terrific material for heat dissipation,” said Bob Carcher, a contract service executive for Premier, an organization that provides group purchasing services to suppliers. “It is used in large MRI and CT, to remove heat from the source.”
Hopp said helium supplies had been limited for some time and the war had exacerbated the problem.
Russia is now sending relatively little natural gas to the West. It has persuaded other countries to transport gas through pipelines instead of sending them in liquid form. These decisions affect the supply of helium, since trace helium is removed to convert natural gas into liquids, with the unintended consequence of reducing the amount of helium for use in the shipping industry through pipelines.
Other diversifying factors negatively affect supply: for example, a facility in Texas that produces helium is being shut down for safety breaches.
That all together means higher costs for the provider. Hopp said he estimated that the cost of helium per MRI machine in 2019 was about $ 34,000. “It’s definitely getting higher and higher than that right now,” he said. “Worse, I’ve seen speculation from the health system that the deficit could be serious enough to force them to shut down their MRI machines.”
David Fachini, director of radiology at Yale New Haven Hospital in Connecticut, said the effects would probably hit community hospitals the hardest. In the long run, he suggests, manufacturers could build machines that do not require helium. But it’s “months away from years,” he said.
Helium is not the only gas that gets smaller. Nitrous oxide is primarily used by the dental office during surgery. About 40% of ammonium nitrate – the source of laughing gas – comes from Russia.
The premiere is “seeing price pressures, rising costs,” said Donna Kraft, a senior director. It can hurt dental practices, which usually get an allocation based on normal and traditional use. As the country emerges from the epidemic shutdown, that baseline may be too small to practice or try to extend more patient visits.
What’s more, Carcher warned that the medical sector may find it difficult to protect the rare gases. Suppliers may choose to purchase their products from higher bidders outside of healthcare.
ECRI states that healthcare providers rely on a “just-in-time” inventory strategy – that is, to purposely keep supplies low to avoid storage costs. That strategy makes sense when everything is calm. It is less effective when there is a large ground war and an epidemic.
Since these snarls are the result of decisions made a few years ago and require more than some quick sewing-up work to fix them, the short-term response is “usually very short, very late,” Hopp said. “Once there is a complete supply shortage, the options available to the government are narrow.”
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