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March 9, 2020

Inside the 'secret' warehouse where Mass Gen has stocked up for a pandemic

Daily Briefing

    U.S. hospitals across the country are bracing for a shortage of so-called "pandemic products," like face masks and protective gear, amid the coronavirus outbreak—and at Massachusetts General Hospital that means evaluating whether the hospital's secret stockpile of the supplies is ready for use, Didi Martinez and colleagues report for NBC News. 

    Our analysis: The 'recurring themes' of disease outbreaks

    About the coronavirus epidemic

    Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, China. As of Monday, officials reported more than 110,200 cases of the virus globally. Officials said as of Monday there had been at least 3,835 deaths linked to the virus, and all but 716 occurred in mainland China.

    The number of newly reported cases in China has been slowing, but the number of newly reported infections from the coronavirus, which are referred to as COVID-19 cases, has been surging in other countries.

    For example, in the United States, state and federal officials as of Monday morning reported 545 confirmed or presumed positive cases of COVID-19, up from 231 on Friday. So far, 22 U.S. deaths have been linked to the virus.

    Epidemic threatens hospital supplies

    The epidemic has posed a threat to hospitals' medical supplies, as China—the epicenter of the outbreak—is the top exporter of medical devices to the United States and number two exporter of drugs and biologics to the United States, Martinez and colleagues report. Common medications exported from China to the United States include antibiotics and paracetamol, which is a pain reliever commonly sold as Tylenol.

    FDA spokesperson Stephanie Caccomo last week said the agency has identified 20 drugs that either are solely produced in China or are made from active pharmaceutical ingredients that solely come from China and has contacted the manufacturers to determine whether they might face "any drug shortage risks due to the outbreak."

    The agency last week announced the first drug shortage due to the virus in the United States, saying a manufacturer informed FDA that it's experiencing an issue "related to a site affected by coronavirus" that manufactures an active ingredient used in the drug.

    MGH's 'secret' supply warehouse

    MGH has not yet treated a COVID-19 patient, but given the increase of cases worldwide, officials at the hospital believe that day is approaching. In the meantime, the hospital is preparing for a potential influx of patients with the virus and a possible shortage of medical supplies and medications by working to stock its "secret" warehouse, Martinez and colleagues report.

    The warehouse, which is located about one hour outside Boston, is filled with hundreds of boxes of "pandemic product[s]" like IV fluid, medical gloves, and protective gowns, Martinez and colleagues report. If these supplies become scarce at MGH, the hospital can tap into its emergency supply at the warehouse.

    MGH has been tracking which medications and supplies could face shortages due to the coronavirus epidemic, as well as if those supplies have any alternatives.

    "[A]s soon as we started to see some of the information coming out of China, this looked like an outbreak that really could spread more broadly and really put stress on the health care system, on our patients, on the public, and on our facilities," Paul Biddinger, chief of MGH's division of emergency preparedness, said. For instance, he explained, "Certain drugs don't have alternatives. And when we face a drug shortage of critical medications, that really threatens patient care."

    Biddinger said MGH has "been looking, since January, at our pharmaceuticals, our other medical supplies, to identify what's manufactured from China. And look at our contingency strategies for what we have to do if we don't get as much as we need."

    According to Martinez and colleagues, MGH already is experiencing a shortage of resources such as N95 respirators and protective masks, and has told staff to use these resources sparingly as it continues trying to increase its stock at the warehouse.

    Biddinger said, "We are trying to hold out as long as we can to tap into that warehouse, because we think there's a chance we will see sustained transmission in the community." He estimated that the supplies at the warehouse could get the hospital "through the worst two weeks" of an outbreak (Martinez et al., NBC News, 3/4; Lai, New York Times, 3/9; Smith et al., New York Times, 3/9).

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