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H1N1: Logistics during a pandemic (3)

by Jurgen Hulst on June 12, 2009

So it’s a pandemic, now what? Let’s assume you’ve read through Michael’s post on contingency planning and his follow-up ‘the logistics of swine flu aid’ and your organisation has updated their pandemic preparedness plans, or is in the process of doing so now. Did you think of everything?

meeting counterparts in protective suits

Meeting counterparts. Source: A.Cook

Let’s take another look at your;

  • Supply chain
  • Staff protection
  • Programme operations

Supply chain and border crossings

Contingency planning done at country level with UN PIC and governments suggests an increased role of national military and police in case of a pandemic outbreak when national services and infrastructure will be impacted.

A high level of staff absenteeism (30% or higher) will extend to your suppliers; make sure to include them in your plans. Will your logistics staff and your shipping agent and main transporter be able to handle customs clearance and possible extra measures for quarantine and maintaining security of supplies? Do they know how to handle cold chain & clearance procedures for medicines & vaccines, which may be needed during a pandemic?

Staff protection

You’ve considered protective equipment for your staff who will be in contact with influenza patients (either at work or at home) and may have purchased particulate face masks, gloves and hand washing gel, maybe even Tyvek protection suits if you’re with a medical organisation.

Did you consider training for protective measures? A pandemic logistics simulation training P2LX in Nov.2008, found that a major part of using protective equipment is learning how to assess the level of risk and deciding when to use it. And: You learn by doing it, not by reading about it. Secondly, the protection of this type of equipment is only effective when used properly.

Programme operations

You went through the four steps as recommended in this earlier post ; prioritise your logistics, sensitivity analysis, contingency planning and communication.

Your contingency planning answered the important question: How will your programme operations adapt to a national pandemic situation, with significantly less human resources and an increased strain on the supply chain?

Does your pandemic preparedness plan extend to your offices at field level? And does it include your local implementing partners? If not, perhaps now is the time to sit down with your partners at field level to discuss their role and activities.

Take note that staff protection will also affect them. How will they deal with it when your staff has all the protective gear and they don’t? Things could get ugly.

In case you are with a medical organisation, did you consider the additional requirements or shift of focus of your programme if you’re suddenly confronted with a surge in influenza patients and deteriorating local healthcare services?

Conclusion

Now that H1N1 has spread globally and a pandemic has been officially declared a possibility is that we will continue to see a gradual increase in cases, until a larger local outbreak happens in a particular region or perhaps your country.

To maintain the key activities of your programme in the field during an outbreak, the basic principle of the supply chain still applies: the chain is only as strong as its weakest link. Your programme operations will only continue successfully if you have looked beyond your own organisation and included suppliers and local implementing partners in your planning, communication and training.
(Guestpost by Jurgen Hulst, @NFIguy)

Prepared? Source: UN Pandemic Influenza Contingency (PIC)

Preparedness. Source: UN PIC - OCHA

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Logistics of swine flu aid

by Michael Keizer on May 1, 2009

Deborah Cannon/AMERICAN-STATESMAN 03/27/06 Michael Leavitt, Secretary of U.S. Department of Health and Human Services talks with an audience at the Hyatt Regency in Austin, Texas on Monday, March 27, 2006. The state held an all-day summit on pandemic flu preparedness efforts. I have had to rewrite this post three times today as new developments rolled in (not the least of which is of course that we are now officially in a pandemic), and as I found more pertinent information

The swine flu pandemic will obviously have a severe impact on our supply chains; however, it will also impact on the demand placed on these supply chains. These demands will come from two sides: the obvious external demand related to the programmed response to the pandemic, but also the less obvious internal demand caused by efforts to protect (and treat) our own staff.

Both will put an increased strain on a supply chain that will already be more vulnerable. Normally, I would have said that this would require forethought and planning, but it seems we are a bit too late for forethought – so let’s stick to planning.

Note that I will write here as if we all work in medical organisations; of course, many of us work in other types of aid work, but as demands in medical aid will be most intense, this presents a ‘worst case’, and although not all of the aspects debated here will be relevant to other organisations, many will.

Much of what I wrote in my post on contingency planning for the supply chain, is applicable to this issue as well. The four-step approach (prioritisation, sensitivity analysis, preparation of plans, resourcing and communication) is valid as well. However, there some things to keep in mind.

One issue that will hit every organisation, will be logistics (including procurement) of goods related to the protection of our staff. It will be necessary to sit down now with whoever in your organisation is in charge of OSH and work out what you will need. Think of protective clothing, microfiltrating face masks, and (depending on whether your staff will be in direct/prolonged contact with influenza patients) many other items. A specific issue is the availability of antivirals. If these are needed in any more than very modest amounts, and you do not have them stockpiled yet, it will be highly unlikely that you will be able to procure them now.

A second step is to look at your organisations programmes, and how they will adapt to the pandemic. Is it likely that your organisation will be involved in the treatment of patients? If so, you will need to start planning for that now: get your programme people to give you an idea of where things might go – again, developing a couple of likely scenarios – see what would be demanded from logistics in these scenarios, and how you can address those demands. I cannot stress enough that now is the time to pipe up if your conclusion would be that logistics cannot address the demands in one or more of the scenarios: both top management and your programme departments should know. Conversely, it would also be a good idea what would be your best guess of what you can do.

In case of a pandemic, your biggest headache (next to keeping your supply chain from collapsing) will probably be procurement: demand for the same limited amount of resources will increase tremendously (share prices for manufacturers of antivirals are already soaring), and you will be just one of the very many customers. So start talking now with your suppliers and see what can still be done. You might already be too late, but you will definitely be too late if you wait much longer.

As with the protection of your supply chain, using a methodical approach to the increased demand caused by the pandemic is essential, and the same four-step approach can be used successfully. However, in the end it is again not so much how you plan, or what you plan, but that you plan which will make all the difference. Don’t be caught on the hop.

(Image by Ryan Schultz. Some rights reserved.)

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The importance of contingency planning

by Michael Keizer on April 29, 2009

Slightly over a week ago, I was trying to write an article for this blog about how health issues could impact logistics. I just could not make it work: the main health impact on logistics would be from a pandemic, and although that seemed pretty realistic to me, I also felt that my readers would probably not see it as realistic enough to spare it a second thought. That was a real issue for me, because the main reason why I wanted to write the post was to get people thinking about logistics contingency planning for a pandemic.

Of course, I am now kicking myself for not have written what would have been a fairly prophetic post – and perhaps have influenced one or two people to take some action.

So my apologies for being late – let’s just say that this is a mistake I will not make very soon again.

The impact

Let’s just assume for the moment that swine flu will go pandemic. What effects will this have on our supply chains?

The most obvious one is that it will put severe demands on it. We will need to have massive amounts of medical goods at the right spot, at the right moment. How to deal with this issue merits a separate post, which you can find here.

Perhaps more insidious is the fact that every supply line depends on people – and in case of a flu pandemic, many of those people will be incapacitated (by illness or death), or be subject to isolation or quarantine. This will mean a severe blow for many of our supply chains: without truck drivers, store managers, clerks, and purchasers, our supply lines will soon break down.

Furthermore, quarantine measures might also mean that transport will be infinitely more difficult: if we can’t have trucks or planes come into the country where we work, goods will not come in either.

How to deal with it

So how to deal with this? At this stage, preparation would include four steps.

The most important issue, which needs immediate action, is to prioritise our logistics: which goods for which programmes are most needed. I would suggest to divide them into three to five groups, ranging from “immediately indispensable” to “doesn’t matter if it’s a couple of months late”. Note that we are not talking about articles here, but about article/programme groups: article 1 for programme X might be in a different group than the same article for programme Y. This needs to be done now: you do not want to have these discussions while you are in the middle of a crisis.

A second issue that needs to be dealt with concurrently with the prioritisation, is a sensitivity analysis of our supply chains: which parts our supply chains will be most vulnerable to disruption? It could be very helpful to develop a couple (not too many) scenarios and see how they impact our supply chains. When doing this, don’t forget that our supply chains extend beyond our own organisation: include the possibility that e.g. your main supplier will be severely impacted, or that your main transporter will be knocked out. Also look outside the logistics departments, e.g. by taking into account that your programme staff might be so severely overburdened that they will no longer be able to make forecasts or report regularly.

Based on the prioritisation and the sensitivity analysis, prepare contingency plans that deal with the various scenarios in such a way that (as far as possible) goods from the highest priority groups will be where they are needed, when they are needed. These contingency plans could include e.g. stockpiling (explicitly taking the risk of increased expiries), already hiring extra staff, and many other possible actions. What it exactly will entail for your organisation will depend on many factors, and there is definitely no one-size-fits-all solution. It will be important here to think laterally and come up with creative solutions: this is an extraordinary situation, and will need extraordinary solutions.

The fourth and last step is resourcing and communication: make sure that you have the (financial) resources to implement your contingency plans – which will mean that you will need to ‘sell’ your plans now to senior management of your organisation – and communicate the plans to all people involved, which would include practically everyone within your organisation, and quite a number of people outside it.

I can hardly stress enough that these steps need to be taken now: if and when the crisis arrives, it will be too late. You might counter that nothing ever goes according to plan, and that the crisis that will really happen is unlikely to be the one you planned for; that might be true, but having these plans and resources at the ready will give you an enormously increased resiliency that will enable you to cope much better than otherwise. To quote general Dwight D. Eisenhower: “plans are nothing; planning is everything”.

A call for action

Go now to the person(s) responsible for logistics planning in your organisation, and ask them whether they have prepared contingency plans for a severe pandemic impacting on your supply chain. And don’t let them get away with generalities; things are much too serious for that. And if you yourself are responsible: did you do your homework? Finally: please come back here and let us know what you did: at this stage, we should all learn from each other.

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