University of Minnesota Alumni Association

Feature

A Broken Chain

At the end of March, shortages of ventilators, surgical masks, and other personal protective equipment (PPE)—not to mention panic-induced runs on items from toilet paper and hand sanitizer to eggs and flour—were giving Americans a crash course on supply chain management.

Illustration Credit: Serge Bloch

At the end of March, shortages of ventilators, surgical masks, and other personal protective equipment (PPE)—not to mention panic-induced runs on items from toilet paper and hand sanitizer to eggs and flour—were giving Americans a crash course on supply chain management. Supply chain management—formerly a somewhat obscure economic concept—started to become a topic of public concern as daily newscasts covered shortages and tallied scarce items delivered to medical facilities. The supply chain, as most Americans soon discovered, affects every aspect of our daily life, from what we eat to what we can buy to what critically needed supplies are available in times of crisis.

By April, with COVID-19 affecting most of the world, global and local supply chains and distribution efforts had begun to creak. On April 13, the New York Times reported that the nation’s food supply chain, composed of the farmers and distributors and packagers and retailers who fill our grocery stores, was showing strain.

For instance, dairy operations that sold to commercial vendors throughout the country were dumping milk because, with restaurants and schools closed, much of their customer base was gone. Distribution and packaging challenges made donating the milk very difficult, even while many in the country were going hungry. CNN reported the Dairy Farmers of American estimated between 2.7 million and 3.7 million gallons of U.S. milk could be dumped a day.

Vegetable farmers were also being forced to plow under thousands of acres of ready-to-harvest crops, due to shuttered restaurants and a dearth of other markets to absorb production. Farms also lacked workers to pick the crops.

“For some Minnesota growers, restaurants were 90 to 100 percent of their market,” says Constance Carlson, the codirector of Statewide Sustainable Agriculture and Food Systems at the U of M’s Extension Regional Sustainable Development Partnerships (RSDP). RSDP is collaborating with the Minnesota Department of Agriculture and the Minnesota Grocers Association to help growers tap into emergency market channels.

Even with that support, it’s a devastating situation. “Agriculture moves slower than the consumer response to a pandemic,” says Sarah Swan Ray, a supply chain development specialist at RSDP, who focuses on more vulnerable growers, including Latino and Hmong farmers. “And the farmer gets a bad reputation. This is a travesty.”

Some growers will decide not to plant this year, reasoning that a financial loss before production is preferable to paying labor costs for goods that may never get to market. Others may move ahead with planting and hope for the best.

It will be difficult, even in a best-case scenario, for growers to donate unsold produce. “They would have to spend money to harvest, clean, package, and move it off the farm,” explains Swan, who notes that many farmers operate on such thin margins that even in good times they don’t pay themselves a salary. “If a crack team of emergency response produce harvesters could take care of the labor, I think farm - ers would be happy to [donate their products].”

Likewise, it will be challenging for many growers to pivot to alternative options, including farmer’s markets or community sponsored agriculture (CSA), where consumers buy local, seasonal food directly from farmers. Social distancing at farmers markets will reduce capacity; selling directly to consumers puts farmers at risk for getting sick. Ray says that older growers and more traditional com - munities —including many Hmong farmers —are less able to adapt to touchless systems, such as ordering on websites or paying with Venmo or other cash-free options. While she and other experts see potential in these new ways of doing business, they note that it’s hard to implement new systems in the middle of the growing season.

Another problem affecting animal farmers came into sharp focus in mid-April, when the first of the nation’s meat processing plants, owned by Smithfield Foods in Sioux Falls, South Dakota, was forced to temporarily close because so many of its workers were ill. This was followed quickly by the COVID-19-related closure of a number of other meat processing plants. That left a number of farmers, particularly in Minnesota, without a place to sell animals as they reached market weight. Some farmers were forced to cull young animals because they lacked space to raise them, given that their lots were already full.

Some worry that these distribution issues could continue to affect the availability and price of meat months from now. In response, on April 28, President Trump signed an executive order under the Defense Production Act, mandating that meat-processing plants remain open as part of the nation’s critical infrastructure.

Medical Matters

A Bitter Pill

Could COVID-19 affect the supply chain of life-saving drugs in the United States?

The Resilient Drug Supply Project is an initiative of the U of M’s Center for Infectious Disease Research and Policy (CIDRAP) that maps the supply chain —from raw materials to patients —of critical medicines used in the United States health care system. In late March, preliminary findings from CIDRAP identified 156 drugs that are critical to keeping Americans alive, noting many of these drugs are sourced or manufactured in countries that have experienced production shutdowns, including China, India, and Italy.

However, because drug manufacturers aren’t required by law to disclose to the Food and Drug Administration or the general public where their products are made, it’s difficult to estimate the precise health risk to Americans due to possible supply chain disruptions. As a result, CIDRAP publicly called upon pharmaceutical companies, their suppliers, and manufacturers to disclose supply chain details on these critical drugs.

“This is life and death, and the public needs to know where their drugs come from and be assured they will always be available in a timely manner,” according to Stephen W. Schondelmeyer, coprincipal investigator of the project and professor in the College of Pharmacy at the University; Century Mortar Club Endowed Chair in Pharmaceutical Management & Economics; and director of the PRIME Institute, an independent and global research, education, and consulting organization that studies economic and policy issues to help improve access to pharmaceuticals and pharmaceutical services.

As experts scrambled to address those issues, other supply chain problems were also becoming apparent: Entities such as the U of M’s Center for Infectious Disease Research and Policy (CIDRAP) warned it was possible the key ingredients for drugs could be disrupted by the global pandemic in coming months (see sidebar at right).

Perhaps most critically, as experts said additional testing for COVID-19 is needed to safely reopen the country, false starts hampered those efforts. Supply chain issues slowed the rollout because tests didn’t work or lacked the critical supplies necessary to properly conduct them.

By late March, the U of M announced it had created an on-site COVID-19 testing location, but tests would be limited to just 64 per day because of the nationwide shortage of testing and extraction supplies. “If we’re planning for a 30-day window of testing, assuming that we receive no other supplies, we can do 64 tests per day for the next 30 days,” Sophia Yohe, M.D., associate professor in the Department of Laboratory Medicine and Pathology, said at the time.

To help circumvent those issues, by mid-April the U of M, the Mayo Clinic, and the Minnesota Department of Health had developed tests to detect antibodies in people who suspected they had had COVID-19 and to test for active infections.

The lab of Marc Jenkins, (B.S. ’80) a Regents and Distinguished McKnight University professor at the medical school and director of the Center for Immunology, completed initial work on this new test. In less than three weeks, Jenkins’ team both completed the enzyme-linked immunosorbent assay, or ELISA, that allowed for detection of COVID-19 antibodies, as well as tested its accuracy. 

Fang Li, associate professor in the Department of Veterinary and Biomedical Sciences, was among the first to publish a peer-reviewed article detailing the underlying structure of COVID-19. Li provided protein material to the Jenkins Lab, and by April 9, with the U of M’s Advanced Research and Diagnostic Lab led by Amy Karger, M.D., the test was further validated.

“What makes this test different is that it was developed here in Minnesota, meaning we aren’t relying on an outside supply chain for kit parts from another part of the world,” said Tim Schacker, M.D., vice dean for research at the medical school. “That’s important because we have more control over the process and can more easily deploy testing where it is most needed.”

On April 22, Gov. Tim Walz announced the state would allocate $36 million to the medical school and the Mayo Clinic in support of a plan to begin testing 20,000 Minnesotans a day, starting with those who are symptomatic.

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