At the height of the coronavirus pandemic, PPE became a scarce and precious commodity. So, how ready are we for the predicted winter wave? Joe Earl talks supply chains and stabilisation.
With the news that 86% of doctors and medical students in England are predicting a second peak of COVID-19 this winter, the warnings are stark.
As the British Medical Association’s figures revealed an inevitability about a rise in cases, its council chairman, Dr Chaand Nagpaul warned: ‘All efforts must be made to avoid a repeat of the horror and tragedy we all experienced earlier this year.’
PPE availability was a horror show at the start of the pandemic, due largely to countries around the globe all battling to protect their populations. Itss scarcity a direct result of governments buying huge amounts of stock. And, in many cases, bidding against each and driving up prices.
So, the $64,000 question is that as winter approaches should dental practices be stocking up now in readiness for this second wave? Or simply ensuring a steady supply?
Future supply issues very much depend on the global trends and progression of the pandemic. I think we’ve all seen how hard that is to predict. However, at the moment prices are stabilising on most PPE. So, if the price isn’t exorbitant, it might be prudent to build up some contingency stock – providing of course the expiry dates are good.
The other thing to consider is that PPE is currently zero VAT rated, which is due to end on 31 October.
Conformity
Availability is reasonably good at the moment. At Dental Sky, we did a lot of work over lockdown when practices were closed to set up new supply chains, register new products and build up inventory. Some manufacturers are limited in the volumes they can supply to dental companies because of government requisition and the prioritisation of frontline medical services.
The knock-on effect is that we have unfortunately seen some dental suppliers invest heavily in PPE that is neither compliant nor safe. Additionally, because they’re sitting on large stocks, some may have continued to sell it rather than withdraw the product(s).
PPE has to be certified by an EU PPE notified body in order to be on the market. So anything that’s genuinely certificated has been tested and been proved to be safe. I suggest dental practices ask to see declarations of conformity, certificates and test reports before purchasing those products with which they are unfamiliar. Dental Sky publishes all the certification for PPE on our website as downloadable PDFs, so there’s complete transparency.
Check before buying
There has also been falsely certificated products on the market in the UK. But the European Safety Federation have a website where they detail any known issues with fake certificates. If you’re not sure on a product, it’s well worth checking that out before purchasing [1].
The European Commission also has a Rapid Alert System for dangerous products. For example, Govek KN95 masks have been on it for a long time with a serious alert clearly stating it does not comply with Personal Protective Equipment Regulations. [2]
There have also been issues with PPE supplied through the Department of Health where the original expiry date has been covered with a sticker with a new expiry date and clinicians have been told that they’ve been re-validated.
We spoke to one of the main manufacturers involved who told us they absolutely would not validate those products themselves. There are very clear reasons why masks in particular have expiry dates and cannot be certified as safe after that point.
We were in discussion with the Department of Health about joining that PPE scheme but decided not to join it in the end. And that’s one of the main reasons why.
Costs
When it comes to costs, a significant upshift in global demand is more likely to influence price than availability now that production has stepped up a gear. But suppliers have also been able to build up their stock levels again. This should mean any spikes in prices should now be a lot easier to average out gradually without having to pass on all of the price increase to clinicians in one go.
As things stand at the moment, most pricing pressure is downwards. So prices are in fact falling. Apart from perhaps when it comes to gloves; reserves are being sold through and new stock coming in is considerably more expensive.
Credibility
So, how can practice teams be sure the PPE they choose is ethically sourced?
It can prove very difficult to be 100% sure. We take it very seriously and perform all the relevant due diligence on our supply chains. We know all the manufacturing sites we use are fully certificated and meet or exceed regulations. But there’s still an element of trust there. So we’re constantly in touch with our manufacturers, building that trust and asking those awkward questions.
In a similar vein, we encourage our customers to also ask us those questions. Unethical practices in manufacturing thrive when no one asks questions and when no one is looking. Constant scrutiny across the board is going to be the most effective way of shining a light on unscrupulous behaviour. By and large trust people who you have used before and who have shown themselves to be trustworthy.
Trust people who have been supplying PPE for years rather than opportunists. Trust your regular supplier partners who support you and support them.
Also trust yourselves. Having a trusted supplier doesn’t stop you doing a bit of research, checking certificates and asking questions. Trustworthy suppliers will be happy to answer your questions and provide evidence.
Focus and priority
We took a decision early on to only supply healthcare professions with PPE. But rationed supplies outside of dentistry in order to save as much PPE for dental practices as possible. Should problems occur again, we will do the same to preserve our ability to supply the UK dental profession with PPE.
It would have been irresponsible of us to turn away doctors and nurses on COVID-19 wards empty handed during the height of the pandemic. But our focus and priority has always been to look after our existing dental customers.
Ideally, we really want to get back to talking about innovations and materials. I hope clinicians take a long-term view and support their supplier partners. We’ve got years of working together ahead when COVID-19 is, hopefully, a distant memory.
References
1. https://www.eu-esf.org/covid-19/4513-covid-19-suspicious-certificates-for-ppe
2. https://ec.europa.eu/consumers/consumers_safety/safety_products/rapex/alerts/?event=viewProduct&reference=A12/01009/20&lng=en
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