Restart Partners: Innovative Approaches to Supply Chain Planning During the Covid-19 Pandemic
1 Overview
Personal protective equipment (PPE) such as masks, shields, gloves, and gowns are essential to limiting transmission rates of SARS-CoV-2, since the disease spreads from person-to-person through close contact. The challenge for the supply chain is to meet demand in the face of considerable uncertainty in demand peaks and manufacturing supply. Demand uncertainty is due to multiple factors. The lack of information on the spread of the disease, if and when a vaccine will be available, new treatments that will make it less dangerous, potential mutations in the virus, economic activity & mobility in the affected areas, level and type of healthcare consumption and percentage of the population who are living in congregate settings and hence cannot isolate. The disease is also affecting disproportionately Black, Latino and Native American populations and the socially vulnerable. Similarly, supply uncertainty has arisen because suppliers cannot meet the full demand for PPE due to unexpected demand surges, hoarding, supply shortages caused by closure of factories or warehouses due to infection or mandate, national policies in major manufacturing countries and a lack of onshore manufacturing when the crisis broke. Supply chain decision makers have unique challenges during the pandemic to provide the types of PPE needed to protect the most vulnerable.
This white paper describes the efforts of Restart Partners, a non-profit organization, to develop a data-driven approach to alleviate supply chain challenges during the COVID-19 pandemic. These efforts include an approach to develop tools that relate PPE demand in diverse populations to supply chain decisions related to procurement, inventory management, and resource allocation, to meet the most needed demand. This approach has evolved through collaboration with governmental, private, and non-profit entities providing essential services such as agriculture, healthcare, and shelters for the homeless. This paper describes how Restart Partners has worked with these entities, as well as research institutions and volunteers, to adopt a multi-pronged approach that includes building decision support tools and establishing a coalition of organizations and partners to support public, private, non-governmental organizations (NGOs) and community organizations responding to the pandemic. It also discusses plans for future developments as everyone works together to conquer COVID-19.
2 Evolution of Restart Partners’ Supply Chain Decision-Making Tool
Restart Partners grew out of a request in the early days of the crisis from the Washington State Government, to help supply chain managers address how much PPE to order during the pandemic. Since the crisis had developed rapidly and had the potential to affect a large section of the population, there was a lack of tools and guidance for state and local government officials nationwide to answer key supply chain questions. Managers needed to know how to manage the inventory of PPE to ensure healthcare workers and broad groups of front-line responders had access to PPE.
Since coming together in late March 2020, a group of volunteers formed a nonprofit called Restart Partners in May 2020. They identified key challenges and solutions, working directly with 22 different state and local governments in the United States. The decision-making tool was designed to address the questions raised by policy users and supply chain managers related to quantifying demand for PPE. Rather than building a tool from scratch, Restart Partners leveraged an existing approach developed by the World Health Organization (WHO) and the Clinton Health Access Initiative (CHAI). The WHO and CHAI approach was focused on national health care sector needs and the protection of critical and support healthcare workers, but Washington State was also interested in the PPE demand for non-health care workers. In order to respond to this need, Restart Partners expanded WHO’s spreadsheet based calculator to include an analysis of worker requirements by adding details on the number of workers by industry and profession using the North American Industry Classification System (NAICS) using data from Bureau of Labor Statistics. Restart Partners’ model accounts for contact rates of the population that falls into each NAICS group, thus estimating the exposure for worker classifications.
Restart Partners received further requests from Utah and California, and various local governments and private entities for this spreadsheet calculator. This original version works well for state-level governmental entities, but a more complex calculation is needed to guide local governments and organizations due to the complex overlaps of different jurisdictions. When supply chain managers work with smaller populations, the impact of uncertainty is also more pronounced and requires a more sophisticated model. Restart Partners was able to estimate answers to questions like, how much PPE is needed to support restaurant reopening in Cook County?
2.1 Building an Interactive Application
Restart Partners decided to extend the spreadsheet calculator into an interactive application, by developing a collection of modules, written in Python, as an open source tool kit that would enable collaborative tool development and integration of research related to disease modeling, the economy, human behavior, and the supply chain (see Figure 1). With the adoption of professional data science and software programming approaches, an interactive application is being created that can be replicated and improved as more users and use cases are added.
Figure 1: Restart Partners’ Module-Based Interactive Application
Restart Partners is well-positioned to leverage research from a variety of sources to more accurately quantify PPE demand and identify supply shortages. Realistic demand and supply scenarios, representing inherent uncertainty, will be developed through coupling information from the various modules. A dashboard and automatically generated graphs will provide supply chain managers with guidance on ordering and inventory management, considering the impact of PPE demand and supply availability. For example, transmission rates of SARS-CoV-2 in a community can impact reopening plans, and reopening plans can impact transmission rates, and both affect demand and supply for PPE.
2.2 Supporting a Systematic Approach to the PPE Supply Chain
Restart Partners has continually emphasized the gap in tools available to make effective decisions related to procurement, inventory management, and resource allocation of PPE in the current pandemic. Currently, Restart Partners is developing a model in collaboration with a city jurisdiction to support inventory management decisions by generating plans with time-based optimal order quantities given budget, supplier capacities, demand scenarios, warehouse capacities, and uncertainties in lead time and item quality. PPE items are ranked by the decision maker according to how essential they are based on different types of worker to account for the higher social and economic cost associated with unsatisfied demand of those items. Model outputs provide strategies for decision makers to hedge against uncertainties and variations in demand and supply. The model outputs have been presented so decision makers can then evaluate tradeoffs between costs, risk of insufficient supplies (under various demand and supply scenarios), system reliability and other factors.
Responsible governments are preparing for a worst-case outbreak in Fall 2020 and Winter 2021 and creating an emergency staging of PPE to ensure that they are well prepared to keep the healthcare institutions in their jurisdictions fully functional even if there is excessive demand or a disruption in supply.
2.3 Establishing a Coalition of Organizations and Partners
Restart Partners recognizes the magnitude of the problem and is working with several other organizations addressing the same problem for their different constituencies. These include the Mitre Corporation, LLamasoft, Healthcare Ready, and the Lincoln Laboratory at the Massachusetts Institute of Technology. Restart Partners is also connected to top engineering departments across the country including the University of Washington, Georgia Tech, Harvard Medical School, University of Michigan, Utah State, and Ohio State.
Restart Partners is aware that, while the US health system is not accustomed to addressing infectious disease outbreaks, there is an international community that has been working on these issues over many years. Restart Partners recently established a US Chapter of the International Association of Public Health Logisticians (IAPHL) to provide support to domestic logisticians in the same way as IAPHL does across the world. The IAPHL formed in 2007 has 8,000 members from 160 countries including 600 in the US. As a free peer to peer support organization they help logisticians address these types of problems. Restart Partners hopes to leverage this organization to share lessons learned and gather feedback as they further develop decision support tools.
3. Future Developments
It is clear that the allocation of PPE and prioritization of testing locations must take into consideration the disparities in communities of color, including in public health clinics, low-income neighborhoods, and housing conditions (e.g., homeless shelters, over-crowded apartments). The lack of PPE exacerbates the spread of the coronavirus, leading to disproportionate illness and deaths in socially vulnerable populations. To tackle this issue, Restart Partners in collaboration with the University of Washington intends to tailor and incorporate a social vulnerability index (SVI), often used in natural disaster management, to support allocation of PPE. We have connected with the Surgo Foundation to expand their work to a more granular level. An optimization model that includes the SVI will prioritize and allocate PPE to those in socially vulnerable neighborhoods, such as those working in homeless shelters and food banks, health care workers in public clinics, and first responders in under-served neighborhoods. Prioritizing socially vulnerable populations for scarce resources can help reduce the risk of COVID-19 deaths and economic dislocation.
The plan is to build bi-level optimization models and a suite of dashboards to empower decision makers to consider the dependent nature of these decisions and effectively and quickly modify decisions to mitigate unexpected changes that impact operations. These models can be extended to include other supplies such as testing kits, ventilators, pharmaceutical supplies, and vaccines, as needs are identified by partners. An interactive application will enable decision makers to ensure that socially vulnerable populations receive an equitable portion of available PPE and other healthcare products.
Written by Restart Partners’ volunteers and funded Research Fellows, Chelsea Greene, and University of Washington faculty and student. © 2020 CC License 1.0. If interested in donating to help fund a portion of this work, please contact David Sarley at david@restart.us, and/or Zelda Zabinsky at zelda@uw.edu. Restart Partners is a non-profit with 501(c)(3) status pending.
