MONTREAL — The shortage of collection tubes with which Quebec – just like the whole world – has had to contend since August 2021 is not about to subside and may even worsen with the now confirmed arrival of a sixth wave. .
Verifications by The Canadian Press with suppliers, the Ministry of Health and Social Services (MSSS), certain CIUSSSs and private laboratories indicate that the rationing of these tubes is severe and leads to postponements or cancellations of intakes. multilevel blood.
Only 50% of demand met
Thus, the MSSS confirms that its supplier no longer meets more than 50% of the requests of all of its clients, including the department itself. This situation has led to postponements of appointments in the public network and to complete cancellations on the side of certain private laboratories.
The situation worsened during the fifth wave and the shortfall is slow to be resolved because in addition to COVID-19, which has led to a much greater demand, hospitals are simultaneously trying to make up for the time lost during the pandemic.
“This is a persistent global supply issue for material used in large quantities and at large scale. According to the information we have, this request would be due to an undue economic situation due to the rise in the COVID-19 infection rate combined with the resumption of medical activities,” explains Marjorie Larouche, spokesperson for the MSSS, in an email to The Canadian Press.
Cancellations and Postponements
The situation has caused significant problems in recent months. In early January, with the fifth wave in full swing, the CIUSSS de l’Estrie had to cancel 6,000 non-urgent blood collection appointments between January 4 and 7, then cancel non-urgent appointments again in the week of January 10 to 14.
At the end of January, private laboratories were closed in Montérégie and, more recently, at the beginning of March, several peripheral collection centers in Centre-du-Québec, such as pharmacies and laboratories, had to refer their patients to the CIUSSS Mauricie/ Centre-du-Quebec.
In the Montreal region, some laboratories have given up offering appointments for blood samples for a few days, as in the case of Services Phleb, a private laboratory that serves Montreal, Laval and Montérégie-Ouest. Not only is Phleb no longer accepting appointments, the lab recently had to cancel several that were booked before the decision to temporarily cease the practice was made.
Other private laboratories had to make colossal efforts to adjust. This is particularly the case at Biron, one of the largest medical laboratory chains in Quebec. “So far so good; we have optimized our ways of doing things to try to preserve our supplies, but the balance remains fragile because we are like all laboratories from all walks of life, from all countries, we have to deal with this shortage, this inability of suppliers to supply at the same rate as they did before,” explains Annie Gauthier, head of communications and public relations for the company.
500,000 more tubes: still not enough
The largest supplier of collection tubes in Canada, the firm BD Canada, which has one of its manufacturing plants in Quebec, confirms that the pandemic has brought about “unprecedented challenges”, according to its director of communications, Ozgur Uzun.
And yet BD claims to have produced half a billion more tubes in 2021 than in 2020 after “investing more than $300 million in tube manufacturing over the past four years” across all of its facilities across the country. world. The company even had to “shift some of its manufacturing from less critical products to products with higher demand,” according to Mr. Uzun.
“The ever-changing needs for the types and volumes of tests required has resulted in the highest and most unpredictable demand in BD’s history,” he explains. He adds that other suppliers have not been able to meet demand at the same rate as in the past, resulting in additional demand for new customers at BD.
Multiple supply issues
However, he adds, the company experiences the same supply issues as all of the industries that produce it, including limited availability and access to raw material, shipping and transportation delays and a lack of manpower caused by the shortage of personnel, but also and above all by abnormally high absenteeism rates of employees who have contracted COVID-19.
Both the MSSS and the supplier indicated that inventory levels are monitored very closely for each establishment and that an allocation is made according to their needs. Weekly meetings take place between the two.
Tight inventory control
Unsurprisingly, all of the supply managers of MSSS health establishments have received the directive “to exercise great vigilance in the management of inventories already in establishments as well as to disseminate this information to the entities under their responsibility”, including CLSCs. and collection centers, explains Ms. Larouche.
“In some regions, meetings are held with prescribing physicians in order to tighten the relevance of test requests and avoid service disruptions,” she adds. Sources at the CIUSSS du Centre-Sud de l’Île de Montréal, one of the largest in the province, confirm that the use of tubes has become extremely parsimonious and monitored very closely on a daily basis, so that we were able to maintain an adequate, albeit fragile, collection service, we were told.
Optimization investments
Annie Gauthier explains for her part that at Biron, on the one hand, we have to do with what we have because the priority goes to the MSSS. “We cannot order as many as we could order before and we must give preference to the public health network. We are aware of that, we respect it and we agree with this way of doing things. Our public health network has a special mission in the province and it is important that he can first and foremost be entitled to the quantities he needs.
On the other hand, the company understood that it would have to change its ways when the pandemic appeared. “What we did initially was to try to optimize the equipment we already have. We try – always in the rules of the art and respecting the parameters that dictate the work of sampling and blood analysis – to use fewer of these tubes. We are also trying to collect a little less blood, without compromising the quality of the analyses.”
But also, she adds, the company has invested in managing the tube shortage. “During the pandemic, we expanded our laboratory facilities and acquired new equipment. What preserves us the most these days, without it being a panacea, is the optimization of what we do and our equipment which is much more efficient and which allows us to do more analyzes a little more with less material if you want, but to have a result that is just as high quality.”
Another element that helped to absorb the decrease was a drop in traffic “especially during the first year (of the pandemic). Several people were afraid to go out and completely stopped or postponed their needs in terms of analysis services or diagnostic services.
There, as in the public sector, vigilance has been raised a notch. “Can we have exactly the same quantities as before? No. It changes. That’s why we have to monitor our supplies even more closely than we did before,” said Ms. Gauthier.
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