Medical Panic Doom setting in -- another definite shortage- getting real for us

This was on the front page as a major headline in the Lehigh Valley Morning Call newspaper this morning. People are freaking out now.

An ongoing global shortage of dye used in X-rays and CT scans is causing both Lehigh Valley Health Network and St. Luke’s University to postpone some patients’ imaging procedures.

Hospitals and health systems are experiencing a shortage of intravenous imaging contrast, a dye used in imaging tests. LVHN and St. Luke’s have sent out notices or posted on their websites that because of this, they are postponing non-emergency or outpatient imaging procedures that require it.

LVHN said in a statement the network “has supply to diagnose the most critical cases including strokes, heart attacks, traumas and other life-threatening emergent conditions.”

A news release from St. Luke’s says the network’s ability to perform imaging tests that require the dye in ”all but the most critical cases” is limited until the supply chain issues are corrected.

Both networks declined to comment further. Patients who had appointments postponed will be rescheduled once supplies return to more normal levels.

Chris Chamberlain, the Hospital & Healthsystem Association of Pennsylvania’s vice president of emergency management, said HAP has been hearing hospitals across the state are dealing with shortages. He said they haven’t heard how badly the shortage has impacted member hospitals’ operations.

Contrast media are chemical substances often used to increase the contrast of structures or fluids within the body, making it easier for medical professionals to spot abnormalities through medical imaging such as CT scans, MRIs, x-rays and angiography procedures. Though the type of contrast media used depends on the procedure, the type used for CT scans and X-rays are iodine-based and these are the ones in short supply.

The shortage is yet another global supply chain issue to occur amid the pandemic and one of many to hit the health care industry. Chamberlain said over the course of the pandemic, the health care industry has faced serious shortages of blood and workers. Shortages of raw materials like silicone and aluminum have created problems for hospitals, too.

The shortage is forcing health networks to prioritize how they use contact media supplies for emergent cases.

“Our doctors will work with their patients to determine whether they may benefit from non-contrast CT scans or alternate tests, such as ultrasounds, MRI or nuclear scans,” Barbara Schindo, Penn State Health spokesperson, said in an email.

What caused the shortage
North America is the world’s largest market for contrast media and the continent’s top provider is GE Healthcare, an American-based multinational company. Most of the contrast media GE Healthcare distributes are made in the Chinese megalopolis and manufacturing hub Shanghai.

But because of coronavirus outbreaks starting in early April, China temporarily locked down Shanghai and some other cities as part of its “dynamic zero-COVID” policy. Shanghai businesses were temporarily shuttered including the manufacturing plant that GE Healthcare’s contrast media comes from. The lockdowns have also affected some other major suppliers of contrast media like Italian company Bracco Imaging SPA.

However, China’s government has prioritized getting industry in Shanghai going again and “key industrial chains, such as automobiles, integrated circuits and biomedicine, continued to recover and ramp up production capacity,” according to a May 11 article by the Chinese-state media publication the People’s Daily. Some reports have also stated the Shanghai plant where iodine-based contrast media is made has resumed operations but shortages would continue at least through the end of June and possibly into July.

GE Healthcare and Bracco did not respond to messages about the current status of the manufacturing plant.

With the shortage expected to last at least another month and a half, HAP is talking with the American Hospital Association and other state hospital associations.

“We’re certainly watching this to ensure the supply of IV contrast media returns so that we don’t see an extended impact,” Chamberlain said.

HAP is also recommending members use conservation strategies, like choosing to use contrast media for select patients and situations as well as expanding searching for alternative suppliers and vendors.

LVHN is exploring alternative sources and vendors for intravenous contrast, according to a statement. Both LVHN and St. Luke’s are using other imaging tools, such as MRIs, as alternatives when appropriate.

Though it’s impossible to predict what might cause a new shortage, Chamberlain said HAP is also advising member hospitals to prepare for what else may occur because of the pandemic.

“It’s really caused hospitals to do more than just take a cursory look at the supply chain,” Chamberlain said. “We relied on our vendors to give us some just in time deliveries and if we were going to have a problem, we just had them double up for us quick and that was about it. Well, what we learned in the pandemic was that that’s not good enough.”

Morning Call reporter Leif Greiss can be reached at 610-679-4028 or [email protected].