Resources: Pandemic Preparedness - Descending Into a Culture of Scarcity

Experts agree that a Pandemic is inevitable and will have a devastating effect on mankind when it develops.  I will continue to advocate building Federal Reserve Inventories (FRI) to bolster our food, chronic illness medicines, and America’s supply chains during National catastrophes like a Pandemic or a nuclear attack on a large American population center.  FRI will keep the supplies coming during future crises and will keep America from developing a "Culture of Scarcity" which could be devastating to our people, our economy and our Nation.  I though I'd share some experience that leads me to worry about our societal expectations regarding necessities of life in a National crisis.  Since the product rationing of World War II, we have never had to endure severe and long lasting outages of products or services that we have come to expect in modern day America. That in and of itself can be a huge National challenge.

In 1977, I volunteered for an Air Force position as the Chief, Medical Logistics Management for our healthcare facilities and medical aid stations in the Republic of Turkey.  Because of the tensions between America and Turkey over the Turkish invasion of Cyprus in 1974, the US imposed sanctions on Turkey, and in turn, Turkey closed off all commercial shipments of goods into the Republic needed to support our Service Members, their families and Armed Forces healthcare facilities, commissaries and Base Exchange shopping centers.

The closure of commercial transportation channels necessitated that the shipment of all goods including food, consumer items, medical supplies, vaccines and equipment entering Turkey come through military airlift and sea lift channels only.  It was a time of hardship for Servicemen and their families.  By the time "Yours Truly" arrived, there had existed for some time what I call a "Culture of Scarcity" in the Armed Forces communities throughout Turkey.  I experienced logistics management challenges every day, and observed some intriguing insights into how we Americans handle scarcity of food, medical materials and essentially every consumer product group during tough times. That 1977-1979 experience gave me a unique glimpse into what America could become during a Pandemic or other National catastrophe.  

You name it, we were out of it.  I saw a woman in the Air Base supermarket (the commissary) with a full shopping basket of canned yams. I happen to be both inquisitive and a logistician, and I just had to ask her why she had cleared the shelves of canned yams. She was both open and unabashed in telling me that she and her family hadn't seen a can of yams in their first 6 months in Turkey.  So, she was building an 18 month inventory safety level that would provide uninterrupted yams to their table until they rotated back to America.

When regular house fans came into the Base Exchange (BX), the Air Base equivalent of Walmart, there would be a line around the corner a few hours before the BX opened.  I asked a medical material team member how folks knew that the fans were arriving that day. He told me there was an informal communication system with high placed BX insiders.  An inside source for 15 inch oscillating fans I asked? bet he said. Large water containers like the type they use to pour water over the winning coach's head at the end of a football game were also very hard to come by.  The same thing was true of space heaters, toys of any kind, all food and above all else, bicycles...they were really hot items. Any kind of bicycle.

Electricity was always a "maybe" - something you couldn't take for granted.  The first week there, I lost all of the contents in my side by side freezer-refrigerator due to an 18 hour power outage.  Pretty soon I learned that compressors really don't do well with variations in electric current, called brown outs, so the refrigerator-freezer didn't last very long.  I know from experience that candles aren't romantic after the first ten power outages...they are just facts of life.

I could have written a book on how to shave in the dark without water. I got pretty good at it and did it several times per week for some time. It seemed that electricity outages also meant no water pressure since pumps use electricity...made sense though.  Drinking water had to be personally chlorinated, and we handed out baby medicine droppers to Servicemen and their families which were used to drop a set number of drops of Clorox per gallon of water. You needed two water containers-one for the water where the Clorox was still doing its job of chlorinating and the other container for the water that had met the required time for full chlorination. The kids were great at pointing out the good water from the bad water containers. 

The real horror for me came when I realized that we had a minimum of 13 folks (most of them children) on rabies vaccine at any one time. Getting vaccine released from "customs impoundment" was a real challenge and ultimately my obsession.  Everything was impounded until the Turkish customs officials cleared the shipment....and nobody knew when the inspector would arrive, if at all the day of the shipment.  I worried all the time, because I knew that while I was just an ordinary Air Force medical logistician, I was all they had in Turkey and I was where the buck stopped on medical supplies and equipment.  Failure to find ways to get the supplies into Country and released from customs to my customers throughout the Republic could very well result in the death of those who depended on my team.  Part of my daily regime like brushing my teeth and shaving was saying a prayer asking that no one die today, due to the lack of medical supplies or equipment.

We lost several shipments of Polio vaccine and Diphtheria, Pertussis and Tetanus (DPT) vaccines due to the impoundment of the vaccines and their spoilage in the impoundment yard.  We were living very close to the edge, barely keeping up with the demand for lifesaving medical products.  But we were in a disciplined orderly Air Force society. In today's America, what effect would these long term and persistent shortages have on the fabric of our society? 

If we have knock down drag out fights over "Tickle Me Elmo" dolls at Christmas time, and long lines for I-Phones, imagine life during a Pandemic when anxious parents are waiting for infant formula outside supermarkets and drug stores when the supply trucks arrive with far too few supplies. You might ask "Why would we be out of common items during a Pandemic?" There are two main reasons.

1. The breakdown of "Just-In-Time" Supply Chain Management.  Our food, gasoline, pharmaceutical, consumer products and medical supply chains work pretty much the same way as our monetary systems....on faith that the materials will always be there for us. The folks have faith and trust in our financial systems, and so we don't see everyone across America withdrawing their money from banks when the stock market or currency markets fall.  The same thing is true with our other commodity groups. Typically, we only purchase what we need for a few days to a week or so. For pharmaceuticals, we normally have a portion of a month's supply of the drugs that maintain our heath.  We are not living in a "Culture of Scarcity," so the supply chains work beautifully based on very long, very accurate product consumption histories.

The Onslaught- When the first report comes out from the CDC that a "Novel Strain" of Influenza has arrived in North America all of us will take inventory of food and water, cold and flu medications, chronic illness supplies and pharmaceuticals and most of the other items we have around the house.  We all know what happens when a large segment of the population decides to stock up on the same items at the very same time. We see it in some cities when the weather service predicts a 3 inch snow event....bare shelves. 

Imagine the rush to re-supply medicine cabinets all across America during the same week.  As store shelves empty out, we become a bit less confident in our supply system, so, by golly, when we see items we need..... or think we might need, we buy them...lots of them.  That siege mentality purchasing drains the supply system dry, since no demand forecasting program can predict a Public Health emergency or the Public's reaction to it. The buying trends are based on fear and not prior week's consumption. As the purchases vacillate wildly, so do the re-supply orders and the supply chain is unable to function as advertised. It is then that we become a "Culture of Scarcity". Instead of having to stick it out for a few days in a snowstorm, we are looking at a long term situation...long after the Pandemic fades - perhaps 3-5 years for accurate consumption trends to emerge and supply chain recovery.  Until then, the Just-In-Time supply system will fail over and over again, trying to make sense of erratic demand for products.

2. The Culture of Scarcity.  It is impossible to predict right now, how American's will behave when there are shortages of everything we take for granted in today's America.  We can only hope that we don't become a society of looters and roving gangs of opportunistic thieves.  The only thing that I believe that can and will short circuit the Culture of Scarcity is a confidence in our Government's ability to flow life's necessities through established supply chains during National catastrophes. If the Federal Government signals an inability to sure-up the food supply, fuel supply, as well as the Healthcare and Public Health Infrastructure, "Katie bar the door!"

During a Pandemic or other large scale catastrophe, Federal, State and local elected officials can urge calm all they wish. But when the kids are hungry and Uncle John has run out of his pharmaceuticals that manage his mental disease, times will get very bad... and very fast. The answer isn't for each American to build large caches of everything they use in their daily life - in fact that would cause more harm than good.  If every American had a three month supply of every product from toilet paper to pharmaceuticals, to meat and canned vegetables, distributors would start to see unexpected and sporadic large spikes and severe drops in demand for products.  What would be going on would be 300 million Americans replenishing their supply caches - all using different reorder points. What happens in that case is rolling and persistent backorders of everything, because there are no standardized shopping trends like the ones most of us use today. These trends are the basis for demand forecasting and are the pillars of a Just-In-Time supply chain. Without solid predictable ordering patterns, our "Just-In-Time" marketplace begins to disintegrate.

The only real solution is for Government agencies to invest in and oversee the management of sufficient supplies of "life-necessity items" and pre-position the Federal Reserves at the "Wholesale Level" – in other words, at civilian distribution centers.  During normal conditions, America's distributors could stock rotate very large quantities of Government-owned products in a way that would result in near-zero losses of the taxpayers 'investment in inventory due to expiration in storage. In a crisis, American confidence in its supply structures would remain high, thus reducing the threat of descending into a Culture of Scarcity.

By maintaining adequate Federal reserves of life's necessities....and releasing some reserves during even the regional disasters like hurricanes and earthquakes, we can demonstrate the dependability our supply structures, further bolstering American's confidence. Is this a tall order? You betcha!  Can this be accomplished? You betcha.

Such programs can work very well if they are managed correctly.  The Government has been maintaining a Strategic Petroleum Reserve for many years and the oil has been replaced as it was rotated out to refineries. In a crisis, American life doesn't grind to a halt as soon as we all fill up our gas tanks and oil storage tanks.  We can and really must initiate the same types of reserves for food, pharmaceuticals, medical supplies and equipment and other critical life support products.  Can we start now?

(c) JVR Health Readiness, Inc. 2008

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