Open back, tie at the neck, tie at the waist, perforated (for easy tear off), slit cuff, thumb loop cuff, elastic cuff, disposable, reusable: Ed Gribbin can tell you that there is nothing simple about a medical gown.
His Merion Station office has three dozen medical gowns of every style, each serving a different purpose and each requiring a different performance textile, thread, expertise and equipment to make. Gribbin runs his own supply chain strategy consultancy in a field that skyrocketed to prominence with the coronavirus pandemic as hospitals and governments have competed for gowns, masks, gloves and other personal protective equipment (PPE) vital to safe testing and treatment.
And as the pandemic wears on, his industry is seeing demand not only for more products, but also for goods made in North, Central and South America.
“Talking to hospitals, chief medical officers and purchasing chiefs at government agencies, there is a huge distrust of importing product from China,” Gribbin said.“Add that to the current trade tensions we have with China and the fact that at any given moment the administration could pull the plug and say the border is shut and we aren’t bringing anything in, everyone is a little skittish. We don’t want to be as reliant on China for production as we have in the past. The fact of the matter is we want to build a permanent supply chain here.”
In January, when few Americans had even heard of the coronavirus, Gribbin became president of the Americas Apparel Producers Network, with members across the globe encompassing the 30 links of the apparel supply chain “from the dirt to the shirt,” as he puts it.
At the start of the pandemic, the group set up a site where suppliers could post their capacity to make critical PPE. Within 15 minutes of going live, it was flooded with posts from 1,000 companies offering capabilities, advice and tools, said Mike Todaro, managing director of AAPN.
“The postings were surprising. Fifty percent who had cut-and-sew capabilities were not in apparel. One was a parachute maker, and awning, tent and umbrella makers. They were people with ingenuity, reinventing their businesses to keep their lights on and help make PPE,” Gribbin said.
He had the Herculean task of categorizing those posts and building spreadsheets playing matchmaker to connect fabric mills with cut-and-sew operations to coordinate the production of critical medical supplies for hospital systems and FEMA. When Emory University asked Todaro for 90,000 gowns by June, he and Gribbin coordinated the effort. More than two dozen network members pitched in, among them Philadelphia’s Boathouse Sports.
Before March, more than 90 percent of gowns were made in and around China, which went into lockdown because of the virus. Supply chains were shut down, and hospitals had nowhere near the inventory that they needed.
“The demand for gowns in medical and nonmedical applications on a month-to-month basis is running 10 times what it was a year ago in July because so many people are using them that never used them before,” Gribbin said.
Doctor’s offices, dental and ophthalmologist practices, police departments and rescue workers all need gowns, often for the first time. And hospitals need many more gowns than ever.
“We just learned that FEMA wants 263 million gowns in the next six months when their original estimate had been 110 million,” Gribbin said.
Gribbin thinks he can work with three facilities in California, Cambodia and Colombia to start on that order with 20 million gowns.
But even as supply chains from China reopen, he said, it’s clear that demand for products made in North and South America is high.
Made in the Americas is preferred. “There is a huge distrust of importing product from China,” Gribbin said. “Add that to the current trade tensions we have with China and the fact that at any given moment the administration could pull the plug and say the border is shut.”
“Everyone is a little skittish. We don’t want to be as reliant on China for production as we have in the past,” he said. “We want to build a permanent supply chain here.”
Last month, the Trump administration made a change that could boost that effort. It moved gown purchasing from FEMA to the Defense Logistics Agency, which is part of the Department of Defense and gives preference to certain domestic products under what is known as the Berry Amendment.
“There is a lot of talk in Congress now, with bipartisan support, for extending the Berry Amendment to include critical medical supplies so they would have to be sourced in the U.S.,” Gribbin said. “It will not affect hospital systems, but it would affect the federal government and the way they buy and possibly state governments in buying PPE.”
As it is, the Department of Defense realized the United States does not have the capacity to produce 263 million gowns domestically, Gribbin said. Because of that, it broke the procurement into three tranches: anyone who could submit an American solution will get considered first, anyone from a country where the U.S. has a trade agreement is next, and then comes anywhere else such as China.
But there’s much more to Gribbin’s task even than sourcing an enormous number of gowns. He must also get the right kind of gowns, ranging from those that are simply resistant to liquid, all the way to gowns with a laminate polyethylene coating impervious to even viral matter. The highest-grade gowns have to be FDA approved.
Then there are disposable vs. reusable gowns. When Gribbin worked in the uniform industry in the 1980s and ’90s, the majority of gowns were reusable, and hospitals had laundry services. Then disposable gowns became popular for their convenience and cost — about $1 to make. But they get used once and go to a landfill along with medical waste. “Hospitals are now starting to ask for washable gowns, which will last longer and are better for the environment,” he said.
Demand for gowns shows no sign of slacking off, given enhanced safety protocols and uncertainty over the virus.
“We think there will be long-term work with state agencies, health-care systems who will all want domestic product. I believe 20% to 30% of medical product will be made in the USA or in this hemisphere. Just last week, the Air Force was on one group call requesting white papers from any interested party on what a government investment might look like in expanding domestic capacity to make more critical health-care supplies with the government as a financial partner with industry to make that happen.”