Prior to and during the COVID-19 pandemic, Canadian provincial health systems and governments did not sufficiently consider healthcare supply chain in their crisis preparedness plans, leading to an exposed and vulnerable healthcare system. There have been many opportunities to learn from past Canadian and global crises, which have emphasized the importance of healthcare supply chain resilience in providing essential care to patients; however, considerations of healthcare supply chain resilience remain a significant gap in preparedness planning. Illustrated through the Canadian response to COVID-19 pandemic, this article will explore how healthcare supply chain resilience should be a necessary consideration in any crisis preparedness plans. Further, without this consideration of healthcare supply chain resilience, it is the person (the patient and healthcare worker), and especially vulnerable populations, that are most put at risk in the event of a future crisis.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Newfoundland and Labrador (NL). Faced with the destabilization of its traditional supply chain, NL leveraged an existing centralized healthcare supply chain structure to organize its supply chain response to the pandemic. To overcome product shortages, health leaders collaborated with their local business community and industries to source and procure personal protective equipment and create domestic manufacturing capacity for critical supplies. The healthcare supply chain response in NL demonstrates the value of a highly integrated and centralized healthcare supply chain management strategy. It also makes clear the value of a diversified healthcare supply chain, one which draws on local manufacturing capacity to create a domestic source of critical supplies and overcome shortages from global suppliers.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Nova Scotia. During the first wave of the pandemic, Nova Scotia faced the massive destabilization of its traditional supply channels and had to grapple with role clarity and communication in its emergency response structure. Nova Scotia was able to centralize its pandemic sourcing, procurement, and management efforts to its provincial health authority. Healthcare supply chain teams were able to rapidly modify their sourcing and procurement processes in order to compensate for the destabilization of their standard supply channels and assume responsibility for the province-wide management and distribution of pandemic supplies. The Nova Scotia case findings make clear both the value of a centralized and dedicated healthcare supply chain response-that integrates all provincial care delivery organizations-and the diversification of the healthcare supply chain.

The COVID-19 pandemic exposed significant fragilities in the configuration of global healthcare supply chains. This was felt acutely by citizens, patients and healthcare workers across Canada. As demand for critical medical products surged in Canada, and globally, provincial healthcare supply chain teams worked to rapidly stabilize their supply chains. These efforts indicate the emerging features of healthcare supply chain resilience. Results suggest that there are five emerging features: (1) redundancy of supply inventory; (2) diversification of suppliers across geographies; (3) maturity of digital infrastructure to create transparency; (4) proactivity; and (5) equity of distribution to protect the lives of all.

Provincial health systems have been challenged by the surge in healthcare demands caused by the COVID-19 pandemic; the COVID-19 vaccine rollout across the country has further added to these challenges. A successful vaccination campaign is widely viewed as the only way to overcome the COVID-19 pandemic, placing greater urgency on the need for a rapid vaccination strategy. In this paper, we present emerging findings, from a national research study, that document the key challenges faced by current vaccine rollout strategies, which include procurement and leadership strategies, citizen engagement and limitations in supply chain capacity. These findings are used to inform a scalable vaccine strategy comprising collaborative leadership, mobilization of an integrated workforce and a digitally enabled supply chain strategy. The goal of vaccinating the entire Canadian population in the next few months can be achieved when supported by such a strategy.

During the COVID-19 pandemic, the rapid surge in demand for critical supplies and public health efforts needed to guard against virus transmission have placed enormous pressure on health systems worldwide. These pressures and the uncertainty they have created have impacted the health workforce in a substantial way. This paper examines the relationship between health supply chain capacity and the impact of the COVID-19 pandemic on Canada's health workforce. The findings of this research also highlight the impact of the pandemic on health workers, specifically the relationship between the health supply chain and the autonomy of the health workforce.

The COVID-19 pandemic has highlighted the many challenges that provincial health systems have experienced while scaling health services to protect Canadians from viral transmission and support care for those who get infected. Supply chain capacity makes it possible for health systems to deliver care and implement public health initiatives safely. In this paper, we present emerging findings from a national research study that documents the key features of the fragility of the health supply chain evident across the seven Canadian provinces. Results suggest that the fragility of the health supply chain contributes to substantive challenges across health systems, thus limiting or precluding proactive and comprehensive responses to pandemic management. These findings inform strategies to strengthen supply chain capacity and performance in order to enable health systems to effectively respond to pandemic events.