Serving Eye Surgeons During the Pandemic: Relying on Ingenuity and Partnerships

Those of us in transportation logistics are feeling the impact of the new realities thrust upon us by COVID-19, but we are especially challenged in the time-sensitive field of processing and delivering corneal tissue for transplants. Most domestic surgeons want to receive tissue within two to three days of it being cleared for use, so we have had to develop new solutions and lean on new partners to help us get sight-restoring tissue into the hands of corneal surgeons on time.

Managing Through the Lockdown

When the virus hit, we anticipated its impact to our supply chain as well as our work life. We began proactively getting ready for worst-case scenarios. This preparation proved to be key and enabled us to shift the work of five labs into one as elective surgery came to a stand-still and tissue was only required for emergencies.

During the worst of the lockdowns in March and April 2020, we micromanaged tissue sourcing and looked to surgeons to dictate whether surgeries were emergencies or elective. Tissue needs became hard to predict day to day, and some recoverable tissue was put into long-term storage for use for glaucoma patients so we could continue to honor the gift of donation.

There also were fewer recoveries during lockdowns, so we prioritized our tissue sources to rely primarily on the eye banks with whom we have had long-term partnerships. We wanted to be sure those valued partners would still be there for us when surgeries returned to a more normalized state.

The Logistical Challenge of Rebounding

Perhaps the biggest challenges we have faced have come as we are ramping back up to meet pent-up demand for transplant surgeries. Tissue supply has been slow to rebound with a 20% drop off in viable tissues due to COVID-19. And, the medical review process required to clear tissue for eligibility is now taking 24 hours longer to evaluate for risks associated with the pandemic. This has put additional pressure on our logistics systems which are already strained due to flight cancellations.

We now manage a delicate balance and our customer service team has been critical in this effort. They engage in proactive communication to manage the flow of tissue requests and reschedule some surgeries if needed. To meet some urgent requests for tissue, we have had to utilize new sources and take on more cost in the process. We do whatever it takes to meet the needs of our surgeons and their patients.

Getting Tissue from Here to There

Before the pandemic, we were able to utilize air freight and courier systems to deliver tissue to surgeons on time. Processing the tissue could be completed quite late in the day without jeopardizing arrival for early surgeries. Now, as noted in AirCargo News, “The collapse of the airline networks means there simply are not enough aircraft to shift the items consumers, businesses and governments need.” The result is a dramatic shift in our logistics partners and how we decide which partner to use.

Today, we are much more reliant on carriers like FedEx because their FedEx First service enables us to ship later and still ensure tissue is delivered to surgeons by 8:00 a.m. When tissue is required even earlier, we rely on the more traditional air freight and courier method, but must allow for a noon shipment. The earlier cut off is challenging but accommodates unexpected flight cancellations or delays while ensuring tissue is available when promised. These adjustments have had additional upstream impacts: changes to our packaging to allow for longer transit times and heroic efforts by our customer support team to communicate effectively with surgeons. Despite the hurdles, CorneaGen is currently delivering tissue on time more than 90% of the time and making consistent progress toward our pre-COVID success rate of 95%.

International Problem-Solving

While CorneaGen has rebounded to near pre-COVID levels domestically, serving international clients remains a challenge. We routinely supplied donor tissue to more than 40 countries before the pandemic. In some places, elective surgeries remain on hold. In others, there is a definite need for corneas but no logistical means to get viable tissue into the country. Shipments are taking longer to arrive than the time for which the tissue can be packed and cooled.

To address these logistical challenges, we are exploring FedEx International service and reaching out to other international air freight specialists who can handle time-sensitive materials. We also are getting creative in identifying bottlenecks: We are problem-solving by testing shipping methods with nonviable tissue to identify and resolve delays and other issues. We are hopeful this inventive and collaborative approach will allow us to resume shipping internationally soon.

I am routinely asked, “How has COVID impacted your work?” But the better question may be, “How hasn’t it?” The pandemic has hit us on so many different fronts—we face supply challenges, variability in demand, and a hampered ability to move tissue from point A to B. Thankfully, the pandemic also has surfaced the creativity, resilience, and commitment of our customer service, logistics, and sourcing teams. I could not be prouder to work with these amazing individuals in the service of CorneaGen’s mission to eliminate corneal blindness worldwide.