‘Ivory Towers’ get their hands dirty – to clean yours

The COVID-19 pandemic exposed weak links in the global supply chain of critical goods like hand sanitizers even in the world’s leading economies. Here, we look into how universities can help address short-term shortages, and how “supply and demand” can find a happier and faster match online.

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By now, we all know that COVID-19 spreads through respiratory droplets (i.e. via coughing and sneezing) and through “contact routes” – this includes touching a virus-contaminated surface and using that hand to touch your mouth, nose or eyes. On average, we touch our faces more than 16-times per hour.[1] More so for the desk-workers, I find – my experience of 5 weeks of home-office and while writing this article makes me acutely aware of my own fidgety hands. A recent study has shown that the COVID-19 virus can survive for up to 72 hours on plastic and stainless steel, less than 4 hours on copper and less than 24 hours on cardboard.[2] Of course, the tenacity and infectiousness of this virus paired with our own cultural and personal habits has implications for hand hygiene standards, as we learn to live with the virus.

While one of the most simple and effective means to clean hands are water and soap, running water is not always available to field staff (police, firefighters, paramedics) and in public spaces (public transport, hospital waiting rooms, administrative buildings).

External application of alcohol and bleach-based products is very effective at disrupting the outer walls of viruses (and bacteria) making them inactive.[3] These are the main components of commercial hand sanitizers – a cheap commodity product in normal times. However, especially during the first weeks of the COVID-19 pandemic we saw global demand for hand sanitizer skyrocketing while supply was limited and falling fast. This led to private racketeering and prize-hikes,[4] that not only inconvenienced private consumers, but also – in parts – led to a disruption of the supply-chain for system critical infrastructure like hospitals and law enforcement even in the most developed and industrialized economies, like Germany.

Status quo ante – gearing-up for home-production

At the onset of the COVID-19 lockdown in Germany in mid-March 2020, the Charité Berlin – one of Europe's largest university hospitals – had an excess demand of 300 to 600 Litres of hand sanitizer per day that was not readily covered by the market. From the 23rd of March until the 23rd of April, chemists from the Humboldt University of Berlin were able to address this short-term market failure by producing 300 (up to 1100 Litres) of hand sanitizer per day following a recipe of the World Health Organization (WHO) (Table 1). Formulation 1 in particular is suitable as pre-surgical hand preparation according to the European Standard EN 12791. We were able to do this in university laboratories with a core staff of only five people. Laying the legal framework for this ‘local action’, however, involved a wider range of stake-holders. By now, the chemical laboratories of the Berlin University Alliance (BUA) have joined up to alleviate shortages of disinfectants for a number of schools, hospitals, and public institutes in the Berlin area.

Table 1. 10-Litre preparations of WHO-recommended hand sanitizer[5]

Formulation 1

Formulation 2

Role of component

Ethanol 96%, 8.333 L

Isopropanol 99.8%, 7.515 L

Active component to inactivate bacteria and viruses.

Hydrogen peroxide 3%, 0.417 L

Hydrogen peroxide 3%, 0.417 L

Inactivates bacterial spores in the solution and in containers.

Glycerol 98%, 0.145 L

Glycerol 98%, 0.145 L

“Humectant”; reduces loss of skin moisture.

Distilled or cold, boiled water, 1.105 L

Distilled or cold, boiled water, 1.923 L

Top-up for a 10-Litre preparation.

Am I allowed to “home-brew” hand sanitizer, and can I get sued?

You cannot simply whip together some chemicals and call it “hand sanitizer”, even if you follow a recipe. Every country has a body like the U.S. Food & Drug Administration (FDA) that regulates the quality of over-the-counter antiseptics.

In Germany, the Federal Institute for Occupational Safety and Health (BAuA) was quick to issue an “exceptional approval for hand disinfectants” as early as the 20th of March.[6] This enabled manufacturing of hand sanitizer “by pharmacies, the pharmaceutical and chemical industry and legal entities under public law for supply to professional users”. Hence, this approval was also applicable to us as public universities.

Most countries have some form of liability clause for “willful and negligent” conduct that entails claims for damages.[7] It is a fool’s errand to ask for an exemption from such a fundamental civil right for small-scale production, even in a time of crisis – as I (and surely many a lobbyist) found out. However, the BAuA’s “exceptional approval” explicitly applies to “[manufacturers] that have practical experience and can accordingly guarantee the required effectiveness and safety of the manufactured product.”

Hence, standard quality management of home-brew hand sanitizer entails: (1) density measurements (areometry) to verify the recommended alcohol content of the final product, and (2) regular gas chromatography flame ionization detection (GC-FID) of samples, especially when raw materials come from new suppliers. In absence thereof, the suppliers’ Material Safety Data Sheets (MSDS) are a sufficient guide to purity and safety of the raw components.

This is standard protocol for most university laboratories, but getting our hands on sufficient amounts of raw materials was still a challenge.

Home-brew hand sanitizers produced at the Humboldt University of Berlin getting ready for shipment.

Academia – the weakest link in the supply chain?

From the mid of March onwards, critical infrastructure world-wide experienced long lead-times and delays for deliveries of hand sanitizers, disinfectants, and the components needed to mix them. This applied even more so for non-critical infrastructure like academic laboratories.

However, on regional level, stocks of raw materials were still available. In particular so, since most pharmacies and hospitals had no immediate use for the raw components: medical facilities rarely have the infrastructure to handle “industry-scale” deliveries in tanks or even in intermediate bulk containers (or IBCs), and have very rarely ventilated, explosion-protected facilities to mix their own hand sanitizers at their disposal. In comparison, chemical stores at universities routinely handle large quantities of solvents in a safe way.

Thanks to a support letter from the regional government – the Berlin Senate – addressed to a selected group of suppliers, we were able to ensure “preferred deliveries” for the “time-limited relief effort” in supplying critical, public infrastructure with hand sanitizer. Here, the involvement of public stake-holders was crucial to ensure our supply chain.

Handing things over to the professionals

On the 9th of April – only two weeks into the lockdown – the Association of the Chemical Industry (VCI) in Germany launched the online-platform “Disinfectant Emergency Supplyto alleviate acute bottlenecks. The platform arranges contacts between all actors in the supply-chain: from raw material suppliers, formulators and fillers of finished disinfectants, to logistics and medical facilities. Within the VCI, a core-team of six are intensely involved in the development and administration of the platform. Also, the VCI reaches out to member companies who provide expertise, advice and action. The Boston Consulting Group provided a team from BCG Digital Ventures free of charge, who developed and built the IT structure for the platform and the B2B processes (on the basis of “Sharetribe”).

All platform registrations are analyzed whether they belong to the specific group of hospitals, care facilities or medical practices, as prioritized by the Federal Government. On the supply side, we check the reliability of the providers according to various criteria (unless they are known as member companies of the VCI or from cross-references). Registrations for users outside of this target group will not be granted to prevent usury and scamming.

The platform includes chemistry giants like BASF, Evonik or Henkel and also many medium sized companies – who produce hundred thousands of Litres additional hand sanitizer per month by now.

The ‘post-mortem’ – with as little ‘mortem’ as possible

The global, unifying experience during the COVID-19 pandemic was one of shortages of disinfectants and of personal protective equipment (PPE). It is evident that the market was unable to meet the short-term demand for critical supplies especially at the all-decisive onset of this crisis, when developments of known cases (and therefore demand for critical supplies) were expected to rise exponentially. It is through insightful preparation and planned redundancy (stockpiling) – as well as through quick and unbureaucratic action – that the worst possible outcome – a breakdown of disinfectant supply – was averted. These are surely two lessons worth taking forward to the next crisis.

Acknowledgements

I thank Prof. Dr. Dr. Sabine Kunst, Prof. Dr. Nicola Pinna, and the other heads of the Berlin University Alliance (BUA) for enabling manufacture of disinfectant during a time of need. I expressly thank Steffen Krach (Berlin State Secretary for Science and Research) for his unwavering support of BUA activities, and Sonja Jost (DexLeChem GmbH) for linking us up with industrial contacts and active sourcing. I expressly thank Manfred Ritz and Dr. Michael Lulei for insights into the operation of the VCI online-platform “Disinfectant Emergency Supply”.

Keywords: COVID-19 • disinfectant • hand sanitizer • local production • WHO

[1]            Y. L. A. Kwok, J. Gralton, M.-L. McLaws, American Journal of Infection Control 2015, 43, 112-114.

[2]            N. van Doremalen, T. Bushmaker, D. H. Morris, M. G. Holbrook, A. Gamble, B. N. Williamson, A. Tamin, J. L. Harcourt, N. J. Thornburg, S. I. Gerber, J. O. Lloyd-Smith, E. de Wit, V. J. Munster, New England Journal of Medicine 2020, 382, 1564-1567.

[3]            United States Environmental Protection Agency. List N: Disinfectants for Use Against SARS-CoV-2. Available from: https://www.epa.gov/pesticide-..., Washington D.C., 2020.

[4]            S. Doyne, M. Gonchar, The New York Times. Is It Immoral to Increase the Price of Goods During a Crisis? 2020.

[5]            World Health Organization. Guide to Local Production: WHO-recommended Handrub Formulations. Available from: https://www.who.int/gpsc/5may/..., Geneva, 2010.

[6]            Bundesanstalt für Arbeitsschutz und Arbeitsmedizin. Allgemeinverfügung zur Zulassung 2-Propanol-haltiger und Ethanol-haltiger Biozidprodukte zur hygienischen Händedesinfektion. Available from: https://www.baua.de/DE/Angebote/Aktuelles/Meldungen/2020/pdf/Allgemeinverfuegung-Haendedesinfektion.pdf, Dortmund, 2020.

[7]            Civil Code of the Federal Republic of Germany (Bürgerliches Gesetzbuch). § 823 Schadensersatzpflicht. Available from: https://dejure.org/gesetze/BGB/823.html.

Go to the profile of Michael Bojdys

Michael Bojdys

Associate Professor, Humboldt-Universität zu Berlin

2 Comments

Go to the profile of Eva Amsen
Eva Amsen about 1 month ago

That's amazing! Thanks to everyone involved for stepping up to produce hand sanitizer, and for documenting all the challenges and bottlenecks.

Go to the profile of Ruth Milne
Ruth Milne about 1 month ago

Facinating read, thanks for sharing this!