US Strategic Stockpile of Medical Supplies Is Outmatched by Coronavirus

By Melanie Evans & Michael Siconolfi - WSJ

Hospitals and states overwhelmed by the coronavirus pandemic say the nation’s safety net of medical-equipment supplies, the Strategic National Stockpile, is falling far short of need and are calling for federal officials to invoke national-defense powers to spur more manufacturing.

State officials in Washington and Massachusetts say they have received a fraction of what they sought from the national stockpile, an emergency federal reserve of pharmaceuticals, medical equipment and protective gear such as protective masks and gowns.

State officials also are calling for a change in the way the stockpile is administered. The stockpile’s formula for doling out supplies is based on population, which is limiting response in areas with escalating cases. Requests should instead be filled according to need, Washington state officials say.

The need is acute. Hospitals are making their own supplies and snatching up donations from businesses. A Department of Veterans Affairs hospital in Washington, D.C., this weekend dispatched security officers to pick up a donation of respirators salvaged from a dumpster a year ago.

“The reality is we are in a war,” Rick Pollack, chief executive of the American Hospital Association, told reporters Saturday.

Federal officials have responded that the stockpile is limited. Health and Human Services Secretary Alex Azar warned Congress last month that reserves of 12 million respirator masks recommended for health-care workers caring for coronavirus patients would be inadequate. He projected emergency demand for 300 million respirator masks, and announced in March that HHS would buy 500 million more in the next 18 months.

The sweeping $1.6 trillion government-rescue plan currently being negotiated in the Senate could include $1.7 billion for the strategic stockpile.

Donated medical supplies on a pallet are wrapped in plastic film as part of an effort in Colorado to battle the spread of the new coronavirus.

But hospitals, doctors and nurses said this weekend that the stockpile alone wouldn’t be enough. They are calling on the White House to use the Defense Production Act to direct private manufacturers to make needed equipment.

“Gloves, goggles and gowns are things we should be able to turn around in this country,” said Pollack, who urged the White House on Saturday to use its power to direct industry to produce equipment, and to deploy the National Guard to deliver supplies.

The Trump administration has resisted the move. “We’re a country not based on nationalizing our business,” Trump said Sunday. “The concept of nationalizing our business is not a good concept.”

The president also said federal aid to California, New York and Washington would include 19 medical stations with a combined 4,000 hospital beds across the three states.

HHS said over the weekend in a tweet that the stockpile “continues to deploy tons of personal protective equipment and other supplies and equipment across the US.”

Demand for the protective gear has grown acute as the virus has spread, forcing doctors and nurses to reuse disposable masks, hospitals to ration supplies and the desperate to enlist help from ad-hoc manufacturers and donations.

The Washington, D.C., VA Medical Center dispatched security to a Maryland industrial park Saturday to pick up respirator masks that a construction recycling company salvaged one year ago, according to Brian Shipp, an owner of Sun Recycling.

Mr. Shipp said his father saved about 35,000 respirator masks found in a dumpster a year ago. His father routinely stashes items of value in warehouses that he owns and told his son about the supply last week, the younger Shipp said. After inspecting the masks, the two men began calling hospitals and nursing homes, offering to give each a share. “There’s no reason why they shouldn’t be used,” Shipp said.

The VA didn’t immediately respond to a request for comment.

Children’s National Hospital in Washington, D.C., is expected to receive 2,500 respirators from Sun Recycling on Monday, Andrey Ostrovsky, an attending physician there, said. Dr. Ostrovsky worked Wednesday to cover for colleagues who couldn’t work after showing symptoms of Covid-19, the disease caused by the virus. He said he worked eight hours reusing one surgical mask, the type offering less protection than the recommended respirators, because that was all that was left.

Washington officials have called for federal officials to consider need instead of population size as they dole out the strategic stockpile’s limited inventory. At present the formula would divide it up among the 50 states, plus New York City, Chicago, Los Angeles County, Washington, D.C., and eight island jurisdictions based on population from the 2010 census, according to HHS.

The Federal Emergency Management Agency, which heads federal response for the White House coronavirus task force, will oversee buying and distribution of protective equipment, a spokeswoman said Sunday.

“We continue to believe that states should be allocated medical supplies based on needs,” said Casey Katims, who handles federal aid requests for Washington Gov. Jay Inslee.

“Please get us more,” said Onora Lien, executive director at the Northwest Healthcare Response Network, a nonprofit under contract with Washington state to coordinate hospital and nursing-home disaster response for 15 counties including Seattle. “It is an urgent need.”

In late February, Washington reported one of the earliest cases to suggest the virus was spreading in the US and quickly asked the federal government for stockpile supplies. It has recorded nearly 2,000 cases so far and 95 deaths, as of Sunday, according to Johns Hopkins University.

As of March 17, the Washington State Department of Health had received more than 540 requests for gear from hospitals, nursing homes and other providers and had filled 54, a spokeswoman said.

Washington state’s shipments from the stockpile have fallen short of requests by hundreds of thousands of protective items, Katims said. Fresh supplies from another request began to arrive this past weekend. “They did not give us everything we asked for,” Katims said.

Under the stockpile formula, states likely won’t receive all the supplies they request, an HHS spokeswoman said. Where the virus is widespread, more supplies may be awarded.

She also urged the hospital sector to respond. “Local hospitals also need to do their part to make sure product goes where it’s needed now, rather than being stored where it’s not currently needed,” she said.

Massachusetts officials have said the state has received only about 10% of the supplies requested. Since making that request, Massachusetts earlier this month  declared a state of emergency, and the number of confirmed Covid-19 cases has ballooned to more than 200, with hundreds more under quarantine.

On Friday, Rep. James McGovern, [D., Mass.] who is chairman of the House Rules Committee, joined other Massachusetts officials to complain to HHS that it isn’t getting the goods it needs from the stockpile.

“Health care providers in the Commonwealth have been working around the clock to meet the urgent demands of the coronavirus disease 2019 (COVID-19) public health emergency,” the lawmakers wrote. “We urge you to grant the request without delay.”