AAlmost everyone now knows that the United States was ill-prepared to fight Covid-19. But few realize that the structural supply chain issues that have plagued the government’s response have not been resolved.
It is crucial to address these vulnerabilities now. It’s unclear when the next inevitable health crisis will strike.
Consider the government’s disastrous distribution of emergency medical supplies. The Federal Emergency Management Agency (FEMA) is responsible for the national strategic stockpile of personal protective equipment (PPE) such as N95 respirators, gloves, gowns and face shields, as well as ventilators and certain pharmaceuticals , such as antibiotics and antitoxins.
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Yet public records requests showed that when the pandemic began, FEMA had no established criteria for distributing supplies to states. And the system he finally put in place was problematic.
He distributed PPE based on calculations that had nothing to do with the number of cases in a state. As a result, less populated states with relatively few Covid-19 cases, including Alaska, Hawaii, Montana and Vermont, received the highest number of PPE items per Covid-19 case. Meanwhile, states beleaguered by cases, including California, Connecticut and Massachusetts, received the fewest masks, gloves and shields per case.
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When states were successful in sourcing from FEMA stock, they often got the wrong items and almost always received smaller shipments than requested. Doctors and nurses have been forced to reuse the same N95 masks for a week, even though they are designed to be thrown away after seeing each patient.
This federal supply chain failure has forced states to bid against other states, as well as the federal government, for items such as medical-grade face masks and disposable gloves. At one point, bidding wars and price gouging drove the price of a ventilator that typically cost $25,000 to over $45,000. Healthcare facilities were paying $5 for N95 respirators that cost 50 cents before the pandemic hit.
Instead of getting supplies to where they were really needed, they went to the highest bidder. Frontline healthcare workers, patients and taxpayers have all paid a heavy price for this inefficient system.
There is a simple way to prevent such a disaster from happening again. Congress could authorize and fund a federal network to collect and disseminate information about PPE, drugs, and other medical items. This would allow officials, likely the Food and Drug Administration, to inventory and properly deliver health care supplies to patients and health care workers in areas that need them.
Of course, monitoring and distributing inventory is only half the battle. The best surveillance system in the world cannot get masks or medicine to hospitals if there is a severe nationwide shortage. And that’s exactly what happened last year.
Over the years, many hospitals and medical equipment distributors had become dependent on cheaper manufacturers from other countries, especially China. But China restricted exports of personal protective equipment when its own coronavirus crisis began.
In response, American manufacturers large and small have sprang into action, investing millions of dollars in the equipment and people needed to boost domestic production of masks, hand sanitizer, face shields and protective clothing. other protective equipment needed to deal with the pandemic, as well as ventilators and other medical equipment.
But these domestic manufacturers are now facing canceled contracts as major suppliers, hospital systems and even state governments once again turn to overseas manufacturing. China is currently flooding the market, selling a few surgical masks for a penny, while American companies struggle to survive. The New York Times recently reported that the 27 members of the American Mask Manufacturer’s Association have laid off 50% of their workers.
Turning to China for supplies isn’t just short-sighted: it’s a threat to national security.
It is absolutely essential that the United States increase domestic production of PPE for future health crises. That means more federal contracts, and even public-private partnerships, to build and maintain not just inventories of masks, drugs, and ventilators, but also the spare manufacturing capacity needed to make them faster. Maintaining this excess capacity would effectively act as an insurance policy allowing us to increase production when needed.
Congress owes it to Americans to appropriately fund these supply chain investments so that the General Services Administration can begin soliciting bids immediately.
US-made PPE might be slightly more expensive than Chinese-made gear. But that money would be well spent: restoring reliable supply chains and maintaining idle manufacturing capacity will pay huge dividends, both in lives saved, jobs created and economically devastating lockdowns averted.
Too many Americans died needlessly from Covid-19 because the federal government lacked a proper method to manage and distribute emergency drugs and healthcare equipment. Congress needs to put a better system in place before the next public health crisis hits.
John Wharton, a US Major General (Retired) who most recently served as Commanding General of the US Army Research, Development and Engineering Command at Aberdeen Proving Ground, Maryland, currently advises world governments and major cities on risk management, infrastructure and resilience initiatives.
