States Brawling in Medical Marketplace With Scant Federal Help

Ventilators must run out before Alabama can request more from the federal government, the state’s health department said Tuesday. The parsimony may help safeguard the national stockpile of medical supplies during the Covid-19 pandemic, but could prove deadly for those suffering in the state, which now has 2,007 cases.

Louisiana received only 5% of the ventilators it sought from the national stockpile. Illinois has “a mere fraction” of its supply requests, Governor J.B. Pritzker said.

Even as President Donald Trump boasted of “great coordination” between state and federal governments during a Tuesday night news conference, needs for personal protective equipment and ventilators remain unmet despite weeks of cajoling and even pleading. Governors said this week that they’re still facing shortages, delays and confusing demands as they try to supply hospitals beset by patients suffering from the respiratory disease caused by a new coronavirus.

“The nation’s governors have been on the front lines of the Covid-19 pandemic,” Maryland Governor Larry Hogan, a Republican who is chair of the National Governors Association, said in a statement. “We’ve stepped up to make tough decisions for our states and to push for more action from the federal level.”

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Trump has said repeatedly that states are the front line in the fight against the pandemic, and urged governors to seek out their own equipment and supplies. Now, states are competing not only with one another but also with the Federal Emergency Management Agency. And they must devise strategies to avoid angering a mercurial president.

Banding Together

In the Midwest, Michigan, Wisconsin and Minnesota formed a consortium to purchase protective personal equipment, now known almost universally as PPE. California has taken on a national role, crowd-sourcing supplies and doling them out to other states in need, like New York, and even contributing to the national stockpile.

The explosion of disease, which began on the coasts but now is tearing through cities and rural areas alike, has killed more than 12,000 Americans. As of Tuesday afternoon, U.S. cases rose 8.7% from the day before to 383,256, according to data compiled by Johns Hopkins University and Bloomberg News.

Hospitals nationwide are facing shortages of masks, gowns, gloves, tests, ventilators, cleaning supplies and toilet paper, a federal survey of hospital administrators conducted in late March found. First responders, including emergency medical personnel, firefighters and police, are also facing these shortages. The national stockpile has failed to replenish the items they need.

Trump activated FEMA in March to respond to the coronavirus after weeks of downplaying the pandemic’s potential to harm the nation.

The agency, divided into 10 regions, generally races in to deal with localized natural disasters, supplying shelter and rebuilding help. Now, it’s responsible for acquiring and apportioning medical supplies, a field in which it has little expertise. The effort is not going well, as FEMA officials have acknowledged they do not have enough equipment in the national stockpile to meet the soaring demands and are scrambling to acquire equipment from other agencies or buy it on the open market.

But in doing so, the agency is colliding with the states, which are acting largely on their own. Calls and an email seeking comment from FEMA were not immediately returned Tuesday night.

Standing Down

Trump said Tuesday that the federal government will “immediately drop out of the bidding” if states are outbid for materiel by FEMA. But some governors say that in practice, the market is dominated by the federal leviathan.

“Domestic ventilator manufacturers have informed the governor that the orders of Colorado and other states will not be fulfilled any time soon because FEMA is jumping the line and demanding all the product,” according to a statement from the office of Colorado Governor Jared Polis. The state has received three allotments from the Strategic National Stockpile thus far, all for personal protective equipment.

On Tuesday evening, FEMA announced it would provide nearly $17 million to Colorado, funding that comes as part of the president’s major disaster declaration.

FEMA sent a list of data-heavy questions to states last week in an effort to determine which have the most urgent needs. The results of that questioning are unclear. Some states that ask for aid have been flatly rejected: Alabama was denied or not given all of its requests, save 4,000 specimen-collection swabs and some PPE.

In hard-hit Louisiana, 200 ventilators that arrived Sunday brought the total supplied by the federal government to 350, or 5% of the state’s request of 7,000, data from the state Health Department showed. The state has requested 6.3 million pairs of gloves and received 483,000, 1.23 million N95 masks and received 208,000, and 989,000 surgical masks and received 494,800.

Negotiating Trump

In Illinois, Governor Pritzker, a Democrat, has been a vocal critic of the president, who has jabbed back at him during his nightly two-hour, free-form news conferences. Pritzker said this week that his state, with more than 13,000 confirmed cases and 380 dead so far, has been forced to act like a nation unto itself.

“This is an ongoing, around-the-clock process of scouring the globe, to identify what PPE is available, reaching out to the producer with a better price and a faster payment than our competitors, overcoming the machinations of shipping across the world during a worldwide pandemic, and attempting to leave nothing to chance in all of that process,” Pritzker said Monday. “It’s our own state procurement initiative that is making the difference.”

Vice President Michael Pence, whom Trump named to lead the federal government’s response to the crisis, held a call with governors this week. Trump described the session as a “lovefest” during his Tuesday news conference.

Even Democrats praised the vice president. “We’re enemies of a virus that does not distinguish between party, state line or anything else,” Michigan Governor Gretchen Whitmer said, adding she speaks with Pence often. “The vice president having been a governor, that is a perspective that I think has been very valuable for getting into the nitty gritty of what state leaders need.”

Louisiana Governor John Bel Edwards, another Democrat, said this week that he had spoken to Pence after Sunday’s shipment to the state. He went out of his way to praise Trump as well.

“I was able to thank him for the 200 ventilators that arrived from the national stockpiles,” said Edwards. “I also thank the president.”

Still, even communication with the vice president isn’t necessarily enough.

“We appreciate the responsiveness to our phone calls,” Charles Boyle, spokesman for Oregon Governor Kate Brown, said in an email. “However, the amount of PPE we are expecting to receive from the national stockpile will still be insufficient.”

For its part, Montana is depending on the kindness of neighbors to help with its more than 300 patients, a significant number in a state of just over 1 million people.

“Montana has received five times more masks, N95 masks, from our friends to the east, North Dakota, than we have from our federal partners,” Democratic Governor Steve Bullock said Tuesday at a news conference.

— With assistance by Daniel Flatley, Sophie Alexander, Richard Stubbe, and Elizabeth Campbell

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