Stockpile

Finally seeing relatively positive trends on Portugal's big COVID-19 dashboard. It's not the end of things, but it is at least a good sign.

However, from the US, three mind-boggling stories concerning the Strategic National Stockpile (SNS) ...

First, is a story from the New York Times about how medical device companies undercut the nation's plan to create a fleet of ventilators. Super-frustrating to learn that thirteen years ago, the US government established BARDA, and one of its first projects was an effort to add seventy thousand new, cheaper ventilators to the SNS. But that program was unable to deliver due to mergers and market forces. After the first contract was finally abandoned, another contract was signed in 2014, but no new ventilators have been built. It sounds like the 16,600 ventilators that are (were) in the SNS are older units, and reports from hospitals receiving those devices indicate that they are in need of some specialized repair.

So – ventilators. We planned to build new devices thirteen years ago, and should have a substantial reserve, except company A bought company B, and company B, who already manufactured a more expensive ventilator, asked for and got more money, then later said they couldn't fulfill the contract, so company C was contracted for even more money five years ago, and we're still waiting on them. Thirteen years.

Next is a story, reported on CNN, about the US sending almost eighteen tons of medical supplies, including personal protective equipment, to China in early February. In the story, there is a link to State Department press release indicating the shipment included exactly the kinds of materials that are in critical supply now:

This week the State Department has facilitated the transportation of nearly 17.8 tons of donated medical supplies to the Chinese people, including masks, gowns, gauze, respirators, and other vital materials.

This was almost three weeks after the first cases of COVID-19 were identified in Washington state, and two days after several senators requested emergency funding. Concerned about the implications, Senator Chris Murphy (D-CT) tweeted:

Just left the Administration briefing on Coronavirus. Bottom line: they aren't taking this seriously enough. 

Notably, no request for ANY emergency funding, which is a big mistake. Local health systems need supplies, training, screening staff etc. And they need it now. 

During a briefing on Sunday, Trump claimed cases would peak by Easter, Jim Watson/AFP, Getty Images

In response, the Trump Administration launched a campaign to label this effort by the Democratic legislators as a 'hoax' being used to discredit him during an election year. We had literally tons of PPE but spent hundreds of millions of dollars sending a large part of our SNS to China in early February. Soon after, President Trump then turned around and labelled the SAR-CoV-2 a 'Chinese virus'. But last Friday, Trump had a phone call with President Xi, and now we're best friends again.

Today, in another 'whiplash' move, and after a bizarre weekend news conference in which he seemed to accuse health care workers of stealing PPE, the US extended social-distancing guidelines to the end of April.

Finally, Greg Burel, who retired in January as the Director of the SNS said something staggering with a throw-away line in this interview on CBS This Morning:

 [I]n response to the 2009 H1N1 pandemic, the stockpile deployed nearly twenty million pieces of personal protective equipment and eighty-five million N95 masks.

'We didn't receive funds to replace those masks, protective gear, and the anti-virals that we used for H1N1.'

So – PPE. Three weeks after the US reported its first confirmed case on January 20, we shipped eighteen tons worth of the material from the SNS overseas. Eighteen tons.

And a decade ago, after we were hit by the 'swine flu pandemic', we never re-stocked the SNS. A decade.

President Trump claims that he's 'not a shipping clerk', but that's exactly what the nation needs right now. It's a lesson in logistics that is so heartbreakingly obvious, and that we should have learned years ago. Kafka himself could not have written a more wretched existential fiction.

How did we arrive here?

I started this on a positive note; I'll try to end on one, too. I just finished reading This Is Chance!, by John Mooallem, which is featured in the 99-Percent Invisible podcast. It's the story of radio-broadcaster Genie Chance, and her determined conduct during the 1964 Alaska Earthquake. Mooallem describes how the quake struck on Good Friday, nine point two on the Richter scale, and how Ms. Chance broadcast for fifty-nine hours over Easter weekend to steady her shattered city. It's a lesson in logistics during a time of immense chaos. While we're social distancing, it's great to hear these words from the author:

What is safety, anyway? Genie seemed to be conceding that there is only randomness, only chance, and if everything beyond us is chance, maybe the only force we have to survive a world like that is connection. By then, it must’ve seemed so obvious to her. It’s a good idea to hold on to each other.

I'll go ahead and cast Reese Witherspoon in my movie adaptation.

Today, the world is nearing a three quarters of a million cases of COVID-19, with over thirty-five thousand deaths. The US reports almost one hundred and fifty thousand cases, and over a twenty-five hundred deaths. Portugal reports over sixty-four hundred cases and one hundred and forty deaths.

cases: 737,670 global • 144,060 USA • 6,408 Portugal

deaths: 35,071 global • 2,573 USA • 140 Portugal

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UPDATE: File under 'Could Be Raining', this story just gets worse –  Taxpayers Paid Millions to Design a Low-Cost Ventilator for a Pandemic. Instead, the Company Is Selling Versions of It Overseas.