In the span of several days, Marylou Sudders and a team of state officials confirmed two separate orders last week: one for hundreds of N95 respirator masks and another promising shipments of 35 ventilators to Massachusetts, every week, for the “foreseeable future," the state’s health and human services secretary said.
They represented victories, if relatively small ones compared to the millions of pieces of equipment the state is chasing. That is, until, it ran into a force seemingly as immovable as the novel coronavirus.
“Force majeure,” Sudders said Friday, citing the legal clause that translates to “superior force” and typically allows parties to opt out of a contract due to unforeseen circumstances. In this case, that was the federal government exercising its authority over the state amid the pandemic, she said.
“They take,” Sudders said, “what we order.”
Such has been one of the many roadblocks Governor Charlie Baker and his administration say they’ve faced in the scramble for PPE’s, the masks, gowns, and face protectors needed to guard front-line medical personnel from the highly infectious COVID-19.
Finding enough has become one of the biggest challenges facing the state and its medical community. And it’s increasingly pushed the oft-diplomatic Baker into a publicly combative stance, challenging the Trump administration to do more.
The frustration spilled into public view Thursday, when the second-term Republican became animated in discussing the “incredibly messy thicket” the state has had to navigate to get equipment. His administration has watched orders “evaporate," he vented. The phrase “quote-unquote confirmed," he said, doesn’t necessarily mean that anymore.
“I’m telling you, we’re killing ourselves trying to make it happen,” Baker said.
“We’ve literally gotten to the point where our basic position is that until the god . . ." Baker said, cutting himself off before he cursed. “Until the thing shows up here in the Commonwealth of Massachusetts, it doesn’t exist."
And several times, it hasn’t. Sudders, who’s heading the state’s coronavirus command center, cited a shipment of 3 million masks that BJ’s Wholesale Club purchased and had landed in the Port of New York and New Jersey. The state, she said, had negotiated to buy them, until the federal government impounded them on March 18.
The same day, the state had confirmed an order with the company MSC Industrial Supply for 400 masks, to be delivered on March 20, Sudders said. The federal government again stepped in — starting a trend that would become familiar when the state’s order for the ventilators also fell apart.
“The order went through," Sudders said, “and the feds did another force majeure.”
The US government hasn’t been the only roadblock, though. Sudders said the state had confirmed an order for 2½ million masks with a Chinese vendor, to the point the state had wire transferred a payment. Then Wednesday, during a nightly conference call with other state officials, Sudders said she asked the state’s purchasing agent for an update.
“I have bad news,” she was told. The Chinese government had canceled the order and rerouted it to Spain. The state got its money back but not an explanation, Sudders said.
“It’s almost as if these orders and products disappear,” she said. “The challenge we’re having now is, you can’t place orders with any level of confidence.”
In his letter to Trump on Thursday formally requesting federal disaster assistance, Baker said the state had already spent $28 million on personal protective and medical equipment. But that’s dwarfed by another $50 million in orders Sudders said the state has placed with little to no return.
And when the state’s been able to tap into the national stockpile of supplies, it’s been a frustrating exercise. On March 5, the state made a request for 4.5 million pieces of equipment, including 750,000 N95 respirators, the masks that offer the fullest protection against contagious respiratory illnesses; 750,000 pairs of gloves; and 750,000 gowns.
As of Monday, the state had received roughly 750,000 pieces in total: 125,000 N95 respirators, 300,000 masks, and 210 coveralls, which weren’t part of the initial request, according to a breakdown provided by the Baker administration.
Sudders said that the federal government told the state Thursday that a third shipment is en route. But still unclear is how many pieces are actually coming, she said.
All the while the demand for equipment has only grown. Many hospitals are requiring doctors and nurses to extend use of masks that they would normally discard after one patient encounter. Massachusetts General Hospital is also studying whether N95 respirators can be sterilized and safely reused. Animal hospitals have even begun donating equipment.
“No one would imagine sending firefighters into a blazing fire without proper clothing and equipment,” reads a petition more than 1,000 physicians signed urging Baker to take additional measures. “But our physicians, nurses, and other healthcare workers are being asked to treat COVID-19 patients without protective gear.”
On Friday, Baker and New Jersey governor Phil Murphy penned an op-ed in The New York Times saying the federal government needs to do more.
“The government must boost private-sector manufacturing of these critical supplies now and get out of the way of states when we seek private-sector suppliers and release more materials from the national stockpile to meet our pressing needs,” the governors wrote.
By Friday afternoon, President Trump invoked the Defense Production Act to compel General Motors to make ventilators, after weeks of resisting mounting calls to use the Cold War-era law.
The hunt for supplies isn’t only a Massachusetts problem. New York Governor Andrew Cuomo, for example, has pleaded for federal help in providing tens of thousands of ventilators — and publicly tangled with Trump — amid the state’s battle with the growing outbreak.
“This is the country’s first 50-state disaster," said Juliette Kayyem, a former homeland security official under President Obama. “If we had a blizzard and we needed help, we would call Rhode Island or Connecticut and ask them to bring stuff over. We don’t have that luxury now.”
To help fill the need, Massachusetts officials launched a “manufacturing emergency response team” to rally companies in the state who might be able to pivot from what they usually produce and start making the critical gear.
The emergency response team was stood up about a week ago, participants said, in an effort to provide a coordinated response from academic institutions, industry, and government.
But Sudders indicated it’s unclear when the effort could start feeding equipment into the state’s supply line.
“I don’t speculate,” Sudders said. “But it can’t be fast enough.”