PROVIDENCE — Scott Fraser wakes up daily to e-mails and calls from strangers with tantalizing offers: You need masks? Medical supplies? How about ventilators?
“I’ve heard from some high-pressure salespeople, some that have been pitching certain machines that they claim can do all kinds of things for tens of thousands of dollars,” said Fraser, the president and CEO of the Rhode Island Health Association, which represents 64 nursing homes. “And I’m thinking, our members are right now concerned about paying their staff and keeping them on the front lines.”
Desperate owners of nursing homes are maxing out their credit cards to buy supplies, but they find promises of delivery aren’t always kept, and prices for suppliers are much higher than normal. Surgical masks that normally cost 18 cents are now over a buck, and N95 masks that used to sell for 85 cents "are quoted up to 7 dollars,” Fraser said.
Vincent Ward, the administrator for Home Care Services of Rhode Island in Woonsocket, said he got some supplies from the state that were distributed at the Cranston Street Armory. “They will last me a little while, but not if we’re expecting a spike," he said, adding that other facilities didn’t get anything.
What other options do they have? Rhode Island Partnership for Home Care, where Ward is a board member, tried to get 100,000 masks from a medical supplier for their members, “but we’ve become such a tiny little customer compared to the world.”
Last month, Governor Gina M. Raimondo set up a team, led by Steven J. King, manager of Quonset Development Corporation, to seek out medical supplies. More than two weeks ago, the governor assured Rhode Islanders that millions of masks and hundreds of thousands of gowns and gloves were on their way.
That hasn’t materialized.
The federal Strategic National Stockpile sent Rhode Island about 210,000 N95 masks and 330,000 surgical masks, 320,000 gloves, 60,000 face shields, 50,000 gowns, and 300 coveralls, according to the Health Department.
The rest of Rhode Island’s order went elsewhere. The governor has also acknowledged that Rhode Island hasn’t gotten most of what it ordered, adding that there were complications getting supplies out of China.
The global marketplace is a jungle of competitors waving cash at suppliers, who are diverting equipment to higher bidders, as states compete against states, which compete against the federal government, as the whole world fights for the same medical supplies.
So, what chance does the littlest state have?
“Rhode Island is not alone in this," said Merrill Weingrod, CEO and founder of China Strategies, a consulting firm in Providence and Shanghai. “Rhode Island is a victim, along with everyone else."
China and other countries around the world are combating the pandemic, which is overtaxing the supply of medical equipment and disrupting the entire market with the tremendous demand, Weingrod said.
“All over the world, these [factories] are getting bombarded with requests that don’t know what they need but know they need a whole lot,” said Weingrod, who is also a founding member of DBI Network, a global network that does supply chain and healthcare consulting. “It creates what we see as a really chaotic market.”
Buyers need leverage and large orders to get attention, and as an entity, the United States would have huge buying power, he said. However, it’s been left up to the states to settle and they’re competing against each other.
“You’ve got shortage of supplies everywhere,” Weingrod said. “You can’t imagine a more perfect, horrible storm.”
States need to find factories that produce the right medical equipment that meets U.S. safety regulations. The cost of materials has increased, because of the demand. Larger bidders swoop in before the supplies leave the warehouse.
Weingrod said his partner in Shanghai, Hainan Mu, describes what he sees now. “He said here’s what you have to do -- you go to the factory every day and have the money available every day, pay every day, and ship every day, or the supply will disappear. If you leave it at the factory or in the warehouse, it will disappear. ... It’s the wild, wild, wild West.”
Weingrod said he’s offered to help the Raimondo Administration negotiate the supply chain in China. “My heart goes out to the people who are all good-spirited people trying to fill this void because people are dying in nursing homes," Weingrod said.
The big picture, he said, “is that everyone got shoved into this emergency overnight.”
With the shortages of PPE, the state Department of Health has been focused on distributing the supplies first to healthcare workers in “high-risk environments."
“We have been working to distribute PPE to hospitals, EMS providers, nursing homes, and assisted living residences, with the goal of being able to distribute some PPE to all healthcare providers who need it," said health department spokesman Joseph Wendleken.
But is risk relative? Nicholas Oliver, the executive director of Rhode Island Partnership for Home Care, said none of the home health care agencies have gotten their all of their requests fulfilled by the state.
They represent 7,800 health care workers who see patients in about 20,000 homes, from prenatal care, to people with disabilities and those in hospice.
The Health Department is allowing heath care workers to reuse their masks, because supplies are low. But home health care workers travel from patient to patient, seeing people who are medically fragile, so they can’t use the same masks for different patients, Oliver said. Without adequate guidelines from the Department of Health and an adequate supply of PPE, Oliver said, “we could be inadvertently spiking the curve.”
The Partnership for Home Care has offered to pay for the supplies from the federal stockpile, Oliver said. At the same time, the members are working on their own connections.
Ward said a friend who works at a medical supply distributor told him he could get about 13,000 N95 masks. “I said, we’ll take them,” Ward said. “I have a list of agencies that would like them.”
Amanda Milkovits can be reached at firstname.lastname@example.org