Health care workers at hospitals and nursing homes in Massachusetts were already protesting the lack of personal protective equipment to deal with COVID-19. Nurses in New York and New Jersey were photographed wearing giant plastic garbage bags for protection. And in the Port of New York, a container of 3 million N95 respirator masks ordered by Massachusetts was confiscated — diverted by federal officials.
The orderly world of the nation’s health care supply chain had turned into “Lord of the Flies.” Today it’s clear how that happened — and why. It’s a tale of incompetence and the politicization of a critical part of the health care infrastructure by the Trump administration — much of it laid bare Thursday by whistle-blower Rick Bright, former head of the Biomedical Advanced Research and Development Authority.
The United States operates a strategic stockpile of drugs and medical equipment; its whole purpose is to prepare for public health crises like a pandemic. The stockpile was part of the Centers for Disease Control and Prevention until the Trump administration put it under the control of political appointees in the Department of Health and Human Services. In a lengthy complaint, Bright laid out detailed allegations that those officials doled out contracts to companies with politically connected lobbyists, sometimes for unneeded or unproven drugs, while ignoring pleas to secure needed protective equipment.
Bright told a House subcommittee he came forward “because science — not politics or cronyism — must lead the way to combat this deadly virus.”
His testimony came on the same day President Trump visited a medical supply distribution center in Allentown, Pa., for a photo-op to announce an expansion of the stockpile to assure a 90-day supply of testing equipment and, eventually, up to a billion N95 respirator masks.
Better late than never — and much better than filching Massachusetts-ordered supplies from a New York container terminal, forcing the state to subsequently arrange for that private New England Patriots jet to fly a second shipment directly into Boston.
Having learned his lesson the hard way, Governor Charlie Baker announced Thursday that since then an additional 7.5 million pieces of PPE had been flown to Massachusetts on six different chartered flights.
“I think there’s a much bigger role for the federal government to play,” he said at his daily briefing, “but we’re going to do what we need to do.”
Of course, it didn’t have to be that way. Bright and Michael Bowen, head of a medical supply company in Texas, detailed how both had begged officials at Health and Human Services to ramp up supplies in advance of the pandemic hitting these shores — while there was still time. While lobbyists connected to presidential in-law Jared Kushner got concierge service from HHS, in Bright’s telling, pleas from actual doctors to prepare for COVID-19 went unheeded.
“I pushed that forward to the highest levels I could in HHS and got no response,” Bright said. “From that moment, I knew that we were going to have a crisis for our health care workers because we were not taking action. We were already behind the ball. That was our last window of opportunity to turn on that production to save the lives of those health care workers, and we didn’t act."
Bowen had been warning for more than a decade that the lack of domestically made PPE posed “a national security risk.” Most recently he told Bright in mid-January that his firm, Prestige Ameritech, had seen a huge uptick in orders, even foreign orders, for N95 masks, and that he had four previously shuttered plants that could be reopened to produce 7 million masks a month.
“Lives were endangered, and I believe lives were lost,” Bright said. “And not only that: We were forced to procure these supplies from other countries without the right quality standards.”
Eventually, Trump invoked the Defense Production Act and awarded contracts worth more than $600 million to a roster of big-name companies like Honeywell and 3M but also to one company that doesn’t make masks at all but merely intended to procure them. A no-bid contract was awarded by the Federal Emergency Management Agency to Panthera Worldwide LLC for $55 million for 10 million N95 masks — that’s $5.50 a mask. Meanwhile, Prestige (which later also got a FEMA contract to manufacture a million N95 masks) makes the same mask at a cost to the government of 79 cents a mask, which means Panthera’s markup could have been nearly 600 percent.
Yes, in the midst of a pandemic cost desperation rules.
Meanwhile, anyone who dares cross Trump, or who even hinted at shortages, like the top inspector general at HHS, or alleges incompetence, like Bright, gets dumped.
The belatedly awakening of the Trump administration to issues with the Strategic National Stockpile notwithstanding, the nation cannot depend, in the days ahead, on foreign suppliers to meet critical domestic needs. Bowen was right. Some medical supplies are matters of national security. The whistle-blower complaint also shows the critical importance of moving the stockpile back under the control of nonpartisan public health officials.
Governors like Baker are also encouraging local industries to retool not simply to meet today’s needs but also for the long haul. Absent new leadership in the White House, those efforts are the nation’s best hope for surviving not just this pandemic but also whatever medical crisis looms down the road.
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