Strategic National Stockpile: Supplies Fail to Go Where Needed Most

Personal protective equipment (PPE) is a term that nearly everyone is familiar with now due to the coronavirus disease 2019 (COVID-19) pandemic. Currently, the international shortages of PPE have been plaguing health care workers and hospitals.

Mask shortages were noted in February though, with a considerable amount of manufacturing issues due the pandemic coupled with stockpiling and rapid efforts to prepare. From surgical masks to N95 respirators, such PPE has become the new gold to acquire. With such shortages noted and an increasingly strained US health care infrastructure working to combat the threat of COVID-19, the Strategic National Stockpile (SNS) was put into place.

The SNS is designed to provide critical supplies including medical counter measures, but also PPE and medical equipment, to help supplement those states struggling to keep up. Kept in storage, the SNS supplies are deployed “If a community experiences a large-scale public health incident in which the disease or agent is unknown, the first line of support from the stockpile is to send a broad-range of pharmaceuticals and medical supplies. Contents are pre-packed and configured in transport-ready containers for rapid delivery anywhere in the United States within 12 hours of the federal decision to deploy. Each package contains 50 tons of emergency medical resources.”

Within the SNS there are several branches that range from information and planning to operational logistics and science. Medical and pharmaceutical products are just 1 piece of the SNS, with PPE and medical equipment also making up inventory.

In recent weeks, as New York City began to become inundated and overwhelmed by COVID-19 cases, the availability of critical PPE and medical equipment, like ventilators, became increasingly strained and then scarce. Calls to deploy the SNS were made across many states.

Unfortunately, a new report is shedding light on the inadequate distribution of PPE and critical medical supplies across states. Published by the Committee on Oversight and Reform, the document notes that just a fraction of critical PPE and medical supplies were distributed from the SNS and that FEMA (Federal Emergency Management Agency) was not brought into federal actions until very late in response.

The document notes that “only 11.7 million N95 respirator masks have been distributed nationwide—less than 1% of the 3.5 billion masks that the Trump Administration estimated would be necessary in the event of a severe pandemic. Only 7,920 ventilators have been distributed from the stockpile, even though a recent survey of 213 mayors—which did not include New York City, Chicago, or Seattle—identified a total estimated need of 139,000 ventilators.”

Moreover, the US Department of Health and Human Services (HHS) staff reported that the last shipments from the SNS were sent out, leaving only 10% of PPE left for federal workers — ultimately that the stockpile for states was depleted.

“According to HHS staff, most of these shipments were not based on states’ requests. The first 2 shipments were allocated pro rata based on 2010 Census population data. The third shipment—labeled the “final push”—does not appear to be based on population. With respect to N95 respirator masks, the document shows that states received either 64,450 or 120,900 respirators in this “final push.” For example, both Vermont and Texas received 120,900 respirators. Based on 2010 Census data, that is equivalent to roughly 193 respirators for every 1000 residents in Vermont, but fewer than 5 respirators per 1000 residents in Texas.”

Furthermore, this report reveals that supplies being sent to the United States via “Project Airbridge” will not be controlled by the government, but rather that suppliers have agreed to sell only half of their shipments to those highly affected areas.

Ultimately, these findings are deeply worrisome and an indicator of bigger issues in relation to pandemic preparedness and response.