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Monday, Apr 6 2020

Full Issue

'This Is Ludicrous': Governors Frustrated With Lack Of National Ventilator Distribution Strategy

States have been forced to compete with each other to get ventilators and other medical supplies after the federal government put most of the onus on the governors to acquire equipment. While some governors try to avoid being too critical of the Trump administration, others expressed their frustration. ā€œTo say, ā€˜we’re a backup’ — I mean, the surgeon general alluded to Pearl Harbor," said Washington Gov. Jay Inslee. "Can you imagine if Franklin Delano Roosevelt said, ā€˜I’ll be right behind you, Connecticut. Good luck building those battleships’?ā€

As the surgeon general told the nation to brace for ā€œour Pearl Harbor momentā€ of cascading coronavirus deaths this week, several governors said on Sunday that their states were in urgent need of federal help and complained that they had been left to compete for critical equipment in the absence of a consistent strategy and coordination from the Trump administration. Some clearly walked a delicate path, criticizing what they saw as an erratic, inadequate federal response, while also trying to avoid alienating the White House as states vie with one another for resources both from Washington and on the market that can mean the difference between life and death. (Rojas and Swales, 4/5)

New York City scrambled on Sunday to get more hospital equipment as it faced the possibility of running out of ventilators in the next few days. As New York state prepared for an apex of coronavirus cases, Mayor Bill de Blasio said about 4,000 patients were intubated as of Sunday and the city expected nearly 1,000 more intubations in the coming days. The city needs 1,000 to 1,500 more ventilators to avoid running out by Tuesday or Wednesday, the mayor said. The city had originally expected to run out on Sunday. (Calfas and Ansari, 4/5)

ā€œEveryone says federal stockpile, federal stockpile. There’s not enough in the federal stockpile to take care of New York, and Illinois, and Texas, and Florida, and California,ā€ said Mr. Cuomo, a Democrat. The Chinese government helped facilitate a donation of 1,000 ventilators, as well as a large supply of masks, that arrived in New York City on Saturday. And New York was expecting a shipment of 140 ventilators from Oregon. ā€œNew York needs more ventilators, and we are answering their call for help,ā€ Democratic Oregon Gov. Kate Brown said in a tweet, explaining that her state was in a better position now. (Ansari, Michaels and Calfas, 4/6)

Republican and Democratic governors alike pushed back, saying the Trump administration had failed to mount the kind of national coordinated response needed to address the crisis and that shortages of tests, ventilators and protective equipment for physicians persisted. ā€œThis is ludicrous,ā€ said Gov. Jay Inslee of Washington, a Democrat. ā€œThe surgeon general referred to Pearl Harbor. Can you imagine if Franklin Delano Roosevelt said, ā€˜We’ll be right behind you, Connecticut. Good luck building those battleships?ā€™ā€ (McCaskill and Ollstein, 4/5)

President Trump announced Sunday that the federal government is sending several hundred additional ventilators to states hit hard by the coronavirus outbreak. Trump duringĀ a White House briefingĀ said that over the last 24 hours, the federal government has delivered an additional 500 ventilators to New Jersey, which is among the hardest-hit states. He said it also has sent 200 ventilators to Louisiana and 300 to Michigan. Another 600 have gone to Illinois, he said, while Massachusetts will be getting 100. (Sullivan, 4/5)

With cases of COVID-19 surging and medical supplies rapidly dwindling, New Jersey Gov. Phil Murphy is calling on federal officials to scale up aid efforts for the state, saying, "It feels like we entered this war, and it is a war, with less ammunition than we needed." New Jersey has reported more than 25,500 cases of the coronavirus and more than 500 deaths — second only to New York. The crush of cases pushed Murphy to take dramatic action on Thursday by granting the state police the authority to commandeer medical supplies and equipment from private companies. (Breslow, 4/3)

In a haunting letter to his friends and colleagues, a Columbia University surgeon describes how coronavirus has forced doctors to ration care for very sick patients who don't have the virus, but still need medical procedures. "We have had to make decisions that I personally have never had to contemplate before," wrote Dr. Emile Bacha, director of the pediatric and congenital cardiac surgery at Columbia University Irving Medical Center. "We have had to ration care and make decisions about who is considered an urgent or emergent case." (Cohen, Bonifield and Nigam, 4/5)

With the peak of Covid-19 infections still ahead and medical supplies still scarce, hospitals and physicians are gearing up for a nearly impossible challenge: deciding who gets a life-saving ventilator and who doesn't. "Physicians who work in parts of the world that don't have adequate resources have had to make decisions like this maybe even on a routine basis, but physicians in the United States have never faced anything like this before," said Dr. Robert Truog, director of the Center for Bioethics at Harvard Medical School. "It is going to be extremely difficult." (de Puy Kamp, Devine and Griffin, (4/3)

Joe Tsai, the billionaire co-founder of Chinese ecommerce giant Alibaba, and his wife Clara Wu Tsai, have donated 2.6 million masks, 170,000 goggles and 2000 ventilators to New York — the US epicenter of the coronavirus pandemic. The supplies were split into two shipments. The first arrived on Thursday at Newark Liberty International Airport, while the second arrived on Saturday at John F. Kennedy International Airport. (Alesci and Liao, 4/4)

Calls are growing for the U.S. to reduce its dependence on China for key medicines and supplies as Americans face widespread shortages in the midst of the coronavirus pandemic. While the U.S. supply chain's heavy reliance onĀ Beijing for medical manufacturing has been glaringly apparent for roughly two decades, both lawmakers and administration officials say the virus has exposed just how vulnerable the country is as it leans onĀ China and other nations to help provide the tools necessary to combat the pathogen. (Beavers, 4/5)

Meanwhile, a website change reveals Jared Kushner's sway over the federal response —

It was a telling moment in the rising tensions between the Trump White House and state governors desperate for medical equipment to deal with the exploding coronavirus crisis. At Thursday's briefing on how the government is responding, Trump's senior adviser and son-in-law Jared Kushner scolded states for not building up their own stockpiles, saying that the "the notion of the federal stockpile was it’s supposed to be our stockpile, it’s not supposed to be states’ stockpiles that they then use." (Gittleson, 4/3)

The official government webpage for the Strategic National Stockpile was altered Friday to seemingly reflect a controversial description of the emergency repository that White House adviser Jared Kushner offered at a news conference Thursday evening. According to a brief online summary on the Department of Health and Human Services website, the stockpile’s role ā€œis to supplement state and local supplies during public health emergencies. Many states have products stockpiled, as well.ā€ (Forgey, 4/3)

In other news about the governors' response efforts —

Across America, as families stuck in their homes anxious and isolated by the new coronavirus, a new daily ritual is taking shape: tuning into the governor’s afternoon press briefing. Residents sequestered under a stay-at-home order in Ohio seem to hang on Republican Gov. Mike DeWine’s every word, sharing his latest orders among friends via text message and on social media and following along with a drinking game — ā€œWine with DeWine.ā€ Signature T-shirts and tumblers are available online. (Smyth and Ronayne, 4/6)

Maryland Gov. Larry Hogan (R) phoned his favorite country radio station the other day and made a confession. He can’t listen anymore. The coronavirus pandemic consumes his every waking moment. The host seemed unsurprised. ā€œDo you ever get tired of being interviewed?ā€ she asked. ā€œBecause I’m seeing you everywhere.ā€ (Cox, Dawsey and Wiggins, 4/5)

The Washington region’s battle with the novel coronavirus intensified Sunday, as the number of confirmed cases soared to more than 7,000 and Maryland Gov. Larry Hogan (R) issued an emergency order requiring nursing home staff to wear protective gear and segregate infected patients to halt the spread of the disease following outbreaks in the state’s long-term care facilities. (Shapira, Chason, Nirappil and Natanson, 4/5)

Yvonne Knight, who has respiratory problems that make her especially vulnerable in the coronavirus pandemic, can’t buy groceries online with her food stamps — even though each trip to the store is now a risky endeavor. Going out to buy food terrifies the 38-year-old woman with cerebral palsy, but she is one of millions of people who receive food aid through the federal Supplemental Nutrition Assistance Program that can’t be used in flexible ways. (Galvan and Khalil, 4/6)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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