If this is a ‘war’ on the coronavirus, then let’s fight it like a war, no more half measures

Last week, faced with intense criticism for the federal government’s failure to deliver needed ventilators to the states, President Trump finally issued an order invoking the Defense Production Act to force General Motors to manufacture ventilators after negotiations had broken down. Trump seeks to ramp up production of medical equipment after harsh criticism of his slow response. “The president vowed that the efforts would produce a combined 100,000 ventilators over the next 100 days.”

Unlikely. As Megan McArdle explained at The Post, Why the Defense Production Act won’t get us ventilators any faster:

The Defense Production Act does not enable General Motors to retool its plant, design a machine or school its workforce on making an unfamiliar product, any faster than a big check from the government would. Nor did command-and-control efforts during World War II, by the way; it took considerable time to ramp up that war production, and it will take a bit of time to get ready for this battle, too.

Despite having committed to transferring 2,000 ventilators in military stocks to the Federal Emergency Management Agency and the Department of Health and Human Services to fight the coronavirus outbreak, the Pentagon has not shipped any of them because the agencies have not asked for them or provided a shipping location, the Pentagon’s top logistics official said Tuesday. Pentagon says it still hasn’t sent ventilators because it hasn’t been told where to send them. Shouldn’t the Coronavirus Task Force have requisitioned this? What’s Vice President Mike Pence doing?

It’s not just the shortage of ventilators, but the drugs given to patients on ventilators is now outstripping supply. Drugs Vital for Ventilator Patients Are Also Running Low in U.S.:

The drive to ramp up the number of ventilators has also increased demand for analgesics and neuromuscular blockers drugs, but distributors have struggled to provide hospitals with all the supplies they seek, according to Vizient.

Vizient identified 12 pharmaceuticals used in intubation and caring for patients on ventilators that could become harder to get as greater numbers of Covid-19 patients require machines to help their breathing.

“These drugs maximize the work the ventilator can do, so the patient can heal and recover,” said Dan Kistner, senior vice president of pharmacy solutions at Vizient. “If we don’t focus on the drugs that are critical to making these ventilators go, then having the ventilators doesn’t matter.”

“If you have a car, but no gas, you can’t get anywhere,” he said.

While President Trump was forced to invoked the Defense Production Act for General Motors to produce ventilators, he has not yet invoked the act for other critical need medical suppliers. Why not?  Wartime Production Law Has Been Used Routinely, but Not With Coronavirus:

A Korean War-era law called the Defense Production Act has been used to place hundreds of thousands of orders by President Trump and his administration to ensure the procurement of vital equipment, according to reports submitted to Congress and interviews with former government officials.

Yet as governors and members of Congress plead with the president to use the law to force the production of ventilators and other medical equipment to combat the coronavirus pandemic, he has for weeks treated it like a “break the glass” last resort, to be invoked only when all else fails.

“You know, we’re a country not based on nationalizing our business,” Mr. Trump said earlier this month. “Call a person over in Venezuela, ask them how did nationalization of their businesses work out? Not too well.”

Seriously, Dude, “Socialism”? What do you think the stimulus bill unanimously passed by Congress last week was? Trump’s desire to run against “socialism” in the 2020 campaign is over, the era of big government is back, and for the moment Donald Trump is a socialist president leading the “war” against coronavirus.

Because Trump has not “federalized” medical suppliers in this national emergency, governors and local governments are forced into a bidding war against each other, and against the federal government in the private market. (These companies arguably are engaged in illegal profiteering and price gouging). Governors Fight Back Against Coronavirus Chaos: ‘It’s Like Being on eBay With 50 Other States’:

A chorus of governors from across the political spectrum is publicly challenging the Trump administration’s assertion that the United States is well-stocked and well-prepared to test people for the coronavirus and care for the sickest patients.

Gov. Andrew M. Cuomo said on Tuesday that the country’s patchwork approach to the pandemic had made it harder to get desperately needed ventilators.

“You now literally will have a company call you up and say, ‘Well, California just outbid you,’” Mr. Cuomo, a Democrat, said in his daily news briefing. “It’s like being on eBay with 50 other states, bidding on a ventilator.”

Gov. Larry Hogan of Maryland, a Republican, said on Tuesday that his state was “flying blind” in the fight against the coronavirus because officials did not have enough tests. When asked during an NPR interview about President Trump’s comments suggesting that a chronic lack of test kits was no longer a problem in the United States, Mr. Hogan did not mince words: “Yeah, that’s just not true.”

And in Connecticut, Gov. Ned Lamont, a Democrat, said on Tuesday that it was “disturbing” to learn that a national stockpile of medical supplies was running empty.

“We are on our own,” he said.

Across the country, America’s governors are going head-to-head with the Trump administration over the need for testing supplies and ventilators, at times defying party lines.

The Post reports, Governors plead for medical equipment from federal stockpile plagued by shortages and confusion:

Governors and state officials have become increasingly frustrated by what they describe as a byzantine and unsteady process for distributing medical supplies from the Strategic National Stockpile. As they try to combat a worsening pandemic, several have complained about chaos and disarray within the system and a lack of guidance about how they can secure lifesaving supplies, according to interviews and documents from officials in more than a dozen states.

More disturbing, there is the appearance of rationing supplies based upon political favoritism:

As states across the country have pleaded for critical medical equipment from a key national stockpile, Florida has promptly received 100 percent of its first two requests — with President Trump and Republican Gov. Ron DeSantis both touting their close relationship.

States including Oklahoma and Kentucky have received more of some equipment than they requested, while others such as Illinois, Massachusetts and Maine have secured only a fraction of their requests.

It’s a disparity that has caused frustration and confusion in governors’ offices across the country, with some officials wondering whether politics is playing a role in the response.

There’s no direct evidence that Republican states are receiving more favorable treatment overall, and some GOP-led states such as Georgia have had trouble filling their requests. But Trump has contributed to the sense that politics could be a factor by publicly attacking Democratic governors who criticize his handling of the public health crisis.

Trump said last week that he is inclined not to speak with anyone who is insufficiently appreciative of his administration’s efforts. He has touted his personal relationships with several governors while also declaring that the federal government won’t be “a shipping clerk” for local officials who seek help in obtaining masks, ventilators and other critical supplies. States should buy the materials themselves, he said.

Aides to governors in some states say they are wary of angering the president or making comments even slightly critical of his administration, fearful that he will lash out at them as they seek help.

Even more disturbing is the influence of Florida Governor Ron Desantis, who has been one of the most reckless and irresponsible governors in this coronavirus crisis. He allowed Spring Break to continue on the state’s beaches, even as the coronavirus sickened vacationers. Many of these spring breakers returned to their home states as “super spreaders” of the virus.

But Desantis now wants to attack the lifeblood of Florida, New Yorkers who travel to Florida for vacation and retirement. DeSantis has ordered visitors to the state from the New York metro area (and Louisiana) to self-quarantine for 14 days. DeSantis’ “Safer at Home’’ order only applies to South Forida, Broward, Miami-Dade, Monroe and Palm Beach counties, and extends only until April 15. Florida is about to become the next “hot spot” for coronavirus, and live up to its deserved reputation as “God’s waiting room.”

During a phone call on Saturday, DeSantis complained about people with the coronavirus traveling from New York to Florida. Minutes later, Trump publicly said he was considering a quarantine for New York, New Jersey and Connecticut. He ultimately decided against it.

One White House official said Trump is attuned to the electoral importance of Florida in November, giving added weight to the arguments DeSantis has made to the administration that his state’s economy should reopen as soon as possible.

“The president knows Florida is so important for his reelection, so when DeSantis says that, it means a lot,” said the official, who spoke on the condition of anonymity to be frank. “He pays close attention to what Florida wants.”

So, this a confirmation of political favoritism in rationing supplies. It is consistent with Trump giving up his New York residency (to avoid prosecution by the NY attorney general) and become a Florida resident last year. His Mar-a-Lago Resort is in Palm Beach, Florida, so there is also some self-serving interests.

Democratic and Republican lawmakers across the country say they’re desperately trying to acquire masks, gloves and ventilators for the most at-risk health care workers in their districts. Desperate lawmakers hunt for medical supplies as Trump takes hands-off approach:

Staring down a dire supply shortage and with the White House taking a largely hands-off approach, many members have taken it upon themselves to coordinate with local, state and federal officials to keep their hospitals and health centers from running out of critical personal protective equipment.

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Trump has largely forced states into bidding wars for protective equipment, with each battling another to buy up precious masks and gloves. And while Trump has invoked the Defense Production Act to compel the production of some critical supplies, many lawmakers say he hasn’t gone far enough.

“It is a good thing there is an effort to ramp up supply,” said Rep. Derek Kilmer (D-Wash.), whose state was the initial epicenter of the outbreak. “But in the absence of more active federal coordination about where that supply goes, this critical lifesaving equipment becomes the equivalent of toilet paper in the toilet paper aisle in the supermarket, where it is a free-for-all.”

Governments, hospital chains, clinics and entrepreneurs are scouring the world for personal protection equipment they can buy. Coronavirus Battle Creates a Global ‘Free-for-All’ to Find Masks:

Global desperation to protect front-line medical workers battling the coronavirus epidemic has spurred a mad international scramble for masks and other protective gear. Governments, hospital chains, clinics and entrepreneurs are scouring the world for personal protection equipment they can buy or sell — and a new type of trader has sprung up to make that happen.

The market has become a series of hasty deals in bars, sudden calls to corporate jet pilots and fast-moving wire transfers among bank accounts in Hong Kong, the United States, Europe and the Caribbean.

The stakes are high, and so are the prices. Wholesale costs for N95 respirators, a crucial type of mask for protecting medical workers, have quintupled. Trans-Pacific airfreight charges have tripled.

“It’s a global free-for-all, trying to get capacity,” said Eric Jantzen, the vice president for North America at Vertis Aviation, an aircraft and air cargo brokerage based in Zurich. “And the prices reflect that.”

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The fractious nature of the American medical system, which lacks a centralized purchasing authority, adds to the problems. In the United States, President Trump told state governors on March 16 that they should find respirators and ventilators themselves.

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Transportation of respirators or masks, Mr. Barner said, is “more complicated than auto parts.”

Even though many hospitals in the United States are desperate for masks, selling to them isn’t always easy.

Deals have stalled because hospitals, accustomed to paying for supplies after they reach their loading docks, have balked at the stiff terms now being demanded by factories, mask traders said. They also fear fraud.

While global production is ramping up, the shortage of N95 masks is so great that companies, unions, and even average people are scrambling to fill the need. And now, after a number of fortuitous events, millions of N95 masks are appearing in mysterious or unexpected places. Millions of N95 masks keep surfacing. So why is there still a shortage?

The latest discovery comes from the Service Employees International Union’s medical workers division (SEIU-UHW). After an extensive search, the union found a distributor with a supply of 39 million respirators that it plans to sell to hospitals nationwide. The situation is more complicated than connecting a buyer and a seller, though. The SEIU has refused to name the distributor, apparently out of concern that the company would be overwhelmed, and one of the hospitals that considered buying the N95 masks through the union seems to have walked away from the deal.

“This is the Wild West,” SEIU-UHW president Dave Regan told the Washington Post. “There are a lot of good actors and a lot of shady actors.”

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While discoveries of thousands or millions of lifesaving masks are good news in a pandemic, they also draw attention to a supply chain that’s been badly mismanaged. The situation also raises the question of why unions, banks, tech companies, and others have taken it upon themselves to find masks for health care workers. Shouldn’t the federal government be dealing with this?

YES, it should!

Inevitably, the entire world needs many, many more N95 masks not only to keep health care workers safe but also to stop the spread of coronavirus. As the search continues, US health workers might be forced to take whatever they can get. For some, that might mean the insufficient, loose-fitting cloth masks, even some that people are sewing at home. Some may just have to settle for face shields, which are now also being manufactured by volunteers.

If the CDC does end up changing its policy and recommending that every American wear a mask in public, the shortage of N95 masks could very well worsen. So if you’re not a health care worker or someone with Covid-19, consider an alternative like a surgical or cloth mask. And if you happen to have any unused N95 masks, consider donating them to health care workers immediately. You could save someone’s life.

By now you all have seen the reporting by medical professionals taking to the media with video of their working conditions to bring it to the public’s attention. Unfortunately, hospitals are threatening to fire health-care workers who publicize their working conditions during the coronavirus pandemic — and have in some cases followed through. Hospitals Tell Doctors They’ll Be Fired If They Speak Out About Lack of Gear:

“Hospitals are muzzling nurses and other health-care workers in an attempt to preserve their image,” said Ruth Schubert, a spokeswoman for the Washington State Nurses Association. “It is outrageous.”

Hospitals have traditionally had strict media guidelines to protect patient privacy, urging staff to talk with journalists only through official public relations offices. But the pandemic has ushered in a new era, Schubert said.

Health-care workers “must have the ability to tell the public what is really going on inside the facilities where they are caring for Covid-19 patients,” she said.

One reason is to prepare other nurses and doctors for the looming onslaught of cases and encourage donations of much-needed equipment, particularly the personal protective equipment or PPE that protects them from being infected and in turn infecting other patients as well as their families when they go home.

“It is good and appropriate for health-care workers to be able to express their own fears and concerns, especially when expressing that might get them better protection,” said Glenn Cohen, faculty director of Harvard Law School’s bioethics center. It’s likely hospitals are trying to limit reputational damage because “when health-care workers say they are not being protected, the public gets very upset at the hospital system.”

[M]any physicians, nurses and other health-care workers taking to social media to express deep concerns about the lack of protective gear or much-needed patient-care equipment like respirators. Some posts have gone viral and are being shared hundreds of thousands of times, often tagged with #GetMePPE. Privacy laws prohibit disclosing specific patient information, but they don’t bar discussing general working conditions.

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Nisha Mehta is a 38-year radiologist from Charlotte, North Carolina, who runs two Facebook groups for physicians with around 70,000 members. She’s fielded numerous requests from health-care workers hoping to get their stories into the public arena.

“I’m hearing widespread stories from physicians across the country and they are all saying: ‘We have these stories that we think are important to get out, but we are being told by our hospital systems that we are not allowed to speak to the press, and if we do so there will be extreme consequences,” she said.

Many say they get daily emails urging them not to talk to the media under any circumstances. “The public needs to hear these stories and other physicians need to hear them to be warned against what’s coming,” Mehta said. “It’s so important that everyone understands how bad this is going to get.”

If this is a “war” against the coronavirus pandemic then the U.S. must commit to go “all in” and fight it like a war, no more half measures. Americans know how to do this, we did it in World War II.

Why Donald Trump is so reluctant to do this is a question that the media needs to start asking. Does he want to win this war, or not? American lives are at stake.