States shouldn’t fight over coronavirus equipment, Gavin Newsom says. Should Trump take charge?
On a Thursday call between all 50 governors and the White House, governors from across the country discussed how states needed to work together with President Donald Trump to acquire personal protective equipment for medical workers amid the coronavirus pandemic.
Trump has left the procurement of needed medical equipment for dealing with COVID-19 to governors. Multiple governors have said in public statements that this means having governors compete against each other for ventilators and other necessary medical supplies, which drives costs up.
Instead, they want Trump and the federal government to handle the purchasing of medical supplies such as new ventilators and distribute them. Trump has not signaled he has changed his mind.
The current system leaves smaller states at a disadvantage, due to factors like less resources and less need to buy in bulk, which can mean discounts or priority with manufacturers, governors have said. It will mean states with the means to pay will get priority rather than states with the most urgent need.
As an example, California Gov. Gavin Newsom on Thursday pointed to 100 million N95 masks — one of the most efficient facial masks at filtering out air particles — the state just procured.
”We did that competing against other states, other nations and likely the United States itself,” he said during a Zoom call with Bay Area nonprofits. “The lack of coordination, just in terms of our purchasing alone, really drives one of the most critical needs, and that is some deeper collaborative spirit of engagement so that we’re not competing against each other, increasing costs and creating more of a bureaucratic morass.”
Some governors have also implored Trump to invoke the Defense National Production Act, which would force private industries to make supplies during the coronavirus pandemic. Trump has not pulled the trigger on those actions yet, voicing concern with government getting involved in private industries and saying some private companies are stepping up anyway.
The White House referred questions on medical supply distribution to the Federal Emergency Management Agency. FEMA said the agency was helping with demand of medical materials and is working with governors.
“As we process orders through the supply chain, we are maintaining close coordination with governors to identify potential bidding conflicts,” a FEMA spokesperson said. “If a bidding conflict does arise, we will work closely with the state to resolve it in a way that best serves the needs of their citizens.”
California’s coronavirus advantage
Newsom addressed the problem in press conferences Monday and Tuesday, acknowledging that California has an advantage over smaller states. He said governors have been trying to work together to make sure they don’t compete for the same resources.
California started with 7,587 ventilators and has been working with private industries to get more, obtaining more than 1,000 from billionaire and Tesla Founder Elon Musk and another 1,010 from the private industry, as well as refurbishing 514 ventilators the state had in storage, Newsom said. Los Angeles County asked for and received about 4,000 from the Strategic National Stockpile this week.
But the state needs a lot more. Harvard researchers projected this month that about 786,000 Californians will require the Intensive Care Unit at hospitals due to COVID-19, and about half of ICU patients with COVID-19 will need a ventilator to breathe, according to estimates provided to the American Hospital Association and reported by The New York Times. If those calculations are correct, about 393,000 Californians could need ventilators during the pandemic.
Newsom’s office said the number of ventilators experts believe are needed has fluctuated, but they know they state will need more than it currently has.
“Many of us are competing for the same limited supplies, and as a consequence of that, people are tripping over themselves to make deals that ultimately are raising the costs of these supplies,” Newsom said.
“But it is incumbent upon governors ... to start aligning our purchasing strategies to recognize that states like California that are uniquely positioned to make large purchases and get the volume discounts that are necessary, creates a crowding out of the market that hurts some of the smaller states,” he continued. “And I don’t want to be in a position as a Californian deeply committed to the people I represent, but also as an American citizen, to take advantage of our purchasing power, our market power, without addressing the legitimate anxiety and needs of some of these smaller state leaders. It is incumbent to begin the process of begin centralizing the procurement.”
Other states haven’t been so lucky on privately obtaining ventilators.
New York, Illinois want Trump’s help
Govs. Andrew Cuomo of New York and J.B. Pritzker of Illinios have also called on Trump to take over distribution, but haven’t reported so much luck with private industries.
“It’s the federal government’s job to make sure that cash-strapped states are not paying more than they should have to for supplies, that we are not watching prices go up by the hour because we are competing against each other, yet for the common good,” Pritzker said in a press conference this week.
Though Cuomo has said the state bought an additional 7,000 ventilators to the 3,000 it had, it isn’t enough. Experts predict the pandemic will peak in the state in the next two weeks, and Cuomo said they need 30,000 more ventilators.
The federal government sent New York 400 and Trump has promised 4,000 more from the Strategic National Stockpile this week. There were only 16,660 ventilators immediately available in that stockpile to begin with.
States with smaller populations could be even worse off if they have to bargain with private manufacturers for ventilators. In Idaho, between about 5,000 and 16,000 people would need a ventilator at some point, based on the Harvard study’s projections. The state has 404 ventilators, according to the Idaho Hospital Association. Idaho Gov. Brad Little has indicated they could receive more from the national stockpile, as governors across the country have said.
Manufacturers have also signaled that it isn’t just demand in the U.S. they’re looking to fill. In a press call on Tuesday, Tom Westrick, vice president and chief quality officer of GE Healthcare, a manufacturer of ventilators and other medical equipment that is partnering with Ford and 3M to ramp up production during the pandemic, acknowledged there is a “global” demand for the ventilators.
Demand for ventilators
New ventilators are still a ways off.
“We don’t have specific timelines and numbers related to the design and the release of the new ventilators,” Westrick said during the call.
GE Healthcare has said they support designating a federal agency to ensure appropriate sourcing and allocation based on patient needs. The company also said it has doubled its capacity of ventilator production and has plans to double it again by the end of the second quarter of 2020 to address unprecedented demand.
Steve Ellis, vice president at Taxpayers for Common Sense, a nonpartisan D.C.-watchdog organization on government waste, said it could be more efficient to have the federal government buy large amounts of ventilators in bulk and distribute. Even though it would mean the federal government choosing where those ventilators go, that’s an issue generally triggered by disaster assistance, he said.
“As we’re sending cash to states, hospitals, and localities the last thing we want is to start a bidding war between them for a limited amount of necessary equipment,” Ellis said. “Doesn’t matter whether is it is masks or ventilators or whatever. That said, increased price often leads to more production. It’s a tricky issue.”
This story was originally published March 26, 2020 at 12:53 PM with the headline "States shouldn’t fight over coronavirus equipment, Gavin Newsom says. Should Trump take charge?."
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