Colorado Gov. Jared Polis was pleading with the federal government to send ventilators.
The state was starting to see hundreds of new coronavirus cases pop up each day, and Polis, a Democrat, worried that hospitals wouldn’t have enough life-saving ventilators to deal with the looming spike.
So he made an official request for ventilators through the Federal Emergency Management System, which is managing the effort. That went nowhere. He wrote to Vice President Mike Pence, leader of the White House’s coronavirus task force. That didn’t work. He tried to purchase supplies himself. The federal government swooped in and bought them.
Then, on Tuesday, five weeks after the state’s first coronavirus case, the state’s Republican Sen. Cory Gardner called President Donald Trump. The federal government sent 100 ventilators to Colorado the next day, but still only a fraction of what the state wanted.
The federal government’s haphazard approach to distributing its limited supplies has left states trying everything — filling out lengthy FEMA applications, calling Trump, contacting Pence, sending messages to Jared Kushner, Trump’s son-in-law, and trade adviser Peter Navarro, who are both leading different efforts to find supplies, according to local and states officials in more than a half-dozen states. They’re even asking mutual friends to call Trump or sending him signals on TV and Twitter.
Sometimes it works. Sometimes it doesn’t.
“This is not something that we should ever be faced with,” Kansas Gov. Laura Kelly, a Democrat, said in an interview. “It really is the federal government's responsibility to build those stockpiles, and distribute those during the time of crisis.”
In Illinois, Democratic Gov. J.B. Pritzker got results after he tweeted at the president and complained on TV. In California, Democratic Gov. Gavin
Newsom, a frequent sparring partner for Trump, chose to instead heap praise on the president. And in Kansas, Kelly submitted seven requests for millions of masks, gowns and gloves that went unheeded until a reporter asked Pence about the situation in a briefing. Pence pledged to call her.
The confusion is indicative more broadly of how Trump and his administration have responded to a number of crises. The president often bounces from one issue to the next, reacting to the headlines of the day. Record turnover rates and competing power centers have hampered long-term planning. The result has been rotating strategies that are hard to fully chronicle.
In this instance, local and state officials of both parties say decisions seem less tied to partisan politics than they are to access to and praise of a president who has suggested he would help only local officials who were appreciative of the federal government’s efforts.
“Right now,you have more discretion at the White House, and we have prized our relationship in order to secure some of the ventilators and other supplies,” said an aide to one governor, who asked that even the state not be named for fear of jeopardizing the supplies. “We operate within the world we live in. We made the decision to have a very constructive and amicable relationship.”
Trump has faced withering criticism that he failed to adequately prepare the country for the coronavirus outbreak after receiving warnings as early as January. Since then, the administration has struggled to provide states with enough tests and provide the proper medical equipment for patients and first responders.
“It’s not clear to us who is making decisions. It looks like continuing chaos at the highest levels,” said Rep. Jamie Raskin, a Democratic member of the House Oversight Committee whose state, Maryland, has had its own disputes with federal officials over the delivery of supplies. “Every state is in charge of its own destiny.”
Trump initially indicated states should try to buy supplies themselves, but they found themselves competing with each other and the federal government as they scoured the globe for supplies. The president then said he would distribute some supplies, but a failure to start the process earlier and put a single agency in charge exacerbated manufacturing and distribution problems, according to local, state and federal officials.
Frustrated governors are now considering whether to create a multistate consortium to oversee the purchase and distribution of supplies.
“I’m bidding on a machine that Illinois is bidding on and California is bidding on and Florida is bidding on. We’re all bidding up each other,” Democratic New York Gov. Andrew Cuomo said Thursday at a briefing. “I’m trying to figure out how to do business with China where I have no natural connection as a state. And every state has to scramble to find business connections with China. It was crazy, that can’t happen again.”
Senate Minority Leader Chuck Schumer (D-N.Y.) called on Trump this week to name a senior military officer to lead the manufacture and distribution of supplies. He sent three names to the White House and called Trump, Pence and chief of staff Mark Meadows to discuss the issue.
“This is a massive undertaking, and the country needs an undisputed person who is organizing all facets of it, someone with experience, someone with strength, someone who will have the full authority of the president behind them,” Schumer said.
Over in the House, Homeland Security Chairman Bennie Thompson (D-Miss.) and Oversight Chairwoman Carolyn Maloney (D-N.Y.) sent a letter to
FEMA inquiring about the agency’s faltering efforts on supplies.
Hospitals are so desperate for supplies they are taking protective masks from auto-body shops and nail salons. They’re also reusing masks, face shields and gowns, while simultaneously limiting interaction with patients, according to a report by the Health and Human Services Department’s inspector general, the agency’s independent in-house watchdog.
“One of the biggest challenges for local units of government is the fact that we haven’t had a comprehensive and coherent effort at the federal level in both the stockpile and distribution of this equipment,” said Toni Preckwinkle, county board president of Cook County, Ill., which includes Chicago.
The White House has repeatedly defended its supply distribution process.
Trump repeatedly notes that a military officer is, indeed, in charge of logistics — Navy Rear Adm. John Polowczyk, vice director of logistics at the Joint Chiefs of Staff. And White House aides say the federal government is able to swiftly assess needs at a county-by-county level.
At FEMA, officials say they are working as fast as possible and have already completed 26 flights from overseas factories to the U.S., delivering 250.6 million gloves, 25.1 million surgical masks and 3.5 million gowns, among other items. An additional 54 flights are planned.
Once the supplies are in the country, the agency directs 50 percent of the load on each plane to high-risk areas, as determined by FEMA and the Centers for Disease Control and Prevention, a FEMA official said. The remaining half is left for distributors to fill previous orders.
“The system that we have in place is one that is essentially infusing our major distribution networks with millions of items,” Pence said. “And then FEMA is directing, on a day-by-day and oftentimes hour-by-hour basis, where those resources are most needed.”
At the outset of the crisis, Trump followed a decade-old federal disaster response playbook for a flu epidemic that put states in charge of initial response, said Craig Fugate, a former FEMA administrator who oversaw the playbook’s development early in the Obama administration.
Under the plan, HHS would send ventilators and other medical gear from the two-decade-old strategic national stockpile to states that ran short, while FEMA would be limited to “direct federal assistance,” such as building emergency hospitals and distributing food, water and other supplies. But as the coronavirus outbreak worsened in early March, the stockpile began to dwindle. Governors and Congress pressured the federal government to take a more active role and tap FEMA to play a greater role.
For weeks, Trump was reluctant. He was wary of declaring a national emergency and putting FEMA in charge, worried about generating public and economic panic. But on March 13, Trump relented, though he never mentioned FEMA in his announcement. His decision came seven weeks after the first U.S. case and days after the coronavirus was declared a global pandemic.
"Even after that emergency declaration was made, FEMA still really wasn’t in charge,” said a former Trump administration official. “For some number of days, FEMA was supporting HHS. And then it became clear that wasn’t working, so the president then announced FEMA is in charge.”
But it was hard to swiftly overhaul the structures that had been created in the initial months of the outbreak.
“You can’t just flip a switch and say ‘FEMA, go fix it,’” the ex-official added.
“There were so many decisions that had been made in the prior months that would be hard for FEMA to immediately address, and one of those was the fact that the national stockpile that HHS manages was nearly empty or running low.”
In mid-March, Kushner was brought in, assembling a kitchen cabinet of outside experts to help increase the production and distribution of supplies. Polowczyk didn’t come on board until March 20, three weeks ago.
It took until March 24 for Trump to first use the Defense Production Act, a Korean War-era law empowering him to order manufacturers, including General Motors, and medical device companies to produce ventilators and protective gear. Three days later, Navarro was put in charge of that effort.
“We had the ability to produce enough ventilators so that we could reach at peak everybody that would need a ventilator in this country,” said Pritzker, the Illinois governor. “And they could have started this in February, and we would have been fine. But we’re not. And it’s very upsetting.”
The DPA allowed FEMA to start “jumping to the front of the line,” Fugate said, intercepting some orders for medical goods to states or hospitals and redistributing them to agency-determined “high-risk areas.”
Yet that created its own problems. In some cases, hospitals and governors, including Polis, said their orders were canceled without notice, only to learn FEMA had received the goods.
If Trump had acted earlier to make FEMA the lead agency and activate the DPA, the administration could have avoided the supply shortages by ordering production of ventilators and other supplies sooner, according to two former administration officials. As of now, manufacturers that have switched to ventilator production, including GM and Ford, say most of their output won’t be available for two months.
“If you were going to engage FEMA in this way, the earlier the better,” Fugate said. “If FEMA had been engaged three weeks earlier, before we saw the explosion of cases on the East Coast, they may have had a better opportunity to get ahead of this, at least in getting procurement and other things in place.”
While Kushner and Navarro each still play a role in supply distribution, a senior administration official said. Polowczyk makes all final decisions in consultation with FEMA, which collects requests from localities and hospitals. Polowczyk similarly controls inventory and reserves, the official noted, even those at the strategic national stockpile, the stash of health care supplies created in 1998 to respond to a bioterrorism attack, terrorist attack or a natural disaster. About 90 percent of the stockpile is depleted.
Navarro and Kushner “work through that process,” the official said, and Pence’s task force signs off on any use of the DPA.
But there appear to still be plenty of workarounds.
