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In Abrupt Shift, Trump Cites Need for Ventilators and Criticizes G.M. Under Intense Criticism, Trump Says Government Will Buy More Ventilators
(about 7 hours later)
WASHINGTON — President Trump lashed out at General Motors on Friday, blaming it for overpromising on its ability to make new ventilators for critically ill coronavirus patients and threatening to invoke the Defense Production Act to compel the company to do so. WASHINGTON — Faced with a torrent of criticism from cities and states that have been pleading for help to deal with the most critically ill coronavirus victims, President Trump announced on Friday that the federal government would issue contracts to buy thousands of ventilators from a variety of large and small makers, though it appeared doubtful they could be produced in time to help overwhelmed hospitals.
In a series of tweets, the president emphasized the urgent need for the ventilators, an abrupt change of tone from the night before, when he told Sean Hannity, the Fox News host, that states were inflating their needs. His announcement came shortly after authorizing the government to “use any and all authority available under the Defense Production Act,” a Korean War-era authority allowing the federal government to commandeer General Motors’ factories and supply chains, to produce ventilators.
Mr. Trump appeared to be reacting to reports that the White House had dragged its feet in awarding contracts to G.M. and Ventec Life Systems, to start new production lines in a converted G.M. plant in Kokomo, Ind. It was the latest example of Mr. Trump’s mixed messages about how to ramp up production to meet a national crisis. Just 24 hours before, he had dismissed the complaints of mayors and governors who said that they were getting little of the equipment they needed for an expected onslaught of serious cases. And this week he praised companies that — General Motors included — were rallying to help provide necessary equipment.
With the Federal Emergency Management Agency still evaluating a $1.5 billion proposal from those companies, Mr. Trump declared that General Motors “MUST immediately open their stupidly abandoned Lordstown plant in Ohio, or some other plant, and START MAKING VENTILATORS, NOW!!!!!!” But he turned on G.M. on Friday, accusing it of “wasting time” and seeking to “rip off” the government. “Our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course,” the president said.
He added, “FORD, GET GOING ON ventilators, FAST!!!!!!” “Now it turns out we will have to be producing large numbers,” Mr. Trump said in a late-afternoon news conference, barely 20 hours after dismissing the gaping demand for more machines. He said that over the next 100 days, “we will either make or get, in some form, over 100,000 additional units,” more than three times the nation’s annual production. Later, he insisted, “We’re going to have plenty.”
Within an hour, General Motors and Ventec announced that they would begin producing ventilators at the Kokomo plant, and that the machines would be “scheduled to ship as soon as next month.” Most of those will have to come from finding existing units, industry executives say, because production lines are already stretched to the limit.
But the statement offered no estimates of numbers and did not address the president’s criticism — leaving it unclear if the companies would simply begin production themselves, or whether the Trump administration would be buying and distributing the machines. Mr. Trump appointed Peter Navarro, the China hawk among his trade advisers, to coordinate use of the Defense Production Act, and Mr. Navarro immediately made it clear that the White House planned to make an example of G.M.
The competing tweets and announcements underscored the chaos that has surrounded the effort to ramp up emergency production. But it was unclear whether Mr. Trump’s use of the law would make much difference. He was essentially ordering the company to do something it had already arranged to do: G.M. announced earlier on Friday that it was moving forward with an emergency joint venture with a small manufacturer, Ventec Life Systems, even in the absence of a contract from the Federal Emergency Management Agency.
Both the president and Dr. Deborah L. Birx, the top health expert on his coronavirus task force, have played down the immediate need for a large number of ventilators in New York and other states, rejecting calls from governors and major hospitals to help them before their needs outstrip their supply. Company executives seemed stunned by the president’s effort to command them to carry through with an effort they had initiated.
“I don’t believe you need 40,000 or 30,000 ventilators,” Mr. Trump said, discussing an urgent request from Gov. Andrew Cuomo of New York. “You know, you’re going to major hospitals sometimes, they’ll have two ventilators. And now, all of a sudden, they’re saying, can we order 30,000 ventilators?” Mr. Trump’s announcement at his coronavirus task force’s daily briefing came on a day of intensive criticism of the administration’s slow response and lack of leadership in a pandemic that has now resulted in over 1,500 deaths in the United States. More than 100,000 people here have been infected with the coronavirus, according to a New York Times database. The United States is the only country so far to hit that milestone.
In a news briefing on Thursday, Dr. Birx, the coordinator of the White House coronavirus task force, also said the talk of a ventilator shortage was overwrought. Much of the criticism has focused on the absence of sufficient stockpiles of basic materials like masks and ventilators, and especially on the lack of urgency in organizing increased production and distribution.
“We were reassured after meeting with colleagues in New York there are still beds remaining and over 2,000 ventilators that have not been used yet,” Dr. Birx said. “To say that to the American people, to make the implication when they need a hospital bed, it won’t be there, or when they need that ventilator, it won’t be there, we don’t have evidence of that right now.” Officials in more than 200 American cities, large and small, report a dire need for face masks, ventilators and other emergency equipment to respond to the coronavirus outbreak, according to a survey released on Friday.
But New York officials said they expected a shortage reaching in the thousands in the coming weeks, as the number of cases continues to grow. “Our single greatest challenge is ventilators,” Mr. Cuomo wrote on Twitter on Wednesday. “We need 30,000 ventilators. We have 11,000.” “It is abundantly clear that the shortage of essential items such as face masks, test kits, personal protective equipment, ventilators and other items needed by health and safety personnel has reached crisis proportions in cities across the country,” Tom Cochran, the chief executive of the United States Conference of Mayors, said in a letter accompanying the survey’s findings.
On Friday morning, Mayor Bill de Blasio of New York hit back at the administration for questioning the request. “When the president says the state of New York doesn’t need 30,000 ventilators, with all due respect to him, he’s not looking at the facts of this astronomical growth of this crisis,” Mr. de Blasio said in an interview with “Good Morning America.” Mr. Trump responded late Friday afternoon that “we have done a hell of a job” and wanted mayors and governors to “be appreciative.” He accused his critics of seeking political advantage.
More than 90 percent — or 192 cities — told the conference that they did not have an adequate supply of face masks for police officers, firefighters or emergency workers. In addition, 92 percent of cities reported a shortage of test kits to diagnose who has contracted the virus — a problem Mr. Trump has said in recent days was all but solved — and 85 percent said they did not have a sufficient supply of ventilators available to health facilities.
Roughly two-thirds of the cities said they had not received any emergency equipment or supplies from their state, the report said. And of those that did receive state aid, nearly 85 percent said it was not enough to meet their needs.
In total, the conference tabulated that cities needed 28.5 million face masks, 24.4 million other items of personal protection equipment, 7.9 million test kits and 139,000 ventilators.
But it is the ventilator issue that swamped the White House late this week, as mayors, governors and members of Congress predicted that doctors would have to leave some patients to die in the coming weeks because the machines would not be available.
In New York, the epicenter of the virus in the United States, doctors and nurses have reported that they were being forced to experiment with putting several patients on a single ventilator — a largely untested, unapproved practice that state authorities are now permitting in an effort to keep alive older adults or immunocompromised patients who could not breathe on their own.
Stories of nurses reusing 85-cent masks because they are in short supply, or others using plastic bags to cover their faces, have reinforced an image of a nation that, for all of its advanced medicine, was caught ill prepared and underfunded by a pandemic.
Both the president and Dr. Deborah L. Birx, the top health expert on his coronavirus task force, have played down the immediate need for a large number of ventilators in New York and other states.
“We were reassured after meeting with colleagues in New York there are still beds remaining and over 2,000 ventilators that have not been used yet,” Dr. Birx said on Thursday. “To say that to the American people, to make the implication when they need a hospital bed, it won’t be there, or when they need that ventilator, it won’t be there, we don’t have evidence of that right now.”
But Mr. Trump went much further in an interview on Fox.
“I don’t believe you need 40,000 or 30,000 ventilators,” Mr. Trump said Thursday night, discussing an urgent request from Gov. Andrew M. Cuomo of New York. “You know, you’re going to major hospitals sometimes, they’ll have two ventilators. And now, all of a sudden, they’re saying, can we order 30,000 ventilators?”
Mr. Trump’s accusation that the need was being inflated prompted special anger in New York.
“When the president says the state of New York doesn’t need 30,000 ventilators, with all due respect to him, he’s not looking at the facts of this astronomical growth of this crisis,” said Mayor Bill de Blasio of New York City. “If they don’t have a ventilator, a lot of people are just not going to make it.”
A ventilator, Mr. de Blasio added, “means someone lives or dies.”A ventilator, Mr. de Blasio added, “means someone lives or dies.”
The White House had been preparing to unveil the G.M.-Ventec joint venture this week, and had hoped to announce that upward of 20,000 ventilators would be available in weeks, and ultimately 80,000 would be produced, which is more than the current global annual production of high-end ventilators. And Mr. Cuomo, responding to an accusation by the president that New York was warehousing the ventilators it was being sent rather than immediately deploying them, said that the current number of hospitalizations did not yet require their use, but that the state was bracing for a sharp rise in cases in the coming weeks. “We’re gathering them in a stockpile so when we need them, they will be there,” he said.
But it canceled the announcement, government officials said, because they needed more time to assess whether the estimated cost — more than $1 billion — was prohibitive, and whether G.M. could produce at those levels. In fact, G.M. scaled back the estimate of the number of ventilators it could produce in coming months in Kokomo, saying the initial output would be closer to 5,000 to 7,500. The city now has more than 23,000 cases of the coronavirus, a quarter of the nation’s total, and deaths are already approaching 400.
Mr. Trump angrily accused the company of backtracking and as “As usual with ‘this’ General Motors, things just never seem to work out.” He claimed the company had promised 40,000 ventilators, and “now they are saying it will only be 6,000, in late April, and they want top dollar. Always a mess with Mary B.,’' a reference to G.M.’s chief executive, Mary T. Barra. Mr. Trump’s abrupt change on the need for ventilators appeared to be in response to news reports that his administration had decided at the last minute not to announce a $1.5 billion contract with G.M. because of concern about the high cost and slow delivery of the machines.
But G.M. says it has been preparing the Kokomo plant while pressing the administration to issue a contract and provide it with about $250 million to buy parts and convert the plant, which ordinarily makes transmissions and other car components, for the delicate work of making machines that can pump air into the lungs of patients. Those reports prompted Mr. Trump to lash out first at the cities, then at G.M. and its chief executive, Mary T. Barra, who he accused of inaction.
Ventilators are complex machines, using more than 1,500 unique parts from more than a dozen nations, and the manufacturers say they will be limited in part by the availability of parts. The company has pared back its early estimates of how many ventilators it could ship in April or May, reducing them to 5,000 to 7,500 from 20,000. But even that would be a huge surge; its partner, Ventec, produces only a few hundred a month.
Critics of the administration note that the planning for increased production should have begun in late January or February, when the alarm sounded that the virus was headed to the United States, and that any production that begins will not be available until May or June. Critics of the Trump administration have said that planning for increased production should have begun in late January or February, when the alarm sounded that the virus was headed to the United States. And even with the president’s announcement on Friday, it appeared highly unlikely that many new ventilators would reach the cities in time for this first, devastating wave of the coronavirus.
Existing manufacturers like Medtronic and Ventec said they stepped up production weeks ago, but they were limited by the availability of parts from more than a dozen countries.
That suggests that the overall boost will not have a major effect until early summer, industry executives said — perhaps in time for a “second wave” of infections.
Because Mr. Trump played down the severity of the coronavirus for much of January and February, and into the beginning of March, the White House got a late start in assessing how much equipment would be needed.
His son-in-law and senior adviser, Jared Kushner, began focusing on the shortages only two weeks ago, and started with the critical absence of test kits, which has made it impossible to map how far the virus has spread or to identify emerging hot spots.
Then Mr. Kushner focused on the medical equipment shortages, working with the National Association of Manufacturers, the Business Roundtable and groups of former and current executives who gathered under the hashtag #StopTheSpread. Some of those executives now say they are operating on their own and no longer coordinating with the White House because they could not get clear signals about what the government wanted, or when.
But it was the G.M.-Ventec deal that attracted the most attention because it seemed the model for a crash merger of high-technology and deep manufacturing experience. G.M. was moving ahead in its Kokomo, Ind., factory, where it makes precision electronic components.
The White House had been preparing to unveil the G.M.-Ventec joint venture this week, and had hoped to announce that upward of 20,000 ventilators would be available in weeks, and that ultimately 80,000 would be produced. But the company complained that FEMA would not commit to spending the $250 million or so it would take to retool the factory.
And with FEMA still evaluating a $1.5 billion proposal from those companies, Mr. Trump got angry at news reports that described the bureaucratic maneuvering. He soon blamed G.M.
On Friday morning, Mr. Trump declared on Twitter that the company “MUST immediately open their stupidly abandoned Lordstown plant in Ohio, or some other plant, and START MAKING VENTILATORS, NOW!!!!!!”
He angrily accused G.M. of backtracking and “as usual with ‘this’ General Motors, things just never seem to work out.” He claimed the company had promised 40,000 ventilators, and “now they are saying it will only be 6000, in late April, and they want top dollar. Always a mess with Mary B.,” a Ms. Barra.
Within an hour, G.M. and Ventec announced that they would begin producing ventilators at the Kokomo plant, and that the machines would be “scheduled to ship as soon as next month.”
But the statement offered no estimates of numbers and did not address the president’s criticism — leaving it unclear if the companies would simply begin production themselves.
David E. Sanger and Annie Karni reported from Washington, and Maggie Haberman from New York. Noah Weiland contributed reporting from Washington.