'A Ventilator Stockpile, With One Hitch: Thousands Do Not Work' diff viewer (4/5)

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A Ventilator Stockpile, With One Hitch: Thousands Do Not Work	A Ventilator Stockpile, With One Hitch: Thousands Do Not Work
2020-06-03 03:18:21 UTC	2020-06-06 09:06:50 UTC (3 days later)
WASHINGTON — President Trump has repeatedly assured Americans that the federal government is holding 10,000 ventilators in reserve to ship to the hardest-hit hospitals around the nation as they struggle to keep the most critically ill patients alive.	WASHINGTON — President Trump has repeatedly assured Americans that the federal government is holding 10,000 ventilators in reserve to ship to the hardest-hit hospitals around the nation as they struggle to keep the most critically ill patients alive.
But what federal officials have neglected to mention is that an additional 2,109 lifesaving devices are unavailable after the contract to maintain the government’s stockpile lapsed late last summer, and a contracting dispute meant that a new firm did not begin its work until late January. By then, the coronavirus crisis was already underway.	But what federal officials have neglected to mention is that an additional 2,109 lifesaving devices are unavailable after the contract to maintain the government’s stockpile lapsed late last summer, and a contracting dispute meant that a new firm did not begin its work until late January. By then, the coronavirus crisis was already underway.
The revelation came in response to inquiries to the Department of Health and Human Services after state officials reported that some of the ventilators they received were not operational, stoking speculation that the administration had not kept up with the task of maintaining the stockpile.	The revelation came in response to inquiries to the Department of Health and Human Services after state officials reported that some of the ventilators they received were not operational, stoking speculation that the administration had not kept up with the task of maintaining the stockpile.
In fact, the contract with a company that was maintaining the machines expired at the end of last summer, and a contract protest delayed handing the job to Agiliti, a Minneapolis-based provider of medical equipment services and maintenance. Agiliti was not given the $38 million task until late January, when the scope of the global coronavirus crisis was first becoming clear.	In fact, the contract with a company that was maintaining the machines expired at the end of last summer, and a contract protest delayed handing the job to Agiliti, a Minneapolis-based provider of medical equipment services and maintenance. Agiliti was not given the $38 million task until late January, when the scope of the global coronavirus crisis was first becoming clear.
It is not known whether problems with the ventilators predated the contract lapse, but maintenance of the machines did halt. That delay may become a potentially deadly lapse.	It is not known whether problems with the ventilators predated the contract lapse, but maintenance of the machines did halt. That delay may become a potentially deadly lapse.
“We were given a stop-work order before we’d even started,” said Tom Leonard, the chief executive of Agiliti, which had won the contract to service the ventilators in the stockpile. “Between the time of the original and the time of this contract award, I don’t know who was responsible or if anybody was responsible for those devices. But it was not us.”	“We were given a stop-work order before we’d even started,” said Tom Leonard, the chief executive of Agiliti, which had won the contract to service the ventilators in the stockpile. “Between the time of the original and the time of this contract award, I don’t know who was responsible or if anybody was responsible for those devices. But it was not us.”
Mr. Leonard said confidentiality agreements with the government over the stockpile prohibited him from giving specific figures on the number of ventilators the company was now working on.	Mr. Leonard said confidentiality agreements with the government over the stockpile prohibited him from giving specific figures on the number of ventilators the company was now working on.
“We still have that first tranche of ventilators, although we’re accelerating the work to get them deployable,” Mr. Leonard said. “We haven’t seen or touched or had anything to do with the ones that have already been deployed to date.”	“We still have that first tranche of ventilators, although we’re accelerating the work to get them deployable,” Mr. Leonard said. “We haven’t seen or touched or had anything to do with the ones that have already been deployed to date.”
Ventilators are sensitive machinery that Mr. Trump described on Sunday as so complex they were like “building a car.” But, experts say, like a car, they cannot be stored for lengthy periods without maintenance. So few are surprised that as the nation’s hospitals scramble to pull together every usable ventilator they can find, some have come out of storage with depleted batteries, missing oxygen hoses and other issues.	Ventilators are sensitive machinery that Mr. Trump described on Sunday as so complex they were like “building a car.” But, experts say, like a car, they cannot be stored for lengthy periods without maintenance. So few are surprised that as the nation’s hospitals scramble to pull together every usable ventilator they can find, some have come out of storage with depleted batteries, missing oxygen hoses and other issues.
California recently discovered that 170 of its ventilators arrived broken, disputing the claim from the Department of Health and Human Services that all of the ventilators shipped by the Federal Emergency Management Agency were ready to use. The agency said in a statement that problems with some ventilators were limited to the devices’ external batteries, and that federal officials were quick to assist the states with any technical issues.	California recently discovered that 170 of its ventilators arrived broken, disputing the claim from the Department of Health and Human Services that all of the ventilators shipped by the Federal Emergency Management Agency were ready to use. The agency said in a statement that problems with some ventilators were limited to the devices’ external batteries, and that federal officials were quick to assist the states with any technical issues.
Federal officials revealed on Wednesday that their stockpile of medical gear was nearly depleted. FEMA has shipped 26 million surgical masks, 11.6 million respirator masks and more than five million face shields to states, setting off a race to obtain millions of recently produced masks from a variety of manufacturers at a moment of huge price spikes for respirators that previously sold for about 85 cents.	Federal officials revealed on Wednesday that their stockpile of medical gear was nearly depleted. FEMA has shipped 26 million surgical masks, 11.6 million respirator masks and more than five million face shields to states, setting off a race to obtain millions of recently produced masks from a variety of manufacturers at a moment of huge price spikes for respirators that previously sold for about 85 cents.
The bigger struggle, however, has focused on ventilators because states have asked for tens of thousands more than the approximately 9,400 that the U.S. government currently has in its stockpile. The Defense Department is also making 1,065 ventilators available, although those require special training and are not used as frequently in hospitals.	The bigger struggle, however, has focused on ventilators because states have asked for tens of thousands more than the approximately 9,400 that the U.S. government currently has in its stockpile. The Defense Department is also making 1,065 ventilators available, although those require special training and are not used as frequently in hospitals.
As White House officials have for the first time looked at a supply they had not thought about, they have discovered it is not only far smaller than what they need — it is also in constant need of maintenance.	As White House officials have for the first time looked at a supply they had not thought about, they have discovered it is not only far smaller than what they need — it is also in constant need of maintenance.
Aric Vacchiano, the vice president of U.S. sales and services at Vyaire Medical in Chicago, which produces the LTV 1200, one of the ventilators in the federal stockpile, said the company had been fielding calls from all over the country as hospital officials rushed to get the machines in working order.	Aric Vacchiano, the vice president of U.S. sales and services at Vyaire Medical in Chicago, which produces the LTV 1200, one of the ventilators in the federal stockpile, said the company had been fielding calls from all over the country as hospital officials rushed to get the machines in working order.
“They’re reaching out in every direction,” Mr. Vacchiano said.	“They’re reaching out in every direction,” Mr. Vacchiano said.
Vyaire was responsible for maintaining some of the ventilators in the federal stockpile until that contract ran out in late August. The company protested when a broader contract to keep the stockpile up-to-date was granted to Agiliti instead. The dispute was not resolved until January, when Agiliti again prevailed.	Vyaire was responsible for maintaining some of the ventilators in the federal stockpile until that contract ran out in late August. The company protested when a broader contract to keep the stockpile up-to-date was granted to Agiliti instead. The dispute was not resolved until January, when Agiliti again prevailed.
It then received thousands of ventilators — it would not say how many — for restoration, and that work is still underway.	It then received thousands of ventilators — it would not say how many — for restoration, and that work is still underway.
A spokeswoman for Health and Human Services did not respond to questions about what had happened to ventilator maintenance during the lapse, but she said the agency had sped up the contract with Agiliti to make the remaining 2,109 ventilators available by April 30.	A spokeswoman for Health and Human Services did not respond to questions about what had happened to ventilator maintenance during the lapse, but she said the agency had sped up the contract with Agiliti to make the remaining 2,109 ventilators available by April 30.
As of Wednesday morning, FEMA had sent about 7,000 ventilators to a number of states, with 4,000 directed to New York. Mr. Trump said he wanted to hold the current stockpile in reserve until it was clear where new hot spots would emerge.	As of Wednesday morning, FEMA had sent about 7,000 ventilators to a number of states, with 4,000 directed to New York. Mr. Trump said he wanted to hold the current stockpile in reserve until it was clear where new hot spots would emerge.
~~Updated June 2, 2020~~	Updated June 5, 2020
	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Even with the federal help, states are scrambling for their own ventilators. They have flooded the few manufacturers in the country with orders, only to discover that the machines are largely made abroad, in China, Ireland, Switzerland and elsewhere.	Even with the federal help, states are scrambling for their own ventilators. They have flooded the few manufacturers in the country with orders, only to discover that the machines are largely made abroad, in China, Ireland, Switzerland and elsewhere.
“We’re very short,” Gov. Ned Lamont of Connecticut said on CNN on Monday. “We had our ventilators all set to come, and at the last moment FEMA redirected them,” he said, to “another place that they considered more urgent than Connecticut.”	“We’re very short,” Gov. Ned Lamont of Connecticut said on CNN on Monday. “We had our ventilators all set to come, and at the last moment FEMA redirected them,” he said, to “another place that they considered more urgent than Connecticut.”
Officials in Illinois say they asked for 4,000 and got 450. New Jersey sought 2,300 and got 300. New Mexico has only 370. Virginia requested 350 ventilators but has not received any. The governor of Illinois asked Vice President Mike Pence for 4,000 ventilators this week and was told the state would not need that many.	Officials in Illinois say they asked for 4,000 and got 450. New Jersey sought 2,300 and got 300. New Mexico has only 370. Virginia requested 350 ventilators but has not received any. The governor of Illinois asked Vice President Mike Pence for 4,000 ventilators this week and was told the state would not need that many.
At the same time, states are trying to grab whatever else they can, converting anesthesia machines for use as ventilators and sometimes fashioning new valves on 3-D printers so that multiple patients can share the same machine. That has never been tested on a broad scale, and it carries some risks.	At the same time, states are trying to grab whatever else they can, converting anesthesia machines for use as ventilators and sometimes fashioning new valves on 3-D printers so that multiple patients can share the same machine. That has never been tested on a broad scale, and it carries some risks.
To manage the scarcity of ventilators in the stockpile, FEMA has begun sending a questionnaire to states seeking ventilators, asking about available resources and whether hospitals have tried converting anesthesia machines. A FEMA official said state leaders could submit requests for ventilators at any time but should not expect their delivery unless patients were at risk of dying within 72 hours without the devices.	To manage the scarcity of ventilators in the stockpile, FEMA has begun sending a questionnaire to states seeking ventilators, asking about available resources and whether hospitals have tried converting anesthesia machines. A FEMA official said state leaders could submit requests for ventilators at any time but should not expect their delivery unless patients were at risk of dying within 72 hours without the devices.
And states are discovering that much of what they can get their hands on needs work.	And states are discovering that much of what they can get their hands on needs work.