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‘Swept Up by FEMA’: Complicated Medical Supply System Sows Confusion ‘Swept Up by FEMA’: Complicated Medical Supply System Sows Confusion
(32 minutes later)
WASHINGTON — In Massachusetts, state leaders said they had confirmed a vast order of personal protective equipment for their health workers; then the Trump administration took control of the shipments.WASHINGTON — In Massachusetts, state leaders said they had confirmed a vast order of personal protective equipment for their health workers; then the Trump administration took control of the shipments.
In Kentucky, the head of a hospital system told members of Congress that his broker had pulled out of an agreement to deliver four shipments of desperately needed medical gear after the supplies were commandeered by the Federal Emergency Management Agency.In Kentucky, the head of a hospital system told members of Congress that his broker had pulled out of an agreement to deliver four shipments of desperately needed medical gear after the supplies were commandeered by the Federal Emergency Management Agency.
Gov. Jared Polis of Colorado thought his state had secured 500 ventilators before they were “swept up by FEMA.”Gov. Jared Polis of Colorado thought his state had secured 500 ventilators before they were “swept up by FEMA.”
For weeks, the Trump administration pushed states to procure their own ventilators and protective gear, like masks, gloves and face shields. But a new effort by the administration to create a hybrid system of distribution — divided between the federal government, local officials and private health care companies — has led to new confusion, bordering on disarray, and charges of confiscation.For weeks, the Trump administration pushed states to procure their own ventilators and protective gear, like masks, gloves and face shields. But a new effort by the administration to create a hybrid system of distribution — divided between the federal government, local officials and private health care companies — has led to new confusion, bordering on disarray, and charges of confiscation.
“Either be in or out, folks,” Governor Polis said on CNN. “Either you’re buying them and you’re providing them to the states and you’re letting us know what we’re going to get and when we’re going to get them, or stay out and let us buy them.”“Either be in or out, folks,” Governor Polis said on CNN. “Either you’re buying them and you’re providing them to the states and you’re letting us know what we’re going to get and when we’re going to get them, or stay out and let us buy them.”
In a lengthy conference call with governors on Monday, Vice President Mike Pence, the FEMA administrator and the Navy admiral tapped to lead the government’s logistical “air bridge” tried to lay out how the new system worked.In a lengthy conference call with governors on Monday, Vice President Mike Pence, the FEMA administrator and the Navy admiral tapped to lead the government’s logistical “air bridge” tried to lay out how the new system worked.
“What the president has stood up through FEMA today is essentially a control tower at the airport,” Mr. Pence said.“What the president has stood up through FEMA today is essentially a control tower at the airport,” Mr. Pence said.
“We have the visibility on medical supplies that are moving into this country and are available to vendors in this country,” he said, according to a recording of the call obtained by The New York Times.“We have the visibility on medical supplies that are moving into this country and are available to vendors in this country,” he said, according to a recording of the call obtained by The New York Times.
Federal officials say they are trying to expedite the shipment to the United States of large quantities of medical supplies procured by private health care providers such as McKesson Corporation, Cardinal Health, Owens & Minor, Medline and Henry Schein. FEMA allows those distributors to sell about half of the equipment to companies and counties that had previously placed orders. The other half of the shipments must be sold to counties that the federal government prioritizes by the severity of the outbreak, based on data compiled by the Centers for Disease Control and Prevention.Federal officials say they are trying to expedite the shipment to the United States of large quantities of medical supplies procured by private health care providers such as McKesson Corporation, Cardinal Health, Owens & Minor, Medline and Henry Schein. FEMA allows those distributors to sell about half of the equipment to companies and counties that had previously placed orders. The other half of the shipments must be sold to counties that the federal government prioritizes by the severity of the outbreak, based on data compiled by the Centers for Disease Control and Prevention.
The federal government will also soon save 10 percent of the supplies on each flight for the national stockpile, according to officials. A Korean War-era production act also allows the federal government to force companies to prioritize its order over another client’s, whether it be a private hospital or another nation.The federal government will also soon save 10 percent of the supplies on each flight for the national stockpile, according to officials. A Korean War-era production act also allows the federal government to force companies to prioritize its order over another client’s, whether it be a private hospital or another nation.
In the past week, 14 flights carrying more than 83 million gloves, four million masks, one million gowns and 300,000 respirators have landed in New York, Chicago, Miami, Los Angeles, Columbus, Ohio, and Louisville, Ky. Mr. Pence said more than 50 flights had been scheduled.In the past week, 14 flights carrying more than 83 million gloves, four million masks, one million gowns and 300,000 respirators have landed in New York, Chicago, Miami, Los Angeles, Columbus, Ohio, and Louisville, Ky. Mr. Pence said more than 50 flights had been scheduled.
The administration pivoted to the system of distribution after President Trump tapped FEMA to replace the Department of Health and Human Services as the agency leading the response to the coronavirus pandemic. States had previously submitted formal requests to the government to obtain materials from the stockpile.The administration pivoted to the system of distribution after President Trump tapped FEMA to replace the Department of Health and Human Services as the agency leading the response to the coronavirus pandemic. States had previously submitted formal requests to the government to obtain materials from the stockpile.
Because the federal government determines which states are in greater need, governors and hospitals executives preparing in advance for the worst have complained that FEMA was effectively commandeering their personal protective equipment, or P.P.E.Because the federal government determines which states are in greater need, governors and hospitals executives preparing in advance for the worst have complained that FEMA was effectively commandeering their personal protective equipment, or P.P.E.
“FEMA realizes that prioritizing P.P.E. deliveries to Covid hot spots can have the unintended consequence of disrupting the regular supply chain deliveries to other areas of the country that are also preparing for the coronavirus,” said Lizzie Litzow, a FEMA spokeswoman, adding that the agency was not seizing any shipments.“FEMA realizes that prioritizing P.P.E. deliveries to Covid hot spots can have the unintended consequence of disrupting the regular supply chain deliveries to other areas of the country that are also preparing for the coronavirus,” said Lizzie Litzow, a FEMA spokeswoman, adding that the agency was not seizing any shipments.
The intervention has confused some local officials and company executives who have watched as the administration has repeatedly called on states to find medical supplies on their own without relying on the federal government. But hundreds of hospitals continue to struggle with widespread shortages of test kits, protective gear for staff members and ventilators, according to a new report by the inspector general for the Department of Health and Human Services.The intervention has confused some local officials and company executives who have watched as the administration has repeatedly called on states to find medical supplies on their own without relying on the federal government. But hundreds of hospitals continue to struggle with widespread shortages of test kits, protective gear for staff members and ventilators, according to a new report by the inspector general for the Department of Health and Human Services.
The chaotic race to procure such supplies has also drawn fraudsters looking to hoard items and resell the equipment at a steep price. A number of F.B.I. investigations are already underway.The chaotic race to procure such supplies has also drawn fraudsters looking to hoard items and resell the equipment at a steep price. A number of F.B.I. investigations are already underway.
Some states also trying to bring order to the process on their own.Some states also trying to bring order to the process on their own.
California, the most populous state, with 40 million people, is attempting to band with smaller states to procure supplies. The collaboration is aimed at ensuring that smaller states do not lose out to California, which because of its size has the ability to outbid others.California, the most populous state, with 40 million people, is attempting to band with smaller states to procure supplies. The collaboration is aimed at ensuring that smaller states do not lose out to California, which because of its size has the ability to outbid others.
“This has been described, I think appropriately, as the wild, wild West,” Gov. Gavin Newsom of California said on Sunday. “We are trying to organize in a more deliberative manner.”“This has been described, I think appropriately, as the wild, wild West,” Gov. Gavin Newsom of California said on Sunday. “We are trying to organize in a more deliberative manner.”
Adding to the disarray is the White House’s ad hoc system of disaster response in which the right call to Mr. Trump can result in one county getting priority over another. Advisers to Jared Kushner, the president’s son-in-law, have surprised FEMA officials in recent weeks to deploy supplies to communities after the area’s representatives got through to Mr. Trump, even if the state had not yet gone through the formal process to secure supplies.Adding to the disarray is the White House’s ad hoc system of disaster response in which the right call to Mr. Trump can result in one county getting priority over another. Advisers to Jared Kushner, the president’s son-in-law, have surprised FEMA officials in recent weeks to deploy supplies to communities after the area’s representatives got through to Mr. Trump, even if the state had not yet gone through the formal process to secure supplies.
For instance, after Mr. Trump heard from friends that the New York public health system was running low on critical supply, Mr. Kushner directed agency officials to ensure that there were enough N95 masks in the administration’s inventory, Mr. Kushner said at a White House briefing.For instance, after Mr. Trump heard from friends that the New York public health system was running low on critical supply, Mr. Kushner directed agency officials to ensure that there were enough N95 masks in the administration’s inventory, Mr. Kushner said at a White House briefing.
Now, Democratic governors are trying to balance how to put pressure on the Trump administration without entirely rupturing their relationship.Now, Democratic governors are trying to balance how to put pressure on the Trump administration without entirely rupturing their relationship.
“It would be like high school cafeteria drama if it weren’t life or death,” said Jared Leopold, a political consultant and the former communications director for the Democratic Governors Association.“It would be like high school cafeteria drama if it weren’t life or death,” said Jared Leopold, a political consultant and the former communications director for the Democratic Governors Association.
Updated June 12, 2020 Updated June 16, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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.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.
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.
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.)
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.
“He’s basically playing political games around life-or-death issues and leaving states to fend for themselves, which is unheard-of for a president to show zero federal leadership in the middle of a national crisis,” Mr. Leopold said.“He’s basically playing political games around life-or-death issues and leaving states to fend for themselves, which is unheard-of for a president to show zero federal leadership in the middle of a national crisis,” Mr. Leopold said.
Confusion still plagues some communities. After Somerset County, N.J., secured an order of 35,000 N95 and other surgical masks, the shipment was taken by the federal government, Shanel Y. Robinson, the county’s freeholder director, told The Franklin Reporter & Advocate.Confusion still plagues some communities. After Somerset County, N.J., secured an order of 35,000 N95 and other surgical masks, the shipment was taken by the federal government, Shanel Y. Robinson, the county’s freeholder director, told The Franklin Reporter & Advocate.
Garren Colvin, the head of the board for the Kentucky Hospital Association, wrote last week to members of Congress saying that four shipments of protective gear were taken by FEMA before they could be delivered to the hospitals that had originally contracted for the supplies.Garren Colvin, the head of the board for the Kentucky Hospital Association, wrote last week to members of Congress saying that four shipments of protective gear were taken by FEMA before they could be delivered to the hospitals that had originally contracted for the supplies.
Gov. Charlie Baker of Massachusetts said the state’s new position was “until the thing shows up here in the Commonwealth of Massachusetts, it doesn’t exist.”Gov. Charlie Baker of Massachusetts said the state’s new position was “until the thing shows up here in the Commonwealth of Massachusetts, it doesn’t exist.”
Private companies have also appeared to lose out on supplies. Dr. Ed Ellison, one of Kaiser Permanente’s top doctors and executives, told staff members last month that the company found 20 million masks to purchase the previous week and that Kaiser’s chief executive had authorized a payment for it that was more than usual because of rising mask prices.Private companies have also appeared to lose out on supplies. Dr. Ed Ellison, one of Kaiser Permanente’s top doctors and executives, told staff members last month that the company found 20 million masks to purchase the previous week and that Kaiser’s chief executive had authorized a payment for it that was more than usual because of rising mask prices.
“But the feds actually seized that shipment before we were able to acquire it,” Mr. Ellison told staff members, according to a recording of the call reviewed by The Times. “And that’s their right. They’re helping to put together for the nation, but just it goes to show you how challenging procurement can be.”“But the feds actually seized that shipment before we were able to acquire it,” Mr. Ellison told staff members, according to a recording of the call reviewed by The Times. “And that’s their right. They’re helping to put together for the nation, but just it goes to show you how challenging procurement can be.”
When asked by The Times days later about the call, a Kaiser spokesman said company officials were unable to find evidence that the government took Kaiser’s masks. The spokesman said the initial information came from a middleman.When asked by The Times days later about the call, a Kaiser spokesman said company officials were unable to find evidence that the government took Kaiser’s masks. The spokesman said the initial information came from a middleman.
Yet in an internal notice to some workers on Monday, Kaiser Permanente said that Cardinal Health, its main supplier of isolation gowns, notified the health system “that FEMA is intervening and taking the U.S. supply from the Cardinal China manufacturer. We will still receive a small resupply under a protected allocation. However, there are very few other sources for isolation gowns.” As a result, Kaiser told workers to conserve the gowns they had.Yet in an internal notice to some workers on Monday, Kaiser Permanente said that Cardinal Health, its main supplier of isolation gowns, notified the health system “that FEMA is intervening and taking the U.S. supply from the Cardinal China manufacturer. We will still receive a small resupply under a protected allocation. However, there are very few other sources for isolation gowns.” As a result, Kaiser told workers to conserve the gowns they had.
When asked about the complaints from some states and hospitals, Janet Montesi, a FEMA spokeswoman, said the agency’s flights were accelerating the arrival of gear to the United States and that its distribution strategy was designed to ensure that hard-hit areas could get needed supplies and not be gouged for them.When asked about the complaints from some states and hospitals, Janet Montesi, a FEMA spokeswoman, said the agency’s flights were accelerating the arrival of gear to the United States and that its distribution strategy was designed to ensure that hard-hit areas could get needed supplies and not be gouged for them.
She said some states that were complaining now could later become beneficiaries of the program if their areas are hit hard by the virus. Given the extreme demand and severe shortage of supplies, she said, “that’s just the reality of what we’re living in.”She said some states that were complaining now could later become beneficiaries of the program if their areas are hit hard by the virus. Given the extreme demand and severe shortage of supplies, she said, “that’s just the reality of what we’re living in.”
Zolan Kanno-Youngs reported from Washington and Jack Nicas from Oakland, Calif. Reporting was contributed by Tim Arango from Los Angeles, Ana Swanson from Washington, Maggie Haberman from New York and Jonathan Martin from Falls Church, Va.Zolan Kanno-Youngs reported from Washington and Jack Nicas from Oakland, Calif. Reporting was contributed by Tim Arango from Los Angeles, Ana Swanson from Washington, Maggie Haberman from New York and Jonathan Martin from Falls Church, Va.