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Doctors and Governors Vie for Masks in Cloak-and-Dagger Deals Doctors and Governors Vie for Masks in Cloak-and-Dagger Deals
(3 days later)
It was a stealth transaction, arranged through “someone who knew someone who knew someone,” taking place at an undisclosed location in an unnamed mid-Atlantic state. The getaway vehicles were disguised as food service delivery trucks, and they mapped out separate routes back to Massachusetts to avoid detection.It was a stealth transaction, arranged through “someone who knew someone who knew someone,” taking place at an undisclosed location in an unnamed mid-Atlantic state. The getaway vehicles were disguised as food service delivery trucks, and they mapped out separate routes back to Massachusetts to avoid detection.
Those were the lengths that a hospital system in Springfield, Mass., went to this month to procure urgently needed masks for workers treating a growing number of patients with the coronavirus.Those were the lengths that a hospital system in Springfield, Mass., went to this month to procure urgently needed masks for workers treating a growing number of patients with the coronavirus.
“Some of this might seem over the top,” said Dr. Andrew W. Artenstein, the chief physician executive of Baystate Health, a four-hospital system in Springfield. “But with the entire Northeast in the throes of the early stages of a surge, our concern was that if we’re transporting scarce equipment, there would be some risk it might not make it back.”“Some of this might seem over the top,” said Dr. Andrew W. Artenstein, the chief physician executive of Baystate Health, a four-hospital system in Springfield. “But with the entire Northeast in the throes of the early stages of a surge, our concern was that if we’re transporting scarce equipment, there would be some risk it might not make it back.”
As state and federal officials consider how and when to allow public life to start up again, supplies like personal protective equipment for health care workers — seen as essential if coronavirus surges re-emerge — remain in dangerously short supply. An intense and chaotic scramble continues to unfold as hospitals, cities and states go out on their own to compete for masks and gowns, with uneven and shifting coordination by the federal government.As state and federal officials consider how and when to allow public life to start up again, supplies like personal protective equipment for health care workers — seen as essential if coronavirus surges re-emerge — remain in dangerously short supply. An intense and chaotic scramble continues to unfold as hospitals, cities and states go out on their own to compete for masks and gowns, with uneven and shifting coordination by the federal government.
In Maryland, Gov. Larry Hogan, a Republican, called on his wife to get favorable deals to obtain more testing kits, which he views as essential for reopening the state. His wife, Yumi Hogan, a Korean immigrant who speaks fluent Korean, was on the phone in the middle of the night recently, he said, helping to secure the final deal with two South Korean labs.In Maryland, Gov. Larry Hogan, a Republican, called on his wife to get favorable deals to obtain more testing kits, which he views as essential for reopening the state. His wife, Yumi Hogan, a Korean immigrant who speaks fluent Korean, was on the phone in the middle of the night recently, he said, helping to secure the final deal with two South Korean labs.
“I was frosted because my team was saying that the F.D.A. approval was going to hold it up,” Mr. Hogan said of a shipment that arrived Saturday.“I was frosted because my team was saying that the F.D.A. approval was going to hold it up,” Mr. Hogan said of a shipment that arrived Saturday.
In California, Gov. Gavin Newsom, a Democrat, who has expressed frustration about competing with other states, countries and even the federal government, this month announced a nearly $1 billion deal to buy hundreds of millions of masks from China.In California, Gov. Gavin Newsom, a Democrat, who has expressed frustration about competing with other states, countries and even the federal government, this month announced a nearly $1 billion deal to buy hundreds of millions of masks from China.
He has refused to provide details of the contract even to state lawmakers amid reports of deals getting upended at the last minute, either from countries offering higher prices or from federal agencies stepping in and seizing goods.He has refused to provide details of the contract even to state lawmakers amid reports of deals getting upended at the last minute, either from countries offering higher prices or from federal agencies stepping in and seizing goods.
In Los Angeles, a group of 18 city workers is sifting through offers of supplies that have flooded city phone lines and email accounts.In Los Angeles, a group of 18 city workers is sifting through offers of supplies that have flooded city phone lines and email accounts.
“It would have been nice if this was done nationally from the very beginning,” said Mayor Eric M. Garcetti, a Democrat.“It would have been nice if this was done nationally from the very beginning,” said Mayor Eric M. Garcetti, a Democrat.
In recent weeks, the city lost out on two deals it thought it had secured. In one case, it had reached an agreement to buy one million masks from one of its usual suppliers, and had even cut the check. At the last minute, the Federal Emergency Management Agency stepped in and bought the supplies, Mr. Garcetti said.In recent weeks, the city lost out on two deals it thought it had secured. In one case, it had reached an agreement to buy one million masks from one of its usual suppliers, and had even cut the check. At the last minute, the Federal Emergency Management Agency stepped in and bought the supplies, Mr. Garcetti said.
In another case, the city thought it had a deal to buy half a million masks that were sitting in a warehouse in Los Angeles. The next day, officials were told that a Russian entity had outbid them, and the supplies were suddenly on a flight out of the country.In another case, the city thought it had a deal to buy half a million masks that were sitting in a warehouse in Los Angeles. The next day, officials were told that a Russian entity had outbid them, and the supplies were suddenly on a flight out of the country.
Supplies of N95 respirator masks have increased in recent weeks, but many hospitals and health care workers say they are still working without adequate gear.Supplies of N95 respirator masks have increased in recent weeks, but many hospitals and health care workers say they are still working without adequate gear.
Dr. Megan L. Ranney, an emergency room doctor at Rhode Island Hospital, said hospitals in New England were running out of hand sanitizer, disposable thermometers, gowns and other vital equipment.Dr. Megan L. Ranney, an emergency room doctor at Rhode Island Hospital, said hospitals in New England were running out of hand sanitizer, disposable thermometers, gowns and other vital equipment.
“The supply chain is still unpredictable and unreliable in every way possible,” Dr. Ranney said. “The need for an organized, equitable distribution system is dire.”“The supply chain is still unpredictable and unreliable in every way possible,” Dr. Ranney said. “The need for an organized, equitable distribution system is dire.”
At Brookdale University Hospital and Medical Center in Brooklyn, private donations of respirator masks have helped offset the shortages, but doctors and nurses are still recycling single-use masks and gowns for up to a week.At Brookdale University Hospital and Medical Center in Brooklyn, private donations of respirator masks have helped offset the shortages, but doctors and nurses are still recycling single-use masks and gowns for up to a week.
The New York State Nurses Association on Monday filed a lawsuit against the New York State Department of Health and two hospital systems, asserting that a lack of protective gear was endangering the lives of front-line medical workers. Many intensive care unit nurses, the association said, have been forced to reuse N95 masks for up to five days.The New York State Nurses Association on Monday filed a lawsuit against the New York State Department of Health and two hospital systems, asserting that a lack of protective gear was endangering the lives of front-line medical workers. Many intensive care unit nurses, the association said, have been forced to reuse N95 masks for up to five days.
“You can’t send an army into battle without armor,” said Pat Kane, the association’s executive director.“You can’t send an army into battle without armor,” said Pat Kane, the association’s executive director.
Supply chain experts and health care providers have called on the federal government to provide stronger oversight for what they describe as a chaotic battle that pits governors, hospital chains and governments against one another. Volunteer efforts like Project N95 have vetted equipment manufactured in China, but counterfeit and defective gear continues to flood the market and price gouging remains pervasive.Supply chain experts and health care providers have called on the federal government to provide stronger oversight for what they describe as a chaotic battle that pits governors, hospital chains and governments against one another. Volunteer efforts like Project N95 have vetted equipment manufactured in China, but counterfeit and defective gear continues to flood the market and price gouging remains pervasive.
“Everyone seems to know a dude whose roommate in college has set up a factory in China, but you just don’t know who to trust,” said Thomas Tighe, the president of Direct Relief, a nonprofit organization that supplies protective gear to health care clinics in low-income neighborhoods. “It’s just too easy to fake these things.”“Everyone seems to know a dude whose roommate in college has set up a factory in China, but you just don’t know who to trust,” said Thomas Tighe, the president of Direct Relief, a nonprofit organization that supplies protective gear to health care clinics in low-income neighborhoods. “It’s just too easy to fake these things.”
As hospital administrators and governors have pleaded for more protective gear, the federal government’s national stockpile has dwindled.As hospital administrators and governors have pleaded for more protective gear, the federal government’s national stockpile has dwindled.
The Trump administration initiated a program, called Project Airbridge, that airlifts protective gear to the United States from overseas. Federal authorities have praised the program, saying it serves as a way to swiftly bring gear to communities that need it the most. Overseen by Jared Kushner, the president’s son-in-law and senior adviser, the administration flies equipment procured by the private sector in a matter of days. It redirects roughly half of each shipment to be sold to locations in the United States deemed to be in most urgent need, while the rest is sold to companies, hospitals and local governments that had already placed orders.The Trump administration initiated a program, called Project Airbridge, that airlifts protective gear to the United States from overseas. Federal authorities have praised the program, saying it serves as a way to swiftly bring gear to communities that need it the most. Overseen by Jared Kushner, the president’s son-in-law and senior adviser, the administration flies equipment procured by the private sector in a matter of days. It redirects roughly half of each shipment to be sold to locations in the United States deemed to be in most urgent need, while the rest is sold to companies, hospitals and local governments that had already placed orders.
But intervention by the federal government has also prompted complaints that FEMA is using opaque and inconsistent criteria to effectively redirect equipment to localities of its choosing.But intervention by the federal government has also prompted complaints that FEMA is using opaque and inconsistent criteria to effectively redirect equipment to localities of its choosing.
Dr. Howard Mell, a spokesman for the American College of Emergency Physicians, said medical workers were confused and angered by the reported seizures. “Where is this personal protective equipment going and how do we get it to the right people?” he asked. “We absolutely should be able to access this equipment if it’s being seized in the public’s name.”Dr. Howard Mell, a spokesman for the American College of Emergency Physicians, said medical workers were confused and angered by the reported seizures. “Where is this personal protective equipment going and how do we get it to the right people?” he asked. “We absolutely should be able to access this equipment if it’s being seized in the public’s name.”
Part of the problem is that while large, established medical supply manufacturers and distributors have ramped up production, they have more orders than they can handle — forcing government officials to turn to newcomers to the business. Some are legitimate, others are not.Part of the problem is that while large, established medical supply manufacturers and distributors have ramped up production, they have more orders than they can handle — forcing government officials to turn to newcomers to the business. Some are legitimate, others are not.
Jesse Greenberg, a spokesman for Medline, the largest privately held medical distributor and manufacturer in the United States and the prime vendor for 40 percent of the nation’s hospitals, said it had seen demand surge by 300 percent. Everyone from hospitals to governors were clamoring to buy equipment, he said, some even offering premiums in an effort to outbid competitors.Jesse Greenberg, a spokesman for Medline, the largest privately held medical distributor and manufacturer in the United States and the prime vendor for 40 percent of the nation’s hospitals, said it had seen demand surge by 300 percent. Everyone from hospitals to governors were clamoring to buy equipment, he said, some even offering premiums in an effort to outbid competitors.
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.
Early on, he said, the company made a decision: It would not take on any new customers, and would instead focus on meeting the needs of its existing customers. No hospital can outbid another, he said; as additional coronavirus-related supplies become available, they are doled out according to an allocation formula based on pre-pandemic ordering history.Early on, he said, the company made a decision: It would not take on any new customers, and would instead focus on meeting the needs of its existing customers. No hospital can outbid another, he said; as additional coronavirus-related supplies become available, they are doled out according to an allocation formula based on pre-pandemic ordering history.
“We didn’t want to be picking and choosing who we were going to supply and who was going to be shortchanged,” Mr. Greenberg said.“We didn’t want to be picking and choosing who we were going to supply and who was going to be shortchanged,” Mr. Greenberg said.
At Hillrom, a $2.9 billion company that sells everything from I.C.U. beds to ventilators and vital signs equipment, company officials took a different tack. A top-level committee of executives was formed to determine where its equipment was needed most — and priority was given to meeting orders from hot spots in the United States, Europe and elsewhere.At Hillrom, a $2.9 billion company that sells everything from I.C.U. beds to ventilators and vital signs equipment, company officials took a different tack. A top-level committee of executives was formed to determine where its equipment was needed most — and priority was given to meeting orders from hot spots in the United States, Europe and elsewhere.
“Typically we don’t triage supplies — it’s first come, first served,” said Howard Karesh, a company spokesman, adding, “This is a completely different way of operating.”“Typically we don’t triage supplies — it’s first come, first served,” said Howard Karesh, a company spokesman, adding, “This is a completely different way of operating.”
Medical officials like Dr. Artenstein, who wrote of his travails in The New England Journal of Medicine, say there is little choice but to resort to cloak-and-dagger techniques.Medical officials like Dr. Artenstein, who wrote of his travails in The New England Journal of Medicine, say there is little choice but to resort to cloak-and-dagger techniques.
The situation in Massachusetts has worsened quickly. The state’s death toll more than doubled in the seven-day period ending Sunday, eclipsing 1,700, and cases rose by more than 12,000, to 38,077, in that same period.The situation in Massachusetts has worsened quickly. The state’s death toll more than doubled in the seven-day period ending Sunday, eclipsing 1,700, and cases rose by more than 12,000, to 38,077, in that same period.
“When I saw the pallets of supplies, and we tested the masks, I was pretty happy that this could work out,” said Dr. Artenstein, who drove several hours to execute the deal. He said he would not disclose the name of his vendor or its location because he did not want to jeopardize his ability to work with the vendor again.“When I saw the pallets of supplies, and we tested the masks, I was pretty happy that this could work out,” said Dr. Artenstein, who drove several hours to execute the deal. He said he would not disclose the name of his vendor or its location because he did not want to jeopardize his ability to work with the vendor again.
Just when he thought he had wrapped up his deal, Dr. Artenstein said, the F.B.I. appeared, checking the shipment of one million masks and seeking to verify Dr. Artenstein’s credentials.Just when he thought he had wrapped up his deal, Dr. Artenstein said, the F.B.I. appeared, checking the shipment of one million masks and seeking to verify Dr. Artenstein’s credentials.
In retrospect, he said, he was glad that F.B.I. agents were there, apparently to ensure that the masks were not going to the black market. But then other federal agencies soon got involved, leading to more than 10 hours of delays, he said. The process ended only after the intervention of the Springfield area congressman, Representative Richard E. Neal, a Democrat and chairman of the House Ways and Means Committee.In retrospect, he said, he was glad that F.B.I. agents were there, apparently to ensure that the masks were not going to the black market. But then other federal agencies soon got involved, leading to more than 10 hours of delays, he said. The process ended only after the intervention of the Springfield area congressman, Representative Richard E. Neal, a Democrat and chairman of the House Ways and Means Committee.
A FEMA official declined to comment on the specific case that Dr. Artenstein described. The F.B.I., citing a policy of not confirming or denying specific investigations, declined to comment on the incident but said it had been working to ensure that personal protective equipment “is not being unlawfully distributed or hoarded” during the coronavirus outbreak.A FEMA official declined to comment on the specific case that Dr. Artenstein described. The F.B.I., citing a policy of not confirming or denying specific investigations, declined to comment on the incident but said it had been working to ensure that personal protective equipment “is not being unlawfully distributed or hoarded” during the coronavirus outbreak.
An official from FEMA said that there have been cases where the federal government has redirected supplies away from communities — even those with growing outbreaks — because it must weigh other variables, including how much equipment a state already has in storage.An official from FEMA said that there have been cases where the federal government has redirected supplies away from communities — even those with growing outbreaks — because it must weigh other variables, including how much equipment a state already has in storage.
Dr. Artenstein said he came away believing that the nation was in desperate need of a central clearing house for these supplies.Dr. Artenstein said he came away believing that the nation was in desperate need of a central clearing house for these supplies.
He was forced to go his own way, he said, because what exists now is a zero-sum game, “and the cavalry does not appear to be coming.”He was forced to go his own way, he said, because what exists now is a zero-sum game, “and the cavalry does not appear to be coming.”
Jennifer Steinhauer, Zolan Kanno-Youngs and Mitch Smith contributed reporting.Jennifer Steinhauer, Zolan Kanno-Youngs and Mitch Smith contributed reporting.