Governors plead for medical equipment from federal stockpile plagued by shortages and confusion
By TOLUSE OLORUNNIPA, JOSH DAWSEY, CHELSEA JANES AND ISAAC STANLEY-BECKER | The Washington Post | Published: March 31, 2020
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As states across the country have pleaded for critical medical equipment from a key national stockpile, Florida promptly has received 100% of its first two requests — with President Trump and Republican Gov. Ron DeSantis both touting their close relationship.
States including Oklahoma and Kentucky have received more of some equipment than they requested, while others such as Illinois, Massachusetts and Maine have secured only a fraction of their requests.
It’s a disparity that has caused frustration and confusion in governors’ offices across the country, with some officials questioning whether politics is playing a role in the response.
Governors are making increasingly frantic requests to the Federal Emergency Management Agency for material. State and congressional leaders are flooding FEMA with letters and calls seeking clarity about how it is allocating suddenly in-demand resources such as masks, ventilators and medical gowns.
“Frustration level is high,” Wisconsin Gov. Tony Evers, a Democrat, said of the struggle to find ventilators for patients infected by the novel coronavirus. “We’re hoping we’ll be able to get them. The federal government needs to help us with that. There’s no question.”
Governors and state officials have become increasingly frustrated by what they describe as a byzantine and unsteady process for distributing medical supplies from the Strategic National Stockpile. As they try to combat a worsening pandemic, several have complained about chaos and disarray within the system and a lack of guidance about how they can secure lifesaving supplies, according to interviews and documents from officials in more than a dozen states.
Evers told FEMA on Friday that Wisconsin still needs 190,000 nonsurgical masks, adding that he thought some of the supplies were stuck in a bureaucratic queue. Oklahoma received 120,000 face shields despite only requesting 16,000, according to the state’s health department. North Carolina, by contrast, requested 500,000 medical coveralls and received 306, state records show.
There’s no direct evidence that Republican states are receiving more favorable treatment overall, and some GOP-led states such as Georgia have had trouble filling their requests. But Trump has contributed to the sense that politics could be a factor by publicly attacking Democratic governors who criticize his handling of the public health crisis.
Trump said last week that he is inclined not to speak with anyone who is insufficiently appreciative of his administration’s efforts. He has touted his personal relationships with several governors while also declaring that the federal government won’t be “a shipping clerk” for local officials who seek help in obtaining masks, ventilators and other critical supplies. States should buy the materials themselves, he said.
“All I want them to do — very simple — I want them to be appreciative,” Trump told reporters Friday. “I don’t want them to say things that aren’t true. I want them to be appreciative. We’ve done a great job. And I’m not talking about me. I’m talking about Mike Pence, the task force; I’m talking about FEMA, the Army Corps of Engineers.”
Aides to governors in some states say they are wary of angering the president or even making comments slightly critical of his administration, fearful that he will lash out at them as they seek help.
But the chaotic system has made it difficult for some governors to bite their tongues.
New York Gov. Andrew M. Cuomo, a Democrat, had harsh words for the process Tuesday, comparing lack of federal coordination to”being on eBay with 50 other states, bidding on a ventilator.”
New York has the nation’s worst outbreak, and Cuomo has said he needs 30,000 ventilators. In addition to providing only 4,400 from the stockpile, FEMA has been outbidding states on the private market, Cuomo said.
“What sense does this make?” he told reporters. “The federal government, FEMA, should have been the purchasing agent. Buy everything, and then allocate it by need to the states.”
Still, some Democrats have given the Trump administration plaudits for being accessible and for responding to their requests. Even after verbally attacking Democrats such as Michigan Gov. Gretchen Whitmer and Washington Gov. Jay Inslee, Trump has approved federal support for their states.
A senior Democratic gubernatorial aide involved in the response effort said White House and FEMA officials usually return calls promptly, and they always agree to consider requests.
The aide said officials in his state haven’t been threatened directly if they don’t praise Trump. And the president generally has been receptive to requests on the phone, he said.
“But we watch the news, we see what he says about people who criticize him,” said the aide, who, like some others, spoke on the condition of anonymity to discuss internal deliberations.
Trump touted his relationship with some Democratic governors during an interview with Fox News on Monday, saying it reflected his strong federal response.
“He’s a Democrat. I’m a Republican. I mean, I get along with many of them because I’m doing a good job,” he said. “They wouldn’t be getting along with me if I wasn’t producing.”
But privately, state and congressional officials have expressed alarm about a system beset by shortages, inefficiencies and disorder.
Some boxes of equipment have arrived in states unexpectedly. One shipment to Minnesota arrived in the middle of the night when the state’s warehouse to receive it was closed, said Deborah Radi, the state’s manager of public health emergency preparedness. Officials in North Carolina said they were scheduled to receive a shipment on Tuesday but did not know what it would contain.
Things have gone more smoothly in Florida, where Trump’s call for states to get their own equipment does not appear to have hurt DeSantis’ ability to access the federal stockpile.
Three days after requesting 430,000 surgical masks, 180,000 N95 respirators and other equipment on March 11, Florida received all of the items. The state received an additional shipment less than two weeks later. As of late last week, it was awaiting a third shipment.
Asked Sunday about Florida’s success with the stockpile, Trump hailed the state for being “very aggressive in trying to get things.”
Officials in Florida have pointed to the close relationship between DeSantis and Trump as a helpful tool in shaping federal policy. The two speak almost daily. Trump has formed an especially close relationship with DeSantis, a former congressman whose pugilistic defenses of the president helped him secure a race-changing endorsement in his 2018 bid for governor. Trump probably will need the 29 electoral votes of his adopted homestead to win reelection.
During a phone call on Saturday, DeSantis complained about people with the coronavirus who were traveling from New York to Florida. Minutes later, Trump publicly said he was considering a quarantine for New York, New Jersey and Connecticut. He ultimately decided against it.
One White House official said Trump is attuned to the electoral importance of Florida in November, giving added weight to the arguments DeSantis has made to the administration that his state’s economy should reopen as soon as possible.
“The president knows Florida is so important for his reelection, so when DeSantis says that, it means a lot,” said the official, who spoke on the condition of anonymity to be frank. “He pays close attention to what Florida wants.”
DeSantis’ office did not respond to requests for comment.
A FEMA spokeswoman, Lizzie Litzow, said requests by states are evaluated by federal task forces at the White House and FEMA. Officials weigh whether the needs are met best by the national stockpile, or whether materials procured from the private sector can fill the gap, she said.
An administration official with knowledge of the rationing process said political affiliation is not a consideration in processing requests, though Trump occasionally has made promises over the phone that FEMA has had to accommodate. Aides now brief him in advance of calls about each state’s needs, the official said.
States’ allocations are made based in part on their population, how many people they have in the hospital, existing state resources, the hospital utilization rate and overall risk levels, according to two administration officials, who spoke on the condition of anonymity to discuss the internal process. Modeling curves showing how much the virus might spread in a given state also are taken into account.
FEMA also looks at what is left in the stockpile and makes decisions based on how much remains — given the request.
“We try to pressure-test what they need because some of these governors are asking for a lot more than they really need,” the official said.
New Jersey Gov. Phil Murphy, a Democrat, said his request for about 2,300 ventilators was not “overasking.” The state has received 300.
“They have a limited supply of stuff, and our asks are significant,” he said in an interview. “Our asks are significant and we are persistent.”
Murphy said he had spoken to Trump several times, including on Friday and Saturday, and the administration had “war-gamed” how they were handling ventilators in a “frank, fact-based conversation.”
He said the federal government had been responsive in building emergency medical centers and setting up drive-through testing sites in New Jersey.
As states have been encouraged to pursue supplies on the open market, some have expressed concerns that they are being preempted because of federal competition.
“Our experience has been that other contracts we’ve entered into have been delayed or have been diverted to the federal government, as has been the case in Massachusetts and Illinois and Kentucky,” Whitmer said Monday.
She said she was talking to “everybody,” including the FEMA administrator and officials with the U.S. Army Corps of Engineers, as well as with Vice President Pence “a couple of times in the last few days.”
While Michigan has only received a fraction of what it has requested from the stockpile, Whitmer offered praise for the federal government — a different tack from the sharp criticism that spurred Trump to attack her publicly last week.
“We’re grateful for the work that they’re doing,” she said.
Candice Broce, a spokeswoman for Georgia Gov. Brian Kemp, a Republican, said, “The Trump administration has been an invaluable partner in Georgia’s fight to mitigate the effects of COVID-19.”
But figures from the state’s health department reveal a shortfall in equipment supplied by the federal government. As of Tuesday, the state had received one-quarter of the requested N95 masks, and just more than a third of requested ventilators.
Oklahoma had received nearly 84,000 N95 masks as of Sunday, more than twice its original request, according to the Oklahoma State Department of Health.
In Kentucky, state officials had received more than they asked for of certain materials after a second request for masks and gloves, according to materials provided as part of an open-records request. The state is still awaiting test kits, however.
Meanwhile, other states were short on critical resources, owing in part to spoiled materials.
A U.S. Conference of Mayors report released on Friday reported that 28 cases of masks shipped to Montgomery, Ala., had dry rot. The governor’s office in California said it received 170 broken ventilators from the national stockpile. A sustainable-energy company fixed the devices.
There also was confusion about the scope of certain shipments, and where in the federal system they were coming from. Pennsylvania received some shipments without packing lists, leaving officials there unsure about what they had been given, said Nate Wardle, a spokesman for the state’s health department.
A spokesman for Louisiana Gov. John Bel Edwards, a Democrat, said Sunday that the state had requested 5,100 ventilators from the federal government and had received none. On Monday, Edwards said Trump in a conference call promised him ventilators soon. Edwards said his state still needed protective gear but that the situation had improved.
Ohio applied for aid early, and the federal government obliged its request with shipments of personal protective equipment. Even with the aid, fewer than 30% of Ohio hospitals have an adequate supply of masks and shields, according to the state’s department of health.
“It’s important to note the supplies we received do not match the items nor the amount we requested,” agency spokeswoman Melanie Amato said.
The Washington Post’s Robert Costa, Amy Goldstein, Lena H. Sun and Beth Reinhard contributed to this report.