At the same time, the Biden administration is struggling to keep its commitments to other countries to provide supplies to fight the virus, including oxygen for the sickest patients. The United States has only been able to meet a fraction of the demands it has received for the gas and materials needed to administer it, recently shipping 1,500 oxygen cylinders and other components to India and 1,000 cylinders to Nepal. Nepal initially requested nearly 20,000 bottles, said a senior US official familiar with the matter.
The struggle to secure vital medical supplies underscores how unprepared the United States is for a new wave of Covid-19 infections. It also highlights the difficulties faced by the Biden administration, as well as governments and healthcare providers around the world, in meeting demand for key medical products in the second year of the pandemic – amid the spread of the highly transmissible Delta variant.
“Because we didn’t have the type of centralized intelligence to identify, test and execute rapid containment, the United States missed our opportunity to contain the virus. It was very difficult to quantify what health systems needed to do to prepare, ”said Charity Dean, former deputy director of the California Department of Public Health. “Without a technological revolution… the United States will not be prepared for another pandemic. At present, the system cannot evolve as fast as the pathogen does. “
A spokesperson for the Department of Health and Human Services said that “the SNS strives to balance its storage needs with the ongoing needs of health facilities.” The Federal Emergency Management Agency is also helping the HHS build up the US stockpile.
Two senior officials working on the federal government‘s storage efforts said part of the reason the United States had not reached its stockpile targets for items such as gloves are due to the fact that the number of Covid-19 cases has dropped significantly and hospitals, public health officials and other health care providers are not submitting claims for ‘help. But the stock is designed to help the nation prepare for unpredictable emergencies, and the government, which sets inventory targets, has not lowered them in the face of weakening demand.
The stampede obtain medical supplies in the face of a generalized health situation The emergency sparked conversations on Capitol Hill about how to better fund and organize the federal stock.
U.S. Representative Brad Schneider (D-Ill.) And David McKinley (RW.Va.) introduced a bill in February that seeks to address shortages of personal protective equipment and testing kits. Earlier this month, Senator Bill Cassidy (R-La.), Senator Maggie Hassan (DN.H.) and Representative Elissa Slotkin (D-Mich.) Introduced legislation to reduce dependency with respect to foreign materials and stimulate the domestic market. manufacture of medical supplies.
“The medical supply chain is a very complex global system of which the national strategic stock is only a very small part,” said Tara O’Toole, a former head of homeland security in the Obama administration. “The stock cannot in a real universe keep enough things on hand to meet the country’s needs for all risks.”
The federal government created the stockpile, originally the National Pharmaceutical Stockpile, in 1999 to address potential biological, disease, and chemical threats to civilian populations. It was finally renamed the Strategic National Reserve in 2003, and the Department of Defense was tasked with managing it alongside the HHS. The stockpile was designed as a stopgap that would allow the federal government to increase supplies to specific areas facing disasters or threats, complementing local procurement efforts. It was not meant to be the only source for private and public institutions to obtain medical supplies in emergency situations.
Hospitals, public health departments and other health facilities are expected to maintain their own stocks of masks, gowns, drugs and ventilators. But during the first months of the Covid-19 pandemic in 2020, they ran out of these basic supplies. The overwhelming number of patients with Covid-19 has forced private and public institutions to search for personal protective equipment and therapeutic products on the open market.
“The supply chain conversations – I had them in January, but we were flying blind,” Dean said. “The preparations that we should have made in January and February were only made in early or mid-March. At this point, the United States was behind in accessing critical supply chains. “
The federal government has activated the stockpile to help fill state gaps in Covid-19 medical supplies and equipment. But the supply was not enough to meet the high demand, and federal officials ran into hurdles in getting more materials on the open market quickly. There weren’t enough masks, gowns, ventilators and medicine for everyone. Companies that made things like N95 gowns and masks lacked the manufacturing capacity to quickly produce the amount of product needed.
A year and a half after the start of the pandemic, the United States still does not have a good way to quickly increase the production of drugs and medical supplies needed to help supplement the strategic national stockpile, in part because manufacturers operate on a just-in-time basis. These standards are supposed to minimize inventory and maximize efficiency, but struggle to accommodate fluctuations in demand.
“Everyone – shippers, hospitals, drugstore chains – no one wants to hold inventory. Who is going to pay for these expensive drugs that sit there month after month? O’Toole said. “This is why hospital stocks have declined.”
The federal government is beginning to work with the private sector to ensure that manufacturers have the capacity to rapidly increase production during large-scale outbreaks.
The Biomedical Advanced Research and Development Authority (BARDA) is job with its parent company, HHS, to find companies willing to change their standard manufacturing practices to increase production of therapeutics and other medical supplies to better prepare for the next pandemic. But increasing US manufacturing capacity isn’t easy, former Trump administration says manager who worked with BARDA told POLITICO. It will take years to build facilities, manufacturing lines and hire staff to oversee production, the former official said.
Given that 57% of U.S. adults are fully vaccinated, and rates of Covid-19 cases have declined significantly in recent months, the federal government estimates that it currently has sufficient supply in the national strategic stockpile to address the small requests from States and to manage a moderate increase in cases due. to the Delta variant. But, officials said, if another nationwide increase occurs, the stock will only be able to supplement state supplies, not completely fill caches.
But the Biden administration is also trying to help countries around the world struggling with acute spikes in Covid-19 cases and deaths, and it is struggling to secure and ship supplies overseas. Beyond calls for vaccines, the administration has received urgent requests for oxygen and oxygen components such as cylinders from countries in Africa, the Middle East and Asia.
The United States committed about $ 18 million in November 2020 to boost the supply of medical oxygen to 11 countries. But the oxygen concentrators – machines that filter oxygen from the air – purchased with this funding have only been delivered to Honduras, Guatemala and Haiti. Starting this month, the US Agency for International Development provided emergency medical supplies with oxygen to Nepal, Bangladesh, India, Maldives, Pakistan and Sri Lanka. Dozens of other countries are asking for the same help from the United States
“Under normal circumstances, even before the pandemic, access to oxygen was a challenge… for many countries at the time. There just hasn’t been enough attention and investment on the issue, ”said Robert Matiru, director of Unitaid, a health initiative that works with the World Health Organization. “Many health systems in several countries have been challenged not by lack of core capacity, but by the fact that surge capacity has simply exceeded them. The oxygen demand is almost double, triple, quadruple of what is normally required. “