This picture is a refrigerated morgue outside of one of NYC’s large hospitals. There are also military staffed mobile medical units set up in Central Park to handle the overflow of patients. Doctors and nurses are being forced to ration and reuse medical equipment, or come up with homemade alternatives to prevent infection.
If health care workers fall ill, more patients are going to suffer and die – and not just from Covid-19, but any issue from heart attacks to car crashes. It has already been reported that some hospitals are even considering do-not-resuscitate orders for dying Covid-19 patients out of fear that such intensive, close-up procedures could get even more health care workers without PPE infected with the coronavirus.
This post asks, why is the world’s biggest economy airlifting medical supplies FROM China and scrambling to find lifesaving equipment when every serious look at US pandemic readiness and global pandemic readiness has identified PPE shortages as a major issue.
Masks: Surgical masks cost 75 cents. In the past, the United States made its own surgical masks. About fifteen years ago, as costs rose, 95% of the manufacturing was sent offshore, primarily to China, where the cost of labor and materials was less expensive. China now makes 50% of the world’s face masks, and currently claims most factory output for their own needs. Today, there aren’t enough domestic manufacturers for critical supplies as America needs 25 times more masks than it has stockpiled in the national emergency stockpile.
In addition to the surgical mask shortage, N95 masks in the stockpile are insufficient and many are expired. Much of the mask stockpile was used in 2009 for the H1N1 pandemic and was never replenished. Additionally, healthy individuals are panic-buying face masks, rather than saving them for medical professionals.
The Trump administration just agreed to airlift 22 cargo planes of medical supplies from China in the coming days, and thousands of individuals have stepped up to sew masks for their local hospitals and healthcare professionals.
Hospital Beds: The US has lost almost 50% of its beds since 1975. Shorter stays, more outpatient surgeries, and better medical care play a part in the decline of beds, but it is due primarily to The National Health Planning and Resources Development Act of 1974. This Act was an effort by the Nixon/Ford administration to reign in escalating Medicare/Medicaid healthcare costs because hospitals are businesses. Empty beds are not profitable, so hospitals kept them full.
The goal was to reduce and avoid unnecessary duplication of healthcare facilities and services; it sought to do so by essentially requiring state permission to build beds. But planning agencies were handicapped in developing and completing state health systems plans because of the unavailability of health data and national standards and criteria for the health care system, inability to recruit staff, conflicts between local and state planning agencies over respective responsibilities, and delays in receiving technical assistance.
New hospitals were not built to replace those that were shut down and existing hospitals did not add more beds.
Ventilators: In 2008, the US Government budgeted money and signed a federal contract with Newport Medical Instruments, a small company in California to make a low-cost, portable, easy to use ventilator to stockpile for emergencies. In 2011, Newport shipped three working prototypes for FDA approval. In 2012, the program was determined to be on schedule to file for market approval by the end of 2013 (yes, that’s five years later).
In May 2012, Newport Medical was purchased by Covidien, a large medical device supplier who manufactures its own, higher priced, models. Covidien demanded more money and a higher selling price. In 2014, the government cancelled the contract with not a single ventilator ever made for the US, but Covidien is shipping their higher priced ventilators around the world.
That same year the government started over with the Dutch owned company Philips, and their low cost prototype was cleared by the FDA in July 2019 (yes, another five years). HHS ordered 10,000 ventilators in December 2019, with a delivery date for mid-2020.
Last week the Defense Production Act was invoked to compel General Motors to retool and make ventilators – something they have said they cannot start until June. Meanwhile, Philips said they have no plans to begin production this year and is, instead, negotiating with Jared Kushner to build 43,000 of their more complex and expensive ventilators for Americans.
There are shocking similarities between the 1918 Spanish flu and the Covid-19 pandemics. Not the least is for the people on the front lines.
