Ordering pricey ventilators raises dilemma for hospitals
Hospitals are holding back from ordering more medical ventilators because of the high cost for what may be only a short-term spike in demand from the coronavirus epidemic, supply chain experts and health researchers say.
The lack of ventilators — and growing calls for a more aggressive government role to fill the gap — was a subject of exchanges this week between President Donald Trump and state officials. The issue also revealed a disconnect between different parts of the health care industry, with the main hospital association disputing the accounts about the adequacy of supply of the lifesaving equipment.
Mechanical ventilators, which help patients breathe or breathe for them, are considered critical to the nation’s effort to contain the worst effects of the pandemic and avoid a crisis like the one Italy is facing. Depending on how bad the coronavirus pandemic gets in the United States, individual cities could come up thousands of ventilators short as patients flood hospitals, researchers say.
“It’s a challenge for states, local governments and hospital administrators to allocate tens of millions of dollars to something when they don’t know if they need it or not,” said Chris Kiple, chief executive of Ventec Life Systems, a small ventilator manufacturer in Washington state. “But if they don’t do it, they are going to be caught flat-footed, and facilities are going to be faced with not enough ventilators to meet demand.”
Ventilator manufacturers could achieve, within a few months, a significant boost in production from about 50,000 units a year currently, said Julie Letwat, a health are lawyer with McGuireWoods in Chicago who is monitoring the industry. Orders have not flooded in, she said, because most hospitals can’t afford to increase inventory of expensive equipment for what could turn out to be a short-term event.
Governors and local health authorities worry about an insufficient supply of ventilators and have been calling on the Trump administration to move aggressively to solve the problem. The president indicated Wednesday that he has a plan to boost ventilator supplies but did not provide specifics. “We are ordering thousands and thousands of ventilators and they are complex,” Trump said at a White House briefing.
The Trump administration has begun to release up to 13,000 older ventilator models cached around the country in the federal Strategic National
Stockpile, saying state officials have not requested them. On Tuesday, the Defense Department said it will contribute an additional 2,000 ventilators to the effort.
Meanwhile, the government is rushing protective equipment to states, packing dozens of flights and hundreds of trucks with supplies for medical workers.
But the cache isn’t designed to be a long-term solution to monumental demand, and some state officials are complaining that the deliveries are falling far short of what’s needed or include expired items.
The Strategic National Stockpile was created in 1999 to respond to bombings and biological, chemical and nuclear attacks. It maintains caches of pharmaceuticals, medical supplies and vaccines in secret locations around the nation.
It has never confronted anything on the scale of the covid-19 pandemic.
When the virus first hit the U.S., federal officials did focus on a hot spot, the Seattle area.
The country’s first coronavirus death occurred there on Feb. 29. That same day, Washington Gov. Jay Inslee requested almost one-quarter million N95 respirator masks, which fit tightly to the face, and 200,000 surgical masks. The governor also asked for 5,000 eye protectors, 60,000 disposable gowns and 70,000 pairs of gloves.
Six days later, the shipment came in.
“They met our entire request,” said Mike Faulk, a spokesman for the Democratic governor.
A second order resulted in the delivery of more N95 respirators and other equipment, Faulk said.
But since then, Washington state has received only about 25% of requests, according to
Jessica Baggett of the state’s joint information center.
Other states haven’t gotten what they wanted.
One other problem is expired equipment.
The Centers for Disease Control and Prevention said Feb. 28 that some items in the U.S. stockpiles have exceeded their manufacturer-designated shelf life. They are still being sent to hospitals “due to the potential urgent demand caused by the covid-19 public health emergency,” the CDC said.
The Department of Health and Human Services is trying to encourage production, saying it intends to buy 500 million N95 masks. Information for this article was contributed by Christopher Rowland and Erin Cox of The Washington Post; and by Andrew Selsky, Michelle R. Smith, Adam Beam, Michael Catalini, Holly Ramer, Martha Bellisle and Andrew Welsh-Huggins of The Associated Press.