A rare look inside the Strategic National Stockpile – and how it went wrong at the start of the pandemic

Corresponding an estimatewould have required the US up to 3.5 billion N95 to adequately protect medical workers and first responders.

Burel blamed a lack of funding for the lack of preparation — federal officials received about $700 million of the $1 billion they requested from Congress. With that money, he said, the stockpile “would have been in a better place to at least be able to respond to SARS-CoV-2 with personal protective equipment.”

“Everyone thought so [the stockpile] should be opening its doors at this moment and handing out PPE to everyone. That was not foreseen at the time.”

Dawn by Connell

It’s uncertain whether additional funding would have made a difference, experts say.

Supplies such as personal protective equipment were generally not part of the stock inventory. The masks purchased in 2009 were not part of the normal inventory budget; Instead, they were purchased with additional funds set aside to help fight the H1N1 swine flu pandemic.

“Everyone thought so [the stockpile] should be opening its doors right now and distributing PPE to everyone,” O’Connell said of the start of the pandemic. “That was not planned at the time.”

A focus on what the market couldn’t offer

Steven Adams, who now runs the stockpile, said officials thought the market could supply the country with masks if needed.

Steve Adams, director of the Strategic National Stockpile, in Lower Manhattan after 9/11. Adams has worked for the Halde for more than 20 years.
Steven Adams, Strategic National Stockpile Director, left, in Lower Manhattan after the September 11, 2001 terrorist attacks. Adams worked for the Stockpile for more than 20 years before assuming leadership in 2021.Courtesy of Strategic National Stockpile

“For many years it was thought that the commercial market would be able to offer things like N95s,” he said. Nobody expected global demand for “the same things at the same time”.

Instead, those responsible for the stockpile had focused on the acquisition and storage of medical supplies for which there were no alternatives and which the market could not provide.

“Investments for the stockpile were prioritized around unique items like smallpox and anthrax vaccines that would not exist in a commercial market unless the U.S. government bought them,” Adams said.

The “billions of dollars” worth of stocks in the camps are essentially useless in the Covid response, said Andrew Lakoff, a global health and national security expert at the University of Southern California.

“The vast majority of them have not done us any good in dealing with the coronavirus,” he said. “They specifically focused on a number of fairly obscure and frankly unlikely diseases like a smallpox attack or an anthrax attack. What we really needed was enough PPE and enough ventilators and stuff like that.”

Who stores the stock?

Deciding what specifically to stockpiles falls to a highly bureaucratic and secretive group of government health officials known as the Public Health Emergency Medical Countermeasures Enterprise. or PHEMCE.

The group’s task sounds simple enough: identify potential threats and what medical supplies are needed to counter those threats.

PHEMCE includes nine agencies, including the Centers for Disease Control and Prevention, the Biomedical Advanced Research and Development Authority, and the Department of Defense.

But a number of key stakeholders were kept out of the action, including domestic manufacturers and healthcare workers, a critical mistake This severely hampered how it could prepare for and respond to threats, according to a National Academies of Science, Engineering and Medicine report published in 2021. The report was commissioned by O’Connell last summer to understand where the PHEMCE was faltering and how it might improve going forward.

An archive image shows emergency medical supplies being provided from the Strategic National Stockpile.
An archive image shows workers moving containers of emergency medical supplies during a drill.Courtesy of Strategic National Stockpile

The most obvious mistake early in the pandemic — the shortage of masks — could have been avoided with better coordination between the government and domestic manufacturers, Lakoff said.

To remedy this, the National Academies report recommended involving domestic manufacturers in the process of deciding what to stockpile.

How can warehousing be improved?

The lack of communication between PHEMCE and healthcare workers was exposed in the early months of the pandemic as New York City hospitals, overwhelmed with critically ill Covid patients, scramble to find ventilators for life support.

The warehouse was able to supply ventilators, but when they arrived, hospitals didn’t know what to do with them — they weren’t the models health workers had long been trained to use, said Gigi Gronvall, an immunologist and researcher at the Johns Hopkins Center for Health Security and co-chair of the National Academies committee that produced the report.

“After all, when the stock is used, it’s not going to be used by the people who manage the stock, it’s used by healthcare providers and public health individuals,” she said.

https://www.nbcnews.com/health/health-news/rare-look-strategic-national-stockpile-went-wrong-start-pandemic-rcna32603 A rare look inside the Strategic National Stockpile – and how it went wrong at the start of the pandemic

Fry Electronics Team

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