WASHINGTON _ Public health officials are preparing to ration a limited supply of ventilators in the Strategic National Stockpile should hospitals be overwhelmed with COVID-19 patients, whose access to the machines could mean the difference between life and death from the respiratory disease.
The Trump administration's primary goal is to avoid the depletion of that stockpile by securing new emergency sources of medical ventilation machines. But members of the White House coronavirus task force are gearing up for a flood of requests from states that could begin experiencing shortages in a matter of weeks.
Without treatment for COVID-19, the disease caused by the coronavirus, ventilator machines _ which provide oxygen to those who cannot breathe on their own _ can be a key factor in keeping critically ill patients alive.
Two days of crisis meetings held at the Department of Health and Human Services with senior White House officials, including Vice President Mike Pence and senior White House adviser Jared Kushner, focused on speeding up the supply chain, as well as the production of other critical hospital equipment, two senior administration officials said.
Unlike the government's effort to stock up on respirator masks _ which are also in short supply, but can be mass produced by domestic manufacturers _ national demand for ventilators poses more complex challenges.
Companies face greater regulatory hurdles to produce the devices, and the machines are more complicated to produce. Several parts that go into the machines would themselves need to be produced in larger quantities, possibly delaying an increase in production by weeks or months.
The United States has more domestic ventilator manufacturers than some of the worst-affected countries in Europe, which, in recent days, have directed local companies to ramp up production dramatically. Allied Healthcare, Medtronic and GE Healthcare are among the largest U.S. manufacturers of ventilators.
The White House is examining other countries' efforts to deregulate manufacturing of the machines, including a call by the United Kingdom for engineering firms to begin producing ventilators for the first time in order to meet demand.
During a Monday conference call, President Donald Trump told state and local officials to prepare to acquire as much medical equipment as possible on their own as the federal government works to supplement their needs.
"Respirators, ventilators, all of the equipment _ try getting it yourselves," Trump said. "We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself."
A White House official told McClatchy that the call "wasn't an either-or" proposition to local governments.
"He said they should also get materials as well," the White House official said. "You should do this as well."
At a news briefing on Monday, Trump said the existing stockpile "may not be enough," but that the government was already putting in orders to increase its inventory.
"We have stockpiles now. We're ordering tremendous numbers of ventilators, respirators, masks, and they're ordered. And they're coming," Trump said. "But if they can get them directly, it's always going to be faster."
The Strategic National Stockpile _ the nation's last-resort cache of medicines, machinery and protective gear _ has only received one request for ventilators so far, according to Health and Human Services Secretary Alex Azar.
But officials with the stockpile are dusting off emergency preparedness plans for guidance on how to allocate sparse resources in the heat of a pandemic.
The stockpile, run by the Office of the Assistant Secretary for Preparedness and Response at HHS, has implemented a review process that will take into account a state's own stockpile of ventilators, hospitals identified as having established shortages, and its ability to distribute them to facilities with the staffing and bedding capacity to make use of the additional machines.
Stockpile officials said the exact number of ventilators in the cache is withheld from the public due to "national security concerns."
"Any pandemic like this runs the risk of exceeding our health care system capacity, and we must acknowledge that," Azar told reporters at the White House on Sunday.
"Obviously this is an unprecedented challenge _ unprecedented," Azar said. "And so we will work to increase the supplies of personal protective equipment, of ventilators, of field medical unit hospitals that we can deploy. We have tremendous supplies, but we want to acquire more."
Two members of the White House task force on the coronavirus pandemic _ Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, and Seema Verma, administrator of the Centers for Medicare and Medicaid Services _ revealed in recent days that the stockpile holds roughly 12,700 ventilators.
That falls far short of projected demand from hospitals across the country that are bracing for a flood of coronavirus patients in the coming weeks.
The Center for Health Security at Johns Hopkins University estimates the country has 160,000 ventilators available for use. Projections from the Centers for Disease Control and Prevention suggest that millions of Americans infected with COVID-19 could require intensive care.
At a news conference on Monday, New York Gov. Andrew Cuomo warned that cities and states around the world are scrambling for the same set of limited supplies _ not only the ventilators, but also oxygen sources, suction pumps and monitoring equipment needed to operate them.
"It is very, very hard to get medical equipment now, because everybody on the globe is trying to buy the same medical equipment," Cuomo said at a news conference. "Everybody wants to buy a ventilator, everybody wants to buy oxygen _ everybody is trying to buy the same equipment, and it is terribly scarce."
The governor made note of Washington's strategic stockpile of equipment, preserved for wartime scenarios or for rare pandemics that overwhelm the nation's hospitals.
"The wave is going to break on the hospital system," Cuomo said. "I don't believe we're going to be able to flatten the curve enough to meet the capacity of the health care system."
