States still need federal help and still find it lacking

Officials in Michigan are running 10,000 fewer coronavirus tests per day than they have the capacity for because they can’t get enough swabs.

Washington state’s attempts to order personal protective equipment are mostly going unfilled amid global competition.

In Ohio, doctors are unsure whether federal shipments of remdesivir — a drug that can help shorten the duration of coronavirus symptoms — will continue past June.

As states try to take the lead on the coronavirus response, many are still turning to the federal government to help shore up critical supply shortages, only to find the federal response hit-or-miss. The White House has dropped its daily briefings with health experts and announced no new initiatives to ramp up supply production, even as top administration officials acknowledge the shortfalls persist.

The haphazard federal response has not only left states wondering whether critical medical supplies will be available month-to-month, but it has also increased anxieties that the US could be once again caught flat-footed if the virus resurges in the fall.

“We have, as a nation, I think been behind the eight ball from the beginning,” Michigan Gov. Gretchen Whitmer told CNN in an interview. “Testing, testing, testing is crucial and this supply chain issue remains a major problem.”

In Michigan, the state is struggling to hit its goal of running 25,000 coronavirus tests per day. The labs have the capacity to do so, but the state only has enough swabs to run about 15,000 tests per day, the Democratic governor said.

The federal government has responded to many of the state’s requests, but the deliveries often include different types of swabs than were requested — which can throw a wrench in the state’s testing strategy — and the timing of deliveries is often erratic.

“I know that the DPA (Defense Production Act) has been used, but we really need to use it, I think, more aggressively when it comes to PPE and additional production of swabs and reagents,” Whitmer said. “All of these are critical components to our ability to keep Covid-19 from growing exponentially again.”

A ‘complete lack of guidance’

While Vice President Mike Pence and some members of the coronavirus task force continue to hold calls with governors on the response, multiple state officials from both parties described it as increasingly useless, with some governors now skipping the calls.

Governors and staffers were shocked earlier this month when a conference call slated as a coronavirus check-in with President Donald Trump quickly devolved into a lengthy tirade from the President on how many of the governors were weak and needed to “dominate” and take back the streets during protests across the country over the killing of George Floyd.

This week, Pence — the head of the coronavirus task force — has insisted that increased testing is contributing to the appearance of new coronavirus spikes and has claimed the media is overblowing the problem. In fact, more testing helps identify and contain outbreaks. And it doesn’t account for the recent uptick in some states, according to health experts.

“It’s frustrating that the administration is not even acknowledging the increase in cases,” said Casey Katims, the director of federal and inter-state affairs for Washington Democratic Gov. Jay Inslee.

He described a “complete lack of guidance” on how states should be responding and added that public health experts don’t support the White House narrative that recent spikes are due to increased testing.

“Epidemiologists and public health experts reject that narrative,” Katims said. “It’s fair to say we are highly concerned.”

The spikes in some states are also coinciding with efforts to reopen economies across the country. The combination has added more demand for personal protective gear while underscoring the need for widespread testing.

On critical supply issues, governors have worked to bolster their own state stockpiles, partner with local manufacturers to shift production to medical supplies and form coalitions to purchase supplies as groups of states rather than individually. But even with those efforts, some state officials said they’re still not getting what they need.

Last week, Inslee sent a letter to Pence imploring the administration to use the Defense Production Act to ramp up PPE production. He noted the state has tried to independently order $400 million worth of protective gear but has received less than 10% of those supplies as states compete against one another, the federal government and foreign nations in the global scramble for PPE.

Rear Adm. John Polowczyk — who leads the administration’s supply chain task force — acknowledged in congressional testimony this month that the government has made strides to increase the production of N95 masks but is still working to stock up on supplies like gowns and gloves

“We’ve turned to our textile industry to make textile gowns, non-disposable gowns and so those are, you know, that’s 50% there but on a ramp to be there by the fall,” Polowczyk.

Some health officials — burned by the administration’s sluggish response at the outset of the pandemic — aren’t buying the promises of preparedness.

“We’re kidding ourselves if we don’t think we’re going to have a massive second wave of infections,” said Megan Ranney, an emergency room doctor who helped found the group GetUsPPE to facilitate donations to health care systems. “One of the things that really worries me is I don’t see anyone planning for the next phase.”

Doctors are still conserving and reusing protective equipment and GetUsPPE receives tens of thousands of requests each week from health care systems with less than a week of PPE on hand, Ranney said.

Doctors are also struggling with access to drugs that can help treat coronavirus patients. The federal government took the lead on distributing remdesivir, but doctors found it difficult to get clarity on who would get shipments and when supplies would be replenished.

“When that all runs out, the real question is when will we have it available in the future?” said Dr. Thomas File, who practices medicine in Akron, Ohio, and is the president of the Infectious Diseases Society of America. “It’s almost like right now, when we see patients and we want to use it, if I use it on a patient now does that mean we’ll have limited supplies when a patient comes in four to six weeks from now?”

Earlier this month, Dr. Robert Kadlec, a US Department of Health and Human Services official, told CNN that the remdesivir supply would run out at the end of June.

Reluctant Republicans

For the most part, Republican governors — eager to stay on the President’s good side and preserve reputations as fiscal conservatives — have been less outspoken about the coronavirus challenges they continue to face. Some have downplayed spikes in their states and moved forward with reopening plans in spite of case increases.

Mississippi Gov. Tate Reeves, a Republican, praised federal officials for their regular contact with governors in a recent press conference and made a veiled request for federal assistance commensurate with other emergency responses.

“As I look to the future in terms of the federal government’s role, I just want to make sure that the federal government continues to maintain their posture,” Reeves said. “Natural disasters have to be managed in the same way, and that is state managed, locally executed and federally supported.”

Democrat governors have been most blunt about the situation.

“Provide COVID money to the state government and local government so that we can function and not go bankrupt,” New York Gov. Andrew Cuomo told CNN’s Mark Morales. “All the studies, all the economists will tell you, you don’t get the economy back if you don’t fund state and local governments.”

Meanwhile, the National Governors Association has made it clear that governors from both sides of the aisle are at least privately pressing for additional assistance. High on its lists of asks for Congress is an assistance package that includes $500 billion in direct federal aid to states and territories to plug budget gaps.

In Arlington, Texas, the city is furloughing employees, dipping into cash reserves and reducing services across the board to make up for the budget strain from coronavirus.

“Without a doubt, the revenue loss that is being experienced by most cities is the direct result of the coronavirus,” said Jeff Williams, the city’s GOP mayor. “Cities are a major part of it. They can’t be left out.”