Strategic National Stockpile
The Strategic National Stockpile was intended to be America’s fallback plan. Through April 1st (the Administration changed the wording on April 2nd), the stockpile was defined as
“…the nation’s largest supply of life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out. When state, local, tribal, and territorial responders request federal assistance to support their response efforts, the stockpile ensures that the right medicines and supplies get to those who need them most during an emergency. Organized for scalable response to a variety of public health threats, the repository contains enough supplies to respond to multiple large-scale emergencies simultaneously.”
The stockpile was initially launched in 1999 and managed by the Department of Health and Human Services (HHS) Centers for Disease Control and Prevention. In 2018, responsibility for the stockpile shifted to the HHS assistant secretary for preparedness and response (ASPR). In March, responsibility for the stockpile shifted again, this time to FEMA.
In the face of the coronavirus pandemic, the stockpile did not offer much resilience. Government officials estimated that the US would require 3.5 billion N95 respirator masks for a severe outbreak. There were only 12 million unexpired N95 respirator masks in the stockpile in February. In early March, the stockpile contained only 16,600 ventilators, and on April 3rd, the federal government had just 9,800 ventilators available. It is unlikely that the stockpile is being replenished since PPE that becomes available is generally immediately put to use in COVID-19 hot spots or delivered to medical centers, and it is difficult to gain insight into the current inventory of the stockpile. For instance, after not receiving a response to their Freedom of Information Act request, ProPublica filed a lawsuit against the Administration to get medical stockpile records.
A group of nine former presidential science advisors warned that the US needs to build the stockpile back up by September 1st in order to be prepared for a possible COVID-19 resurgence in the fall, and that state and local supply inventories need to be stocked as well. Their recommendations revolve around increased funding for producing essential medical goods, stockpiling supplies, and improving the coordination of the supply chain and distribution.
Moving forward through the pandemic
During the hearing, the vice director of logistics for the Joint Chiefs of Staff, Rear Admiral John Polowczyk, testified that the US is ramping up domestic production of at least some critical medical supplies. Polowczyk cited the current capacity to manufacture 180 million N95 respirator masks each month, his expectation for the production of an adequate number of reusable gowns by the fall, the beginnings of at least some nitrile glove manufacturing (compared to essentially zero previous domestic capacity), and initiating the process of onshoring the making of some ventilator drugs.
Despite these signs of progress, at the moment, the US does not appear ready for another surge of coronavirus. And that surge may come sooner rather than later.