US Medical Supply Chain Failures Caused Coronavirus Deaths

FRONTLINE investigation to be broadcast

on PBS and online Oct. 6 at 10 p.m. EST/9 p.m. CST

A major ongoing months-long investigation by The Associated Press (AP), the PBS series “FRONTLINE,” and the Global Reporting Centre is analyzing the failures of the medical supply chain to respond to the pandemic. The bottom line is that warnings by experts and manufacturers for years have been ignored by both congress and presidents. The consequence is tens of thousands of needless deaths in the coronavirus pandemic. The AP writes:

“Medical supply chains that span oceans and continents are the fragile lifelines between raw materials and manufacturers overseas, and health care workers on COVID-19 front lines in the U.S. As link after link broke, the system fell apart.

This catastrophic collapse was one of the country’s most consequential failures to control the virus. And it wasn’t unexpected: For decades, politicians and corporate officials ignored warnings about the risks associated with America’s overdependence on foreign manufacturing, and a lack of adequate preparation at home, the AP and “FRONTLINE” found.

As the pandemic rolled into the U.S., Asian factories shut down, halting exports of medical supplies to the U.S. Meanwhile, government stockpiles were depleted from a flu outbreak a decade earlier, and there was no way to rapidly restock. The federal government dangerously advised people not to wear masks, looking to preserve the supply for health care workers. Counterfeits flooded the market.

Although it will take years for researchers to understand why the pandemic was disproportionately worse in the U.S., early studies that compare different countries’ responses are finding that shortages of masks, gloves, gowns, shields, testing kits and other medical supplies indeed cost lives.

Meanwhile, studies in nursing homes -- in China, Washington state and across the U.S. -- found that COVID-19 cases were significantly higher in places with shortages of personal protective equipment, or PPE. Harvard Medical School professor Dr. Andrew T. Chan and colleagues found health care workers who didn’t have adequate PPE had a 30% greater chance of infection than colleagues with enough supplies. Black, Hispanic and Asian staffers had the highest risk of catching COVID-19, they found.

“And these are unacceptable deaths, each of which could have been prevented if we had had adequate supply chains in place in advance of the pandemic,” said UC Berkeley Professor William Dow.

Dow and his colleagues say there would be massive savings, in lives and tax dollars, if the government invested more in buying and storing stockpiles of supplies. 

‘This is a case where no individual health care organization is large enough to move the market and induce suppliers to invest in those types of supply chains,’ said Dow. ‘So the government needs to be able to go in and guarantee a certain amount of purchases so that it will be in the self-interest of each one of these manufacturers to be willing to put in the investments into that supply chain.’  

Despite early warnings from inside the White House, the federal government failed to substantially mobilize domestic manufacturers until April, three months after the virus began spreading exponentially across the U.S.  

The impact of the virus varies greatly from country to country. But it is now clear that those with well-managed, diverse and flexible supply chains were able to protect against the deadly spread in ways the U.S. failed.  

The warnings of looming and potentially deadly supply shortages from the White House began confidentially in February when White House trade adviser Peter Navarro wrote to the COVID-19 task force, urging the administration to halt exports and ramp up production of N95 masks. The U.S. “faces the real prospect of a severe mask shortage!” he wrote on Feb. 9.  

In addition to halting exports and prohibiting the sale of N95 factory equipment to China, Navarro pleaded that the U.S. government must provide ‘immediate purchase guarantees for all U.S. supplies at maximum production capacity.’ 

And according to health care workers, the Government Accountability Office and even the FDA, N95 masks continue to be in short supply. The White House denies this.”

 

The AP article goes on to point out that people responsible for pandemic preparedness in the Clinton, Bush, Obama and Trump administrations all said they warned about inadequate supply chains. Neither congress nor the White House made this a priority due to the cost of maintaining a US supply chain. 

In the wake of the 2014-21016 Ebola virus outbreak, an Obama advisor recommended that the US government needed to stockpile protective equipment during an emergency. The problem with that is that foreign suppliers may not be able to keep up with demand if their output was needed domestically. That is what happened.

A 2019 Trump administration pandemic simulation exercise concluded that the U.S. would not have stockpiled enough antiviral medications, needles, syringes, N95 respirators, ventilators, and other needed medical supplies to adequately respond. That is what happened less than a year after that exercise. In the wake of that exercise, the Trump administration made no move to prepare.

As time passed, American manufacturers of supplies either went bankrupt or shut down manufacturing due to limited demand for US supplies that were more expensive than foreign-made supplies. This failure may have saved billions of tax dollars, but that savings has now cost the US trillions in economic losses and thousands of lives. That was penny wise, but pound stupid.

Maybe this experience will result in a meaningful change. At the August Republican National Convention the president stated that “over the next four years, .... we will .... bring home our medical supply chains, and we will end our reliance on China once and for all.” Joe Biden announced a plan to invest $700 billion to support U.S. manufacturing by purchasing domestically made medical supplies and other goods.

Where does responsibility lie?

In the past, the president has blamed sitting presidents for the bad things that occurred while they were in office. He blamed Bush for the Iraq war and said he should have been impeached for it. If one applies the same standard of responsibility to Trump, he should be impeached for his failures. How one apportions responsibility to members of congress will depend factors such as on who failed to act and who opposed action.