How the Trump administration played catch-up with the nation’s ventilator supply
A case study on the benefits of centralized management strategies
Just last week the Trump administration announced the US ventilator supply was so plentiful the federal government would begin exporting the machines to Ethiopia, El Salvador, Ecuador, Honduras, and other nations in need. Three weeks before, on April 2nd, Gov. Andrew Cuomo declared NY state had just six days before it would take its last breath.
The federal government’s failure to design, implement, and manage a ventilator acquisition and distribution is a case study that offers lessons in strategic planning, centralized ownership of process design and implementation, and transparency with stakeholders.
In early April, Senators Christopher Murphy (D-CT) and Kamala Harris (D-CA) wrote to Vice President Pence urging for details about the volume of ventilators and other medical supplies in the Federal Strategic National Stockpile and information regarding the allocation process of those supplies to combat the COVID-19 pandemic.
“Hospital administrators, mayors, governors, and members of Congress, myself included, have been begging your administration for months to establish a centralized acquisition process,” wrote Murphy. “Efforts now must focus critical resources to areas of our country experiencing the greatest increase in COVID-19 cases with the largest capacity shortfalls. But without any explanation of the means by which the federal government is determining which states get what supplies, doctors, nurses, medical providers, and the general public are left in the dark to speculate about the political motivations behind them.”¹
Meanwhile, Gov. Cuomo pleaded President Trump for assistance in securing ventilators for NY state hospitals, and Trump responded by deeming it was the responsibility of each governor. Trump repeatedly delayed invoking the Defense Production Act—an Act he’d invoked hundreds of thousands of times for defense purposes²—until the pressure from legislators and health experts was too great, and then he made the motion to force manufacturers to produce ventilators and other medical supplies knowing fully well that GM and others were a few steps ahead of him.
Soon the federal government took action, and they started negotiating with China for ventilators, all while many governors, at Trump’s command, were already communicating directly with Chinese manufacturers. Cuomo and other governors in states facing ventilator shortages quickly realized they were competing with each other and with the Federal Emergency Management Agency—not to mention other nations—for supplies.
The demand for ventilators is a moving target. In response, on April 14th the federal government launched the voluntary Dynamic Ventilator Reserve, a public-private effort designed to facilitate the reallocation of ventilators from states with excess supply to states in need.
The Council of Economic Advisers (CEA) declared the Reserve is unlikely to require reinforcements from the federal stockpile, as shown in Figure 1 below. Even under an aggressive scenario, the CEA projects the national ventilator supply would still be 2.1 times higher than demand during the forecasted peak.³
We may be in the clear, at least for the first wave of the pandemic on US soil, but the federal government has plenty to learn.
Key insights from the ventilator supply management case study
- Centralized management of a planned process creates efficiencies. The Trump administration is in a unique position that enables it to centrally manage medical supply acquisition on behalf of the states and oversee allocation and distribution to each state based on a supply-and-demand analysis.
- Informed and swift decision-making is critical. The last few months were not the time for Trump to be apprehensive and pass responsibility to the states and manufacturers. Lives were at stake, just not his.
- Transparency to stakeholders is essential for cooperation. Concealment of information that is necessary to maintain the security of a nation state—without risking imminent threat from other nations—is inexcusable. If the federal government is hiding details on its medical supply stockpile from senators and governors, there is likely something behind the curtain the feds don’t want the states, and the general population, to see.
A humble leadership that makes decisions based on facts and reason—and holds itself accountable for its mistakes—yields a stronger, more prosperous country. The politicians we elect should learn from their faults, and if we aren’t satisfied with the results, we must show it on election day.
The latest Gallup global approval poll, a 2019 report, shows a global approval rating of US leadership at its lowest level for any of the past three administrations — a 31% median.⁴ And in the last month, while the domestic reputations of most democratic leaders have climbed since the beginning of the pandemic, Trump has received only a minuscule boost amid ever-growing international criticism.⁵
But before we cast our votes, we must ensure our votes will be counted. The Trump administration and conservative-led states are making moves to combat vote-by-mail alternatives and stymie voter registration efforts, and the ACLU and other groups are continuing to organize. Now is the time for a centrally managed plan. Civil rights leaders must make informed decisions quickly, and they must be transparent with their stakeholders.
Whether you like it or not, we are all connected now more than ever, and the entire world will be watching the results come in on election day.
¹ Medical Device and Diagnostic Industry Online
² New York Times
³ Whitehouse.gov
⁴ Gallup
⁵ The Economist
