More than once, President Donald Trump has falsely claimed that the federal stockpile of emergency medicine and supplies he inherited from his predecessor was an “empty shelf.”
While the government does not publicize all of the contents of the repository, at the time Trump took office, the Strategic National Stockpile, as it is formally known, reportedly contained vast amounts of materials that state and local health officials could use during an emergency, including vaccines, antiviral drugs, ventilators and protective gear for doctors and nurses.
“The SNS was definitely not an empty shell,” Dr. Tara O’Toole, a former homeland security official during the Obama administration who is now executive vice president at the nonprofit strategic investment firm In-Q-Tel, told us in an email.
At least three times in the past week, however, Trump has sought to blame former President Barack Obama’s administration for the current state of the stockpile, which has been unable to meet the demand for additional supplies expected to be needed to treat people with COVID-19, the disease caused by the novel coronavirus, or to protect the doctors and nurses caring for those patients.
During a White House coronavirus task force briefing on March 26, in which Trump mentioned the number of respirators, face shields and ventilators that had so far been distributed by the Federal Emergency Management Agency, the president said: “We took over an empty shelf. We took over a very depleted place, in a lot of ways.”
When a reporter asked him about that claim during another briefing the following day, Trump again said he inherited “an empty shelf” that he had to refill.
And he continued to use that inaccurate description on March 30, during an interview with the hosts of “Fox & Friends.” “We started off with an empty shelf,” he said, adding, “We didn’t have very much in terms of medical product … and we built something really good.”
Strategic National Stockpile
The Strategic National Stockpile was created in 1999, and, as of April 2, was described on a Department of Health and Human Services website 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.”
(That description was later altered to say, “The Strategic National Stockpile’s role is to supplement state and local supplies during public health emergencies.” The change was made after Trump’s son-in-law and White House adviser, Jared Kushner, said on April 2: “The notion of the federal stockpile was it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use.” Some interpreted Kushner’s remarks to mean the federal stockpile was not meant to be used by states, which would be false. But, in context, Kushner said the federal government is trying to “make informed data-driven decisions, both on ventilators, masks, any other supply we can get, to make sure it’s going to the people who need them.”)
Most of the materials in the stockpile are stored in large warehouses around the country, and where those warehouses are located, and exactly what’s in them, is not publicly disclosed.
But NPR science correspondent Nell Greenfieldboyce was allowed to visit one facility in June 2016 — only months before Trump was inaugurated in January 2017. In her article about the warehouse she toured, she described the shelves as being the opposite of bare.
“A big American flag hangs from the ceiling, and shelves packed with stuff stand so tall that looking up makes me dizzy,” Greenfieldboyce wrote.
Greenfieldboyce, for NPR, June 26, 2016: The Strategic National Stockpile got its start back in 1999, with a budget of about $50 million. Since then, even though the details aren’t public, it’s clear that it has amassed an incredible array of countermeasures against possible security threats.
The inventory includes millions of doses of vaccines against bioterrorism agents like smallpox, antivirals in case of a deadly flu pandemic, medicines used to treat radiation sickness and burns, chemical agent antidotes, wound care supplies, IV fluids and antibiotics.
I notice that one section of the warehouse is caged off and locked. Shirley Mabry, the logistics chief for the stockpile, says that’s for medicines like painkillers that could be addictive, “so that there’s no pilferage of those items.”
As we walk, I hear a loud hum. It’s a giant freezer packed with products that have to be kept cold.
Just outside it, there are rows upon rows of ventilators that could keep sick or injured people breathing. Mabry explains that they’re kept in a constant state of readiness. “If you look down to the side you’ll see there’s electrical outlets so they can be charged once a month,” she says. Not only that—the ventilators get sent out for yearly maintenance.
In fact, everything here has to be inventoried once a year, and expiration dates have to be checked. Just tending to this vast stash costs a bundle — the stockpile program’s budget is more than half a billion dollars a year.
And that was the scene at just one of the repositories where the medicine and supplies are housed. As of 2016, there were at least six warehouses holding “approximately $7 billion in products across more than 900 separate line items,” according to a report from the National Academies of Sciences, Engineering, and Medicine.
“[A]lthough we couldn’t reveal where it was or what exactly it had inside. It looked like a prepper’s Ikea, with row after row of containers filled with mystery medications and equipment — including that one item everyone’s been talking about lately, ventilators,” Vice News said.
In her story, Greenfieldboyce also quoted an official with a consulting firm the government had recently hired to analyze how well the stockpile could respond to a range of threats.
Rocco Casagrande, the managing director of Gryphon Scientific, told her that he couldn’t publicly discuss the results of the analysis. But, she wrote, he did say “that across the variety of threats that we examined, the Strategic National Stockpile has the adequate amount of materials in it and by and large the right type of thing.”
That doesn’t sound to us like empty shelves, either.
O’Toole, who also chaired an advisory committee on the stockpile for the National Academies of Sciences, Engineering, and Medicine, did tell us in an interview that “the SNS mission has expanded” over the years and “one could argue resources did not expand commensurately.”
But the idea that the stockpile should be able to provide all of the supplies needed during a pandemic is misguided, she said.
“It was never, never, never intended to be the full answer to any disaster,” she explained. “It was intended to bridge from the moment of crisis until a little while after when the private sector would be able to gear up and use the whole global supply chain to deliver what was needed.”
Some Supplies Not Fully Restocked
It’s true that some of the supplies in the stockpile that governors are currently asking the government to send to states were not completely restocked during Obama’s presidency.
For example, the Washington Post reported on March 10 that the reserves of the N95 respirator masks were not “significantly restored” after tens of millions of the devices were distributed from the stockpile during the H1N1 influenza pandemic of 2009. Medical personnel wear the respirators because they can “filter out at least 95% of airborne particles,” according to the Food and Drug Administration.
Greg Burel, who was the director of the Strategic National Stockpile for more than 12 years until he retired in January, recently told CBS News: “We didn’t receive funds to replace those masks, protective gear and the anti-virals that we used for H1N1.”
He told Vice News that he decided to use the program’s limited funding to instead purchase vaccines, flu medications and other pharmaceuticals.
“We had to trade off those funds that we had, and we chose to invest in those lifesaving drugs that would not be available from any other source, in the quantity needed, and in time. I definitely want to see my healthcare workers protected; that’s very important. But if I’m thinking, ‘Do I buy this many masks to protect this many workers, or do I buy this many medicines to keep people safe that we can’t get elsewhere?’ there’s no easy answer here,” Burel said.
In other cases, the Obama administration’s attempts to add more equipment, such as ventilators, to the stockpile were not successful.
As the New York Times reported earlier this week:
New York Times, March 29: Thirteen years ago, a group of U.S. public health officials came up with a plan to address what they regarded as one of the medical system’s crucial vulnerabilities: a shortage of ventilators.
The breathing-assistance machines tended to be bulky, expensive and limited in number. The plan was to build a large fleet of inexpensive portable devices to deploy in a flu pandemic or another crisis.
Money was budgeted. A federal contract was signed. Work got underway.
And then things suddenly veered off course. A multibillion-dollar maker of medical devices bought the small California company that had been hired to design the new machines. The project ultimately produced zero ventilators.
That failure delayed the development of an affordable ventilator by at least half a decade, depriving hospitals, states and the federal government of the ability to stock up. The federal government started over with another company in 2014, whose ventilator was approved only last year and whose products have not yet been delivered.
On CNN’s “State of the Union” on March 15, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that there were 12,700 ventilators in the stockpile. At the time, there were 3,487 cases of COVID-19 in the U.S, according to the Centers for Disease Control and Prevention.
As of April 2, there were 239,279 reported cases of COVID-19 in the U.S. In a task force press briefing that same day, Rear Adm. John Polowczyk said that the U.S. has delivered more than 7,600 ventilators to the states, and still has some in reserve.
Still, O’Toole said she wishes there was less of a focus on expanding the stockpile because it will never be enough and will always lack something that is needed.
“You can’t stockpile your way out of a pandemic like this,” she emphasized.
One of the reasons for the current supply shortage, she said: “We’ve allowed our own national capacity to manufacture things to degrade and in some places go away. And we’ve done that for cost-efficiency sake.”
She later added: “What we need is not a big stockpile. We need a new strategy. We need to use the technologies we have now to create the capacity to respond to something in close to real-time.”
That means being able to “rapidly design and manufacture what we need, when we need it, and the quantities demanded,” she said.