As requests for ventilators from the national stockpile reached a crescendo in late March, President Donald Trump made what seemed like a bold claim: His administration would have 100,000 within 100 days.
At the time, the Department of Health and Human Services had not ordered any new ventilators since the start of the COVID-19 pandemic in January. But records show that over the following three weeks, the agency scrambled to turn Trump's pledge into a reality, spending nearly $3 billion to spur U.S. manufacturers to crank out the breathing machines at an unprecedented pace.
An analysis of federal contracting data by The Associated Press shows the agency is now on track to exceed 100,000 new ventilators by around July 13, about a week later than the 100-day deadline Trump first gave on March 27.
By the end of 2020, the administration is expected to take delivery of nearly 200,000 new ventilators, based on the AP's review of current federal purchasing contracts. That would more than double the estimated 160,000 ventilators hospitals across the U.S. had before the pandemic.
We became the king of ventilators, thousands and thousands of ventilators, Trump boasted in an April 29 speech.
But over the past month, demand for ventilators has decreased even as the U.S. death toll from the novel coronavirus has surged past 75,000. After observing unusually high death rates for coronavirus victims who were put on ventilators, many doctors are using them only as a last resort.
That's raising the unexpected prospect that the United States could soon be awash in surplus ventilators, so much so the White House is now planning to ship thousands overseas to help boost the virus response of other nations.
In a speech to Republican members of Congress on Friday, the president credited his son-in-law, White House senior adviser Jared Kushner, with heading up the effort to purchase the ventilators. We built, and we built, and we built, Trump said.
Now we have nine factories that are throwing out ventilators at numbers that nobody can believe. It was really there's not been anything like that, since the Second World War, where we did the same thing with other types of product.
Daniel Adelman, a professor at the University of Chicago Booth School of Business who teaches health care analytics, said the U.S. government is now buying more than twice the number of ventilators it needs, even under a worst-case scenario forecasting the spread of COVID-19.
But Adelman said mathematical models cannot predict with certainty how many ventilators will be needed if there is a resurgence of the coronavirus later in the year or if there is another pandemic in the future.
It seems incongruent with the forecasts that you're seeing, Adelman said of the government purchases. I'd probably rather they order too many rather than ordering too few.
In patients with severe cases of COVID-19, the virus attacks the lungs, causing fluid to collect in tiny air sacs called alveoli. That makes it difficult for the lungs to transfer oxygen from the air to the blood, which can be deadly. To treat these low oxygen levels, doctors have historically relied on ventilators.
The Strategic National Stockpile, the federal government's emergency reserve of medical supplies, had about 16,660 ventilators ready to deploy at the start of March, with an additional 2,400 out for maintenance.
By the middle of the month, health officials and governors in states with the worst virus outbreaks began expressing concerns that the supply of breathing machines could run out, potentially leaving thousands of critically ill patients gasping for air.
Among those calling for additional ventilators was Gov. Andrew Cuomo (D-N.Y.), who predicted on March 24 that all of the ventilators in his state would be in use, and patients in need would be left without proper treatment. Cuomo said projections showed New York would need at least 30,000 additional ventilators to get through the mid-April peak of the outbreak. At that point, FEMA had sent New York 400.
Trump expressed skepticism at Cuomo's figures even as his administration rushed to send New York 4,000 additional ventilators about one-quarter of the nation's entire emergency stockpile. Still, Cuomo pleaded for more.
You pick the 26,000 people who are going to die," Cuomo said at a news conference, It wasn't just New York, however. Similarly dire projections of a ventilator shortfall were also then circulating within the White House.
The scariest day of my life was about a month ago when, after a long day of meetings, my team told me that we were going to be needing 130,000 ventilators; that we were short hundreds of thousands of ventilators, Trump recounted in an April 14 briefing. I had governors requesting unreasonable sums that the federal government just didn't have.
By late March, a bipartisan chorus of state governors and members of Congress were calling on the president to exercise his emergency authority under the Defense Production Act to force U.S. companies to produce ventilators.
Trump had resisted invoking the Korean War-era law, which grants the president sole authority to direct U.S. industrial production of critical supplies in times of national emergency, saying the private sector was stepping up production of ventilators and other medical supplies on its own.
But on March 27, Trump changed course, announcing that he would invoke the Defense Production Act to produce ventilators, which meant companies would have to give priority to federal orders over other customers.
In the next 100 days well, first of all, we've already delivered thousands of them but within the next 100 days, we will either make or get, in some form, over 100,000 additional units, Trump said.
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