The Strategic National Stockpile, holding respirator masks, gloves, ventilators and other equipment, drew extensive complaints from states and hospitals this spring after President Trump’s declaration of the virus as a national emergency caused the Federal Emergency Management Agency to inherit the storehouse, which had been depleted for years.
Its return to the Department of Health and Human Services, now underway, coincides with other shifts. An assistant HHS secretary, chosen in mid-March to coordinate federal coronavirus testing efforts, is phasing out of that role. Meanwhile, the White House’s coronavirus task force, led by Vice President Pence, has become significantly less active, convening at least two times a week, rather than daily, according to officials.
Taken together, these moves reflect the White House’s focus on reopening the country and an effort to make federal agencies function better than they did as the virus was starting its spread in U.S. communities.
“In the midst of a pandemic, the government always gets it wrong until it gets it right,” said one of two senior administration officials who spoke on the condition of anonymity to discuss internal decisions. “That’s what happened. . . . The government was feeling its way around this” when the White House centralized management of the administration’s response under the presidential task force.
The shifts are taking place as cases rise again in several states with the easing of stay-at-home restrictions. Hospitalizations for covid-19, the disease caused by the novel coronavirus, are escalating in parts of the country. The virus has killed at least 116,000 people across the country, and more than 2.1 million have tested positive.
The officials say the changes will equip the government to handle a second wave of the pandemic, if one comes in the fall, as well as the persistence of the first wave.
With the stockpile’s move back to HHS, the money available to it and the way of allotting supplies are considerably different than they were as recently as March, according to one of the senior administration officials.
For one thing, the official said in an interview, the Cares Act and other coronavirus relief packages adopted by Congress steered $16 billion to rebuild the stockpile. “We feel comfortable that will give us a 90-day supply to handle a pandemic,” the official said in an interview, noting that U.S. manufacturers were able this spring to increase production of masks, ventilators and other supplies in less than that time.
The new funding is a sharp increase for the stockpile created in the late 1990s in response to terrorist events. The stockpile was always intended for regional crises, not a national one, and its primary emphasis was on drugs and equipment for bioterrorism and other attacks; equipment to respond to natural disasters and infectious-disease threats was a more recent addition.
The Centers for Disease Control and Prevention, which oversaw the stockpile until late in 2018, had a yearly budget for it of about $600 million. After the stockpile was deployed on a national basis during the 2009 H1N1 influenza pandemic, public health officials and trade groups called for it to be replenished, but that did not happen.
HHS also is planning significant changes in how the stockpile will allot equipment. Before the move to FEMA in March, the department had employed a formula in which 25 percent of a state’s request for supplies was based on its population and 25 percent on its number of coronavirus cases. The rest was held back so the stockpile would not run out.
Once FEMA assumed control, allocation decisions were made based more on need. In early April, Department of Homeland Security officials acknowledged the supplies were nearly depleted. Some states complained they got a small fraction of their requests, while others received more.
In the interview, a senior administration official said some states had asked for more than they needed, citing an unidentified state that requested 40,000 ventilators but ended up using 1,500.
To help calibrate how much any state or hospital needs, the official said, health officials have been building a tracking system in which the government collects information on how many masks, gowns, face shields and other gear are used during a typical hospitalization for covid-19 patients with shorter and longer stays.
The amounts are relatively consistent among hospitals, the official said, and will form the basis for how much of any given request for equipment to fulfill.
The official said the new method is close to ready but added, “We are not completely happy with the integrity of the data we are getting,” some of which is not automated. Building this method, “it is being wired in an enduring way, instead of doing it on the fly, working until midnight.”
While the stockpile was under FEMA’s control, staffers from several parts of HHS worked as advisers. Now FEMA, with regional offices, will still be involved in the distribution of supplies.
One change already involves detailed daily reports FEMA has compiled for internal use, tracking cases, deaths, diagnostic tests and the amounts of each type of equipment given to each state.
Now these briefing reports contain less detail. “The data presented is more focused on national- and state-level covid infection,” said a senior government official speaking on the condition of anonymity because the official was not authorized to discuss the reports, “and not on trends in counties.”
As part of the other shifts to return responses to the pandemic to the government’s sprawling health department, HHS Secretary Alex Azar has created a structure in recent weeks that officials are calling sustainment, borrowing the military term for logistics, staff and other support to carry out a mission. In doing this, HHS brought in Vice Adm. Daniel B. Abel, the Coast Guard’s deputy commandant for operations, to help coordinate the department’s pandemic-fighting activities, convening daily meetings that had been led by FEMA.
And Brett Giroir, assistant secretary for health, is finishing work with states on developing individual testing plans, which the department is requiring, rather than creating a uniform national testing strategy.
Frances Stead Sellers contributed to this report.