Hence the recent back-and-forth over ventilators between President Trump and Gov. Andrew M. Cuomo (D) of New York, where a wave of covid-19 cases is projected to crest over the coming few weeks. “He’s supposed to be buying his own ventilators,” Mr. Trump said of the governor. “You pick the 26,000 people who are going to die because you only sent 400 ventilators,” said Mr. Cuomo.
Washington is now sending an additional 4,000 ventilators to New York, and the governor, in calmer tones, has acknowledged that no entity, including the federal government, can meet the state’s demand. That’s alarming because New York has managed to procure only half of the 30,000 ventilators it expects to need by mid-April; other states are likely to face similarly dire predicaments.
Before the pandemic, demand for ventilators was static. Now it’s incalculable, and manufacturers have no means to meet it in the coming months. That helps explain Mr. Trump’s reluctance to invoke the Defense Production Act of 1950, which empowers him to order production of equipment. In the case of ventilators, the order would be meaningless on the schedule required by New York and other states.
Existing ventilator manufacturers appear to be ramping up fast. Non-medical companies — Mr. Trump has mentioned big automakers — would need many months, at best, to produce a ventilator costing $50,000, composed of 1,750 unique parts and 1 million lines of software code. The president said automakers were already doing so; they are not.
New York’s need is unquestionably urgent. Mr. Cuomo is begging for ventilators from any source, promising to redeploy them where they are needed after his state manages the tsunami it expects next month.
In fact, that shouldn’t be the governor’s job. It should be managed by the federal government — by the Federal Emergency Management Agency, for instance, the Defense Logistics Agency or the Department of Health and Human Services. Inevitably, the job will be ethically excruciating. But it can be managed, to a degree, by surging the supply to meet the demand when and where it arises.
Even with perfect administrative acumen, there may not be enough devices. A major manufacturer, Medtronic, is going all-out to quintuple production, with a weekly goal of 500 acute units made at its plant in Ireland in the coming weeks. Most of that, though not all, will probably go to the United States. Other major producers are also ramping up. That’s good for states bracing for the worst. It is also probably inadequate to satisfy aggregate demand in a timely way.
That leaves states in what amounts to a procurement free-for-all. The federal government can’t miraculously solve the supply problem. For now, it doesn’t appear to even be managing it.