The Washington PostDemocracy Dies in Darkness

How Trump backed into the coronavirus success he talks about most often

President Trump speaks about the coronavirus Wednesday in the White House. (Alex Brandon/AP)

During the White House briefing on the coronavirus pandemic Wednesday, President Trump expressed frustration with the media.

“We’re making hundreds of thousands of ventilators right now,” Trump said, referring to the devices used to aid patients suffering from covid-19, the disease caused by the virus. “Nobody writes about that. You know, at the one time, all they talked about was ventilators, right? Because you didn’t think it was possible for me to solve that problem. And I solved it, and nobody can believe it.”

“Nobody thought this could be done,” he added later. “The fake news was very unhappy that it was done. But you guys don't ask me about ventilators anymore."

“Who's unhappy that ventilators are being made, Mr. President?” a reporter asked.

“Everybody. Everybody,” Trump replied. “Because you never mention it. You never mention it. There’s no story that what a great job we’ve done with ventilators. We’re now supplying ventilators all over the world.”

“You should say, ‘That’s a great story,’ ” he continued. “Instead you say, ‘Trump was slow’ or — slow? We were so fast.”

This point, that his administration handled the question of ventilator availability adroitly, is important to Trump, because he uses it as validation of his team’s other approaches to the pandemic.

“What are we doing with therapeutics? What are we doing with vaccines? We’re going to have those answers, too,” he said during the briefing. “We’re going to have them, just like we took care of ventilators.”

The thing about this argument, though, is that the country avoided the worst-case scenario with ventilator demand despite Trump’s actions, not because of them. His administration was, in fact, slow to engage on the issue, and it is due to a number of factors unrelated to the White House that more Americans didn’t die of a lack of ventilator availability.

What the administration did

A critical part of Trump’s argument is that the country is making hundreds of thousands of ventilators “right now,” as he said Wednesday. When concerns about the availability of ventilators first emerged, the government had only about 10,000 ventilators in the nation’s stockpile. Some portion of those didn’t work, as California discovered when the federal government sent it 170 broken ventilators last month. As of April 6, the government had disbursed fewer than 8,000 ventilators to the states. By that point, more than 1,000 people a day were dying of covid-19.

The warning signs about ventilators were well known.

“As early as mid-January, U.S. officials could see that hospitals in China’s Hubei province were overwhelmed with infected patients, with many left dependent on ventilator machines to breathe,” the Associated Press reported April 6. “Italy soon followed, with hospitals scrambling for doctors, beds and equipment.”

But through late February, the message from Trump was that the virus wasn’t likely to have an outsize effect on the United States. He assured the public on Feb. 26 that the 15 cases recorded in the country would winnow down to zero. February was a lost month, with few steps taken by the administration to prepare for the virus, which was already spreading undetected among the public.

It wasn’t until late March that Trump used his authority to force General Motors to build ventilators. Ford had already announced it was partnering with General Electric to build the machines, of their own volition. Those devices, though, wouldn’t be available until early June.

“Ford’s timeline suggested,” the New York Times reported, “that if the administration had reacted to the acute shortage of ventilators in February, the joint effort between Ford and General Electric might have produced lifesaving equipment sometime in mid- to late April."

Or — now.

A central part of Trump’s rhetoric on ventilators is that governors — particularly Gov. Andrew M. Cuomo (D-N.Y.) — requested far more ventilators than they needed. Cuomo at one point estimated that the peak of covid-19 cases in his state could mean that some 40,000 ventilators were needed. By the end of March, New York had 11,000 ventilators on hand, after buying 7,000.

The number of ventilators the state has needed has been far lower than Cuomo’s estimate, prompting Trump to repeatedly crow about his own more-accurate assessments of the situation. But Cuomo’s estimate was based on being prepared for a possible worst case identified by epidemiologists and an effort to ensure there was no chance doctors would have to ration the devices. For all of Trump’s noting that Cuomo’s worst case didn’t come to fruition, he doesn’t mention the flip side of the issue: The federal government didn’t have 40,000 ventilators to provide anyway.

Why shortages didn’t occur

Why did New York avoid that worst case? For a variety of reasons, almost none of which were a function of Trump or the White House.

The state was one of the first to enact a stay-at-home order, closing nonessential businesses and encouraging people not to leave their houses unless necessary. That helped push down the number of people needing treatment.

Another reason stems from changes in how the devices were used. Trump has repeatedly declared no patient was denied a ventilator, but in at least one hospital in New York City, multiple patients were connected to a single ventilator, effectively meaning there were not enough ventilators to go around. As the number of cases increased, doctors discovered other, less invasive treatments could mean ventilators weren’t needed, such as laying patients prone or using other devices that delivered more oxygen to patients.

Less optimistically, doctors also found many patients were dying of complications other than the breathing difficulties that have come to define the covid-19 illness. As The Washington Post reported this week, for example, the disease appears to also cause clots in patients’ blood, which can prove fatal. In some cases, it was reported that hospitals limited resuscitation efforts that would require ventilators, to limit the risk of infection for staffers.

As states evaluated their needs for addressing the virus, there emerged an ad hoc sharing network. California found lower need for ventilators and sent some to other states, including 500 to New York. (By April 6, the federal government had sent New York 4,400 ventilators.) New York, later seeing hospitalizations decline, passed some on to Michigan and Maryland. Within New York itself, Cuomo announced a plan to seize ventilators from less-affected areas to be used in hard-hit New York City, though it’s not clear whether that happened to any significant degree.

The Trump administration did set up the Dynamic Ventilator Reserve earlier this month, aimed at facilitating the lending of ventilators between hospitals. It was announced as New York was already sending its ventilators to other states.

Earlier this week, Trump promoted articles from the conservative National Review discussing how the ventilator shortage hadn't come to fruition.

“Kyle Smith, ‘The Ventilator Shortage That Wasn’t,’ ” Trump said Monday, referring to one of the articles. “ ‘The Ventilator Shortage That Wasn’t’ — because we got it fixed.”

Smith didn’t make that claim, instead simply tracking where shortages hadn’t come to pass. New York did get ventilators from the federal government, but there’s no indication any were manufactured as a result of actions taken by the Trump White House.

On Monday, Trump claimed the only reason the media had focused on ventilators in the first place was to criticize him.

“Remember, it was all ventilators. And the reason it was all ventilators — they said, ‘There’s no way he’ll ever be able to catch this one,’ ” Trump said. “And not only did we catch it, we are now the king of ventilators all over the world.”

Now that the threat has dissipated.

Ariana Eunjung Cha contributed to this report.