Trump Says US Ventilator Shortage Was "Unforeseen." Nothing Could Be Further
From the Truth.
By Nick Turse, The Intercept
24 March 20
In recent days, President Donald Trump has repeatedly defended his
administration against the suggestion that the government is failing to
secure enough ventilators - medical devices that help Covid-19 patients
breathe and can save the lives of those suffering serious respiratory
distress.
"We have tremendous numbers of ventilators, but there's never been an
instance like this where no matter what you have, it's not enough," Trump
said on March 18. "It sounds like a lot, but this is a very unforeseen
thing. Nobody ever thought of these numbers." A day later, he doubled down,
noting that "nobody in their wildest dreams would have ever thought that
we'd need tens of thousands of ventilators."
Except, of course, somebody did think that. A lot, of somebodies, actually,
and for a very long time. Almost every federal agency you can imagine has,
in fact, warned about shortages - and some have offered specific and
sobering estimates of need - for the better part of two decades.
Almost 15 years ago, for example, the Department of Health and Human
Services published a 400-page Pandemic Influenza Plan that was nothing if
not explicit. Analyzing models based on flu pandemics in 1957 and 1968,
which suggested there could be more than 900,000 hospitalizations under a
similar scenario, HHS determined that "demand for inpatient and
intensive-care unit (ICU) beds and assisted ventilation services could
increase by more than 25%." If that happened, they predicted, "mechanical
ventilation" would be needed in as many as 64,875 instances. A more severe
pandemic like the flu of 1918-19 could result in ventilator shortages which,
in turn, could lead to difficult questions about rationing. How many
ventilators might be needed to stave that off? A staggering 742,500.
That startling report was just one of many to sound the alarm. Most were
written in the wake of 2003 Severe Acute Respiratory Syndrome, or SARS,
outbreak or the 2009 H1N1 influenza pandemic.
A May 2003 report by the Government Accountability Office noted that "few
hospitals have adequate medical equipment, such as the ventilators that are
often needed for respiratory infections . to handle the large increases in
the number of patients that may result."
Another GAO report issued a few months later similarly warned that "few
hospitals reported having the equipment and supplies needed to handle a
large-scale infectious disease outbreak." Half of the 2,000 hospitals
surveyed by the GAO had, "for every 100 staffed beds, fewer than 6
ventilators."
A 2005 Congressional Research Service report echoed those concerns in
relation to H1N1 avian flu. "If this strain were to launch a pandemic. large
numbers of victims may require intensive care and ventilatory support,
likely exceeding national capacity to provide this level of care," the
report said.
A July 2006 Congressional Budget Office report warned that the United States
had only about 100,000 ventilators, with three-quarters of them in use on
any given day. That number may have remained stable for the last 14 years,
according to Vice President Mike Pence, who referenced the "more than
100,000 ventilators that are in healthcare facilities and hospitals around
America today" in a briefing on Saturday. (The New York Times puts the
number of hospital ventilators at about 160,000.) Meanwhile, according to
the 2006 CBO report, HHS had calculated that "a severe influenza pandemic
like the one in 1918 would require 750,000 ventilators to treat victims."
In August 2006, the Defense Department rolled out its "Implementation Plan
for Pandemic Influenza," offering both a prescient prediction and important
advice: "Considerable demand for ventilators is likely, especially in the
event that the pandemic occurs before a vaccine is available. Where
feasible, consideration should be given to stockpiling instead of
'just-in-time' acquisition of adequate numbers of ventilators."
A year later, President George W. Bush's White House warned that "a severe
influenza pandemic would place a tremendous burden on the U.S. healthcare
system" and that the "projected demand for inpatient and intensive care unit
beds and mechanical ventilation services would overwhelm" the healthcare
system. In November 2007, the Interior Department issued a "Pandemic
Influenza Plan," noting that a pandemic could lead to a shortage of
ventilators.
The list of overlooked warnings from federal agencies goes on: A 2009 report
by the Occupational Safety and Health Administration, which predicted that,
in the event of a pandemic, "healthcare facilities can be overwhelmed,
creating a shortage of hospital staff, beds, ventilators and other
supplies." A report by President Barack Obama's Council of Advisors on
Science and Technology about the H1N1 flu, pointed out that "[d]uring the
peak, 1 or 2 out of every 2,000 Americans might be hospitalized," and that
patients "requiring mechanical ventilation. could reach 10 to 25 per 100,000
population, requiring 50 to 100 percent or more of the total ICU capacity
available in the United States and placing great stress on a system that
normally operates at 80 percent of capacity."
More recently, Trump reportedly ignored increasingly alarming updates from
the U.S. intelligence community about the danger and spread of Covid-19.
Trump's falsehoods about coronavirus preparedness aren't confined to his
contention that "nobody has ever heard of a thing like this," of course. He
has also claimed that automakers including Ford, GM, and Tesla are lending a
hand to produce ventilators "fast" to make up the shortfall. It just isn't
true. And ventilators are just the start. Trump has responded similarly to
criticism about the alarming shortage of specialized N95 masks needed by
healthcare workers on the frontlines of the pandemic.
When asked how doctors in a country as wealthy and powerful as the United
States could be left without crucial masks, he resorted to his go-to
defense: "This is unprecedented or just about unprecedented. As time goes
by, we're seeing it's really at a level that nobody would've believed.. We
started with very few masks.. And now we're making tens of millions of masks
and other things."
But the need for large stockpiles of masks, like the need for ventilators,
has been no secret. "As occurred during the SARS outbreak in Canada,
hospitals would especially need N95 particulate respirators to protect
medical staff against infection," according to the 2006 CBO report. "Widely
adopted just-in-time practices. leave too small an inventory margin to
accommodate the increased demand for supplies that would accompany an
influenza pandemic."
