Fears grow over federal ventilator supply as coronavirus cases mount

A patient in a hospital bed on a ventilator
Questions are swirling around whether there are enough supplies of ventilators for hospitals to satisfy the enhanced capacity expected from the coronavirus. (Getty/sudok1)

Some hospitals are taking steps to preserve their supply of ventilators, even making their own devices, as the number of supplies in a federal stockpile remains up in the air.

The concern around ventilator supply comes as cases surrounding the coronavirus have ramped up over the past week to more than 4,000. 

The Centers for Disease Control and Prevention maintains a national stockpile of medical supplies that includes ventilators and personal protective equipment (PPE) like masks.

But it remains unclear how many ventilators the federal government has stockpiled. Department of Health and Human Services (HHS) Secretary Alex Azar dodged a question on supplies for what he said were national security reasons.

Need a ventilator? How to apply to the CDC

A hospital must go through several different steps to ask the Centers for Disease Control and Prevention’s (CDC's) stockpile for more ventilators. Here is a breakdown from a report from Johns Hopkins Bloomberg School of Public Health:

  • Hospitals must make an initial request to their incident command system. That request is then sent to a local health department or emergency management agency;
  • Next, a governor must approve the request for more ventilators before the request goes to the CDC or HHS; and
  • During a national emergency, CDC could determine allocation strategies for ventilators such as population size or number of patients and standing capacity.

President Donald Trump said Tuesday that the government ordered “massive numbers of ventilators” but didn’t specify how many.

“We have tremendous amounts of equipment,” he added without specificity. But there aren’t a lot of recent data on the number of ventilators in the stockpile.

The stockpile has an estimated 8,900 ventilators as of 2010, according to a February report from the Johns Hopkins Bloomberg School of Public Health.

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A severe flu pandemic could lead to a 25% increase in demand for ventilators, according to an HHS report.

States are starting to get nervous as well about the ventilator capacity. Connecticut Gov. Ned Lamont told CNBC that he isn't waiting for the federal government's stockpile to come through. 

Trump told governors during a call Monday that they can order ventilators themselves to avoid any bureaucratic delays of getting a ventilator via the stockpile.

The Department of Defense announced they will give 2,000 specialized respirators and 5 million masks to federal health agencies, according to an Associated Press report.

With the number of coronavirus cases on the rise, hospitals aren’t waiting for the national stockpile.

Several major hospital systems such as Kaiser Permanente have canceled elective procedures, which can help improve ventilator capacity, experts say.

“Anesthesia machines can be used for ventilators,” said Craig Coopersmith, M.D., former president of the Society of Critical Care Medicine.

Canceling elective procedures, which the U.S. surgeon general has recommended, can also free up healthcare staff and space for intensive care units, Coopersmith added.

Some hospitals are also taking the lack of ventilators into their own hands, literally, by building simpler ventilators.

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Coopersmith said he has heard from hospitals that are building simpler ventilators that were first used in a hospital and aren’t as complex as state-of-the-art ventilators.

“In a crisis, the goal is not to have every possible mode of ventilation,” he said.

HHS said the stockpile is deploying PPE such as masks to “temporarily fill in gaps left by the commercial market as well as state and local supplies,” a spokesperson said.

The agency directed hospitals to contact their local health departments if they need more supplies. HHS didn’t say how many ventilators are in the national stockpile or the number of orders it has made.

“We have been transparent that more supplies are needed—hence the request to Congress for additional funding so we could procure more and scale up production,” HHS said. “The role at the federal level is to appropriately implement regulatory relief, provide alternative sources and support manufacturing, and adjust allocation to appropriately target areas in need.”

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