The Trump administration, however, appeared to do the opposite. On March 19, President Trump declared at a press briefing: “The federal government is not supposed to be out there buying vast amounts of items and then shipping. You know, we’re not a shipping clerk.” This was what resulted in the chaotic P.P.E. marketplace, described by Andrew M. Cuomo, the Democratic governor of New York, as “50 states competing against the states, and the federal government competing against the states,” which he said drove up the cost of masks for New York from 85 cents to around $7 apiece. To solve this “madness,” he asked for the federal government to step in and take control of all buying to suppress bidding wars and to direct P.P.E. more efficiently toward hot spots — as the Bush administration’s previous guidelines, the administration’s own planning and numerous public-health experts, mayors, governors and congressional representatives suggested.
It wasn’t just the political opposition, as well as a small number of conservatives, asking the administration to provide more leadership — the private sector was also pleading for direction. Starting in late January, representatives from six of the largest medical-supply companies and members of the Health Industry Distributors Association, a trade group, had raised concerns about supply-chain problems. They requested guidance from senior administration officials on what became daily calls, according to documents released by the House oversight committee. Bafflingly to some high-level industry leaders, however, after nearly two months, they were still trying to get the administration to take straightforward actions — all while the supply chain was visibly fracturing.
An industry leader, who met with the president and the vice president, and requested anonymity to avoid retaliation, described widespread frustration among private-sector health care leaders at the administration. He recalled a “shocking” and “galling” White House sit-down in March, in which the vice president, Mike Pence, started by discomfiting the health care professionals with handshakes, and then tried to smooth over an hour of criticism they had unloaded on a senior H.H.S. official by simply asserting they’d get the problems solved. “It was like we were in two different realities,” the individual said. “I could see the vice president was in a bubble.”
The administration’s attempts to deal with the P.P.E. crisis reportedly emanated from a team of unpaid consultants, many in their 20s with little to no experience in health care, assembled by Jared Kushner, the president’s son-in-law. After distributing the dregs of the Strategic National Stockpile, the federal government focused on procuring whatever supplies it could from corporate medical distributors and the gray market, distributing them through FEMA. An analysis by The Associated Press suggested that rural states with less serious outbreaks were awarded more P.P.E. per confirmed case than states with significantly more dangerous outbreaks. This raised accusations of political favoritism in a life-or-death situation — though the administration has strongly denied this.
Kushner’s team, meanwhile, was also starting Project Airbridge, a program that expedited the delivery of P.P.E. from Asia to America by paying for it to be flown rather than shipped. During the first four months of the outbreak, Project Airbridge would help bring in 5.3 million respirators and 122 million medical masks. These figures, though large, represent just a tiny fraction of the 3.5 billion respirators that Kadlec said were needed. In June, Project Airbridge would be wound down without fanfare.
At the outset of the pandemic, at least from Baystate Health’s point of view, what the administration’s response succeeded in creating was a feeding frenzy. In this kind of chaos, everyday citizens had little chance, and so Keroack reached out to Representative Neal. At first, this seemed to accomplish nothing, and Artenstein left the federal agents and the masks, and drove home. But that evening, when he was back at the hospital, he got word that the shipment had been loaded onto the trucks. Representative Neal had managed to get on the phone with the Department of Homeland Security, and delivered a strongly worded message to release the respirators. Still, as Salls monitored the trucks on their long drive north, she was nervous each time they stopped for gas. The masks finally hit the guarded warehouse well after midnight, and pictures of them were giddily shared. Over the next few days, the remaining three-fourths of the order arrived in chunks, with Representative Neal’s chief of staff, Tranghese, ushering each portion through customs. But Baystate’s ordeal was far from over.
Many in the health care industry encouraged the president to make use of the Defense Production Act, which allows him to exert control over domestic manufacturing during national emergencies. But for weeks during the initial phase of the pandemic, the administration resisted invoking the D.P.A. Eventually, at the end of March, it began to make limited use of the act, ordering companies like 3M, the largest remaining American producer of N95s, to increase respirator production in the United States. (The company had already taken many of the steps to expand production at the outset of the pandemic that the administration would later mandate.) It would never take a primary role in distributing P.P.E. nationwide, instead directing supply mostly to hot spots and letting the market work out the rest.