WASHINGTON – More than two months after what President Donald Trump calls a “war” against COVID-19, his administration’s efforts to combat the deadly disease, as well as its disastrous effects on the American economy, often create more problems let them solve it.
Bidding wars for lifesaving equipment, a power struggle between Trump’s son-in-law and the Vice President, politics, centralizing authority and decentralizing responsibility, and creating new Government programs while permanent bureaucracies are ignored, have all contributed to the chaos within the political, economic and health systems.
Banks have not been able to process loan requests for a new Small Business Administration relief program, companies trying to produce personal protective equipment for health professionals cannot attract attention of the Federal Emergency Management Administration, and doctors and ventilators in ambulatory surgery centers are inactive. a soft moratorium on elective operations is on the sidelines.
These problems are minor compared to the growing crisis of coronavirus cases, the scarcity of fans and the possibility that billions of dollars in aid are not enough – or well enough directed – to avoid catastrophic economic collapse.
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All of this gives the impression that no one is really in charge in the midst of the most dreadful crisis the nation has faced in generations.
“This country is relearning what it understood during the Cold War – we don’t elect presidents for the good days, we elect them to handle the bad days,” said representative Eric Swalwell, D-Calif. “Donald Trump cannot handle a bad day, let alone an extended pandemic. “
The composite sketch from interviews that NBC has conducted in recent days with more than a dozen people involved in various aspects of the crisis reveals a struggle for deadly and economic survival in which men and women, states and cities, hospitals and businesses of all kinds have without sufficient support. The lack of national leadership occurs even at a time when Congress and the Federal Reserve are injecting money into the system and many companies wishing to provide assistance have found that they cannot connect with federal agencies.
Many of those interviewed for this article spoke on condition of anonymity to avoid angering the president, or because they were not allowed by their employers to speak publicly, and some only provided details of small pieces of the puzzle. Their slices of the world represent Democratic and Republican politics, federal, state and local governments, big and small businesses, the healthcare system and various parts of the supply chains that have been broken or folded under the weight of a huge financial pressure and extremely varied demand. for a range of goods and services.
Some praised aspects of the president’s efforts, including cracking down on hoarding and rising prices, encouraging Americans to stay at home to prevent the spread of the disease, and using part of his energy to obtain medical equipment from private companies.
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But together, their stories reveal that poor pandemic preparedness has been compounded both by the policies that have been implemented and by the Trump administration’s inability to coordinate the distribution of healthcare assets – equipment such as ventilators, masks and gloves and qualified medical personnel. – and the effort to support an economy suddenly fell.
More than three years after his tenure, Trump has accused his predecessor, Barack Obama, of a sterile national stockpile of necessary medical supplies and at the same time said that the federal government should not be considered a supplier.
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“The states should have built up their stocks,” he told a White House media briefing this week. “We are a backup. We are not an order clerk. “
He also invited his son-in-law, Jared Kushner, to speak on the response for the first time, acknowledging the prominent role Kushner has played behind the scenes in recent days in a task force that was the domain of the vice president. Mike Pence.
“I was really under the direction of the vice president and he asked me to get involved in different projects,” said Kushner in response to a question about reports that he was leading a “parallel” working group. alongside Pence’s efforts.
The biggest problem on the front line in the fight against coronaviruses is scarcity. In itself, this is not a Trump manufacturing problem, but it has been exacerbated by his insistence that states and cities compete with the federal government and private sector buyers, including deep-pocket hospitals, for test kits, fans, masks, dresses and other items.
The truth is, there isn’t a lot of equipment out there. Most of the personal protective equipment used in the United States is made in China, where the coronavirus devastated production months ago.
In addition to this, the growing demand and the derogation from certain federal rules for protective equipment have inspired the development of a very hot “gray market” for goods. This market means less quality control, buyers who often do not know sellers or brokers because they are inundated with requests, soaring prices and orders that are frequently canceled at the last minute, according to many. people involved in tendering for equipment.
This can mean losses in terms of the opportunity cost of bidding team time, money thrown away or, worse still, the risk of equipping emergency medical personnel with substandard equipment.
“The demand curve far exceeds the supply curve … resulting in the entry of uncontrolled and uncertified suppliers,” said Chaun Powell, vice president for strategic supplier engagement at Premier healthcare consultancy.
Of course, any president would have been challenged by the enormity of this crisis, and Trump has found ways to show creativity in the resources at his disposal.
For example, the federal government now pays for the cost of transporting personal protective equipment from abroad to deliver it to private buyers in exchange for the right to identify the countries that get 50% of the materials first, a said a spokesperson for the Federal Emergency Management Agency. an email exchange on the “Project Airbridge” program.
If he wanted to, Trump could invoke the Defense Production Act to take and allocate 100%.
Faced with pressure, he issued an order Friday to have 3M, the manufacturer of the Minnesota-based N-95 facial mask, ship foreign-made protective equipment to the United States and stop sending products made in the United States in other countries. The ordinance states that when it comes to equipment necessary to fight COVID-19, “it is the policy of the United States to prevent brokers, distributors and other national intermediaries from diverting this material abroad “.
Often the president chooses to point out how he convinced personal friends, political allies or business people before the federal government to participate. On March 30, he held a press conference on Rose Garden during which several CEOs spoke of their efforts to provide slices of personal protective equipment. One of them, MyPillow founder Mike Lindell, has donated more than $ 200,000 to Trump’s campaigns and affiliate committees.
Another CEO, Greg Hayes of United Technologies Corporation, announced the donation of 1.1 million pieces of personal protective equipment to FEMA, some of which were originally designated the previous week. UTC’s long-standing merger with defense contractor Raytheon was approved by Trump’s Justice Department four days before the Rose Garden event.
More often than not, reports from across the country and across sectors of the economy show the ineffectiveness of the federal government at best and incompetence at worst. In some cases, the actions of the administration may have had unforeseen drawbacks.
American surgeon Jerome Adams’ warning to limit elective surgery was the right choice, but hammered out ambulatory surgery centers, just as home support guidelines had a painful effect on health care providers who did not are not involved in the fight against coronaviruses more broadly, according to Jim Rechtin, CEO of Envision.
His business, which operates more than 250 ambulatory surgery centers and employs 27,000 clinicians, including 11,000 working in emergency rooms, has ventilators and doctors who can travel to work with patients with coronavirus. He’s looking for ways to get ventilators to hospitals – despite his concern not to restock them – and clinicians must be paid.
“It’s a mismatch of supply and demand – part of that is coordination and part of the financial help to get there,” he said, adding that there are ” signs that there is early activity in this area but that we could use more, faster. “
Two people who spoke on condition of anonymity said that FEMA was not responding to requests from companies seeking to supply goods for the fight against coronaviruses. The regional offices of the emergency management office are well trained in disaster response, but the White House has essentially dismissed this organizational structure out the window in favor of centralizing power. Trump has also chosen not to use supply chains established in other agencies, preferring a working group model that has not yet faced the daunting management challenge.