Fight for PPE wages 'bidding war' among cities short on supply

HOUSTON, Texas (KTRK) -- Houston Fire Chief Samuel Peña said cities aren't trying to hoard personal protective equipment. They just want enough to keep their first responders safe.

But, as coronavirus testing expands and more positive cases are being identified, doctors, nurses and other healthcare workers are scrambling to find enough PPE to replenish their dwindling supply.

"There is no secret that there is a worldwide shortage of personal protective equipment," Peña told 13 Investigates. "We're all competing for limited equipment and we're all trying to do the responsible thing for our departments.

First-responders and healthcare workers are on the frontlines of the fight against novel coronavirus, which has infected more than 1 million people worldwide and killed more than 5,600 Americans.

But, the PPE that could help ensure those workers remain safe has become increasingly difficult to purchase, causing some local officials like Peña to look as far as the Middle East.

Peña said they're considering every possible vendor, and even received a shipment of gowns from Mexico, but price is becoming an issue.

"The cost of a mask that was maybe $1 or $2 just six, eight months ago, now it's between $5 and $6, so the cost of doing business is going up," Peña said. "This pandemic is forcing us to expend additional resources, limited resources, to acquire that."

Houston Mayor Sylvester Turner said a large purchase order for PPEs wasn't honored after someone else offered to pay more and created a "bidding war."

And Texas isn't alone. As cities across the U.S. are left vying for the same equipment, it is creating a competition for those materials and driving up prices, causing some localities to start forming alliances and pooling resources.

"A system that's based on state and local governments looking out for themselves and competing with other state and local governments across the nation isn't sustainable and if left to continue, we'll certainly exacerbate the public health crisis we're facing," said John Cohen, an ABC News contributor and former Acting Undersecretary at U.S. Department of Homeland Security. "There's a very real possibility that those state and local governments that have the most critical need won't get the equipment they need."

13 Investigates teamed up with investigative reporters at ABC Owned Television Stations across the U.S. to look at the lengths some states and local municipalities are going through to increase their PPE supply.

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As testing expands, city officials are forced to spend big dollars in order to have enough equipment for healthcare workers.



State response

In New Jersey, Governor Phil Murphy said his state is "desperate" for more PPE. Illinois Governor JB Pritzker told CNN the fight for supplies is like the "Wild West." And on Monday, Pritzker said the federal government sent the wrong type of mask - they received surgical masks instead of N95s.

In Philadelphia, the Federal Emergency Management Agency only fulfilled 44 percent of the state's requested PPE, leaving them short more than 382,000 N95 respirators and still in need of more than half a million face and surgical masks, according to a report Thursday from the U.S. House Committee on Oversight and Reform.

But, in a tweet Thursday morning, Trump pushed back on states' claims that the federal government isn't providing enough equipment, fast enough.



"Some have insatiable appetites & are never satisfied (politics?). Remember, we are a backup for them. The complainers should have been stocked up and ready long before this crisis hit. Other states are thrilled with the job we have done," he tweeted. "Sending many Ventilators today, with thousands being built. 51 large cargo planes coming in with medical supplies. Prefer sending directly to hospitals."

Still, North Carolina has received only a portion of the masks, gowns, gloves and face shields it requested from the federal government. Officials there are fighting back against scammers who are trying to take advantage of the need for PPE by "making offers and demanding up-front payment for something that looks sketchy and is probably not a real thing," said Wake County EMS Assistant Chief Jeff Hammerstein.

Wake County also "merged" orders with five other counties and two major hospital systems in an effort to order bigger bulk and decrease competition.

New York Governor Andrew Cuomo, whose state has more than 92,000 confirmed cases, said states are willing to pay whatever it takes to get their hands on supplies and even though that continues to increase costs, it is not even considered price gouging since it is private market competition among bidders.

The gear includes everything from gloves, face shields, gowns, sanitizers and N95 masks, a respiratory protective device that is the best way to prevent a COVID-19 positive patient from transmitting the virus to the workers treating them.

"Not only is it a lack of supplies would harm us or hurt us in the ability to take care of patients, but it would endanger the staff as well and if staff gets sick and they can't come in to take care of patients that makes it even doubly challenging," said Cliff Daniels, chief strategy officer for Methodist Hospital of Southern California.

California Gov. Gavin Newsom said the state needs more than 100 million N95 masks just to meet needs. He said governors across the U.S. are starting to form partnerships and consider connecting procurement teams to work together and ensure "none of us are being greedy at this moment and that we have the capacity to move things around."

"We want to help other states even as large as Illinois and Washington State, some of the largest states in our nation, to see if we can help procure not only a reduction in costs per unit, but also procure a mindset where we're not playing in the margins of a zero sum where it's us versus them," Newsom said.

There were nearly 240,000 confirmed COVID-19 cases in the U.S. as of Thursday afternoon, according to the Johns Hopkins University's Coronavirus Resource Center. In addition to protection for frontline workers, the equipment to keep critically ill patients alive is also at the center of the bidding war.

"When I showed you the price of ventilators went from $25,000 to 45,000. Why? Because we bid $25,000. California says, 'I'll give you $30,000' and Illinois says, 'I'll give you $35,000' and Florida says 'I'll give you $40,000,'" Cuomo said during a press conference Saturday. "We're literally bidding up the prices ourselves."

Cuomo called on the federal government - or even states themselves - to get organized and eliminate private market competition.

"You can't have the states competing against the states, and then by the way, when the federal government goes out to buy the same equipment for their stockpile, now it's 50 states competing against the states and the federal government competing against the states," Cuomo said. "This is not the way to do business. We need a nationwide buying consortium."

Federal supply

The federal government says it is providing some relief. The U.S. Department of Health & Human Services announced last month that it would purchase 500 million N95 respirators over the next 18 months for the Strategic National Stockpile.

But, health care workers say they need the equipment now and a FEMA spokesperson acknowledges its Strategic National Stockpile can't fulfill every state and local government's requests.

Now, the government is relying on additional funding to "exhaust all means to identify and (obtain) medical and other supplies needed to combat the virus."

The Coronavirus Aid, Relief, and Economic Security Act, which was signed by President Trump last week, allocates $27 billion "for the development of vaccines and other response efforts, including $16 billion to build up the SNS with critical supplies, including masks, respirators, and pharmaceutics," according to FEMA.

U.S. governors join President Donald Trump at least once a week for a conference call about the latest on the coronavirus pandemic and where current supply of PPE stands.

Even when FEMA shares materials from its stockpile, it is sometimes only enough to get cities through a few more days and at times has left cities discussing the possibility of shutting down testing sites due to lack of supplies.

Amid the shortage, the federal government is encouraging the reuse of PPE and creating guidelines for how to adequately clean and recycle the equipment, including some items that healthcare professionals have said are typically intended for one-time use.

"There's no secret that the supply chain has taken quite a shock," W. Nim Kidd, chief of the Texas Division of Emergency Management said Tuesday. "When the governor has been talking to hospital CEOs, they're on a rationing program right now so that they don't completely run out. Where in normal days it might be one mask to one provider per each patient, CDC guidelines and the things that we're asking all of our responders and healthcare workers do is to at best, if possible, try to use one mask, per one provider per one shift."

During a press conference Monday, Trump said national companies across the U.S. are donating tens of thousands of pieces of PPE to FEMA and ramping up production. Hospitals across the U.S. are also accepting donations of this equipment to help meet supply demands.

Earlier this week, FEMA said 80 tons of PPE supplies were delivered to New York, New Jersey and Connecticut, which have become one of the U.S.' hotspots for cases. Supplies were also delivered this week to Chicago and FEMA says items will be distributed across the U.S. based on the greatest need, such as "areas experiencing the greatest increase in COVID-19 cases with the largest forecast capacity shortfalls."

But, cities say the materials aren't getting in the hands of healthcare workers quick enough.

Cohen said the pandemic is unlike any other natural disaster. It is taking over the entire U.S.; not just one localized region.

It's something FEMA is tasked and prepared to handle, he said, but the government was too slow to act, leaving critical need areas struggling to acquire equipment and establish hospital overflow areas.

"They were created to deal with situations like this and they're beginning to manage this disaster in the way that they prepared to do so. The only question I have is why did it take so long for the administration to activate FEMA at this level? This should've been done months ago," Cohen said. "We've lost time and when you lose time in a natural disaster or any type of public health crisis, people die."

Now, first responders and healthcare workers continue to put their own lives at risk to respond to the global crisis.

"This is an invisible threat," Pena said. "This virus is no joke."

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