Face masks in the national stockpile have not been substantially replenished since 2009
The H1N1 influenza pandemic of 2009 triggered the largest deployment in U.S. history of the Strategic National Stockpile, the federal government's last-resort cache of drugs and medical supplies. The stockpile distributed 85 million N95 respirators - fitted face masks that block most airborne particles - along with millions of other masks, gowns and gloves.
The gear to protect medical personnel came from multibillion dollar emergency funding authorized by Congress in 2007 and 2009, leading to calls for the government to better prepare for the next outbreak.
The trade group for manufacturers of personal protective equipment in mid-2009 urged "immediate action" to restock N95 masks. The International Safety Equipment Association warned of "significant shortages" if another pandemic caused demand for masks to surge.
A nonprofit representing public health agencies, the Association of State and Territorial Health Officials (ASTHO), echoed industry's appeal in a 2010 report funded by the federal government, recommending the repository of masks be "replenished for future events."
But the stockpile's reserves were not significantly restored after the 2009 pandemic, in the view of industry and public health experts. With a limited budget of about $600 million annually, officials in charge of the stockpile focused on what they say was a more pressing priority: lifesaving drugs and equipment for diseases and disasters that emerged before the new coronavirus, which has no vaccine or specific anti-viral treatment.
"In hindsight, it appears to be shortsighted," said Gerrit Bakker, ASTHO senior director of public health preparedness. "It's an issue of, 'Will there be any (masks) left when they get to me? And if the stockpile won't have enough for my state, what am I going to do?' "
The limitations of the stockpile - valued at $7 billion - reflect challenges in what many experts say is an underfunded public health system that leans toward smaller inventories to hold down costs and looks to fast-moving private supply chain when crises emerge. Public health and emergency preparedness officials also say the stockpile's budget lags behind the expanding threats of the past two decades - from terrorist attacks, to natural disasters to deadly infectious diseases.
The Department of Health and Human Services said last week that the stockpile has about 12 million N95 respirators and 30 million surgical masks - 1% of the estimated 3.5 billion masks the nation would need in a severe pandemic. Another 5 million N95 masks in the stockpile are expired.
Robert Kadlec, HHS assistant secretary for preparedness and response, mistakenly told a Senate committee last week that the stockpile held 35 million N95s. "It strikes me we should have substantially more," said Sen. Mitt Romney, R-Utah, before health officials corrected Kadlec's error, saying there only one-third that many.
HHS announced last week that it planned to buy 500 million N95 masks over the next 18 months. To spur private industry, the government is guaranteeing that it will buy them even if coronavirus dissipates and hospitals cancel orders.
Bids are being accepted through March 18, but masks are already in high demand. On Tuesday, the Centers for Diseases Control and Prevention loosened its guidelines to match generally those of the World Health Organization, which recommends respirators only for procedures that cause the patient to cough, sending tiny virus particles into the air. "Facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand," the CDC said in a statement that is expected to unsettle health-care workers who have been trained to use the more protective gear during contagions.