By Rich Lowry
Sunday, April 19, 2020
At a coronavirus-task-force briefing at the beginning of
April, White House adviser Jared Kushner explained the approach that would — as
events proved — get the country through its ventilator crisis.
He was relentlessly pilloried, mocked, and distorted in
the press for it.
After nearly four years of unrelieved Trump hysteria in
the media, it’s hard to rank the worst journalistic outrages, but how Kushner’s
remarks were misreported and misinterpreted belongs high on the list.
Much of the press coverage and subsequent commentary focused
on one sentence at that April
2 briefing: “The notion of the federal stockpile was it’s supposed to be
our stockpile. It’s not supposed to states’ stockpiles that they then use.”
Cue the outrage. As CNBC put it, correctly, in a
headline, “Jared Kushner slammed for saying the federal medical supply
stockpile isn’t meant for states.”
The blue-checkmarks on Twitter descended in force.
Representative Ted Lieu tweeted, “Dear Jared Kushner of the @realDonaldTrump:
We are the UNITED STATES of America. The federal stockpile is reserved for all
Americans living in our states not just federal employees. Get it?”
Former director of the United States Office of Government
Ethics Walter Shaub thundered, “Who the hell does the nepotist think ‘our’
refers to? It is for the American people.”
Partisan outlets piled on. “Jared Kushner, President
Donald Trump’s son-in-law and White House adviser,” Salon wrote,
“claimed that the federal stockpile of medical supplies is not for individual
states to ‘use,’ even though that is exactly the reason why the stockpile
exists.”
And so did mainstream outlets. ABC News rapped Kushner
for his “inaccurate description” of the stockpile, which “actually is intended
for states’ use.”
In a piece for The New Yorker, Susan Glasser went
even further. She wrote that the press briefing “will surely go down as one of
the Administration’s most callous performances.” It was symptomatic, she
argued, of a federal response that was a “failure by design — not a problem to
be fixed but a policy choice by President Trump that either would not or count
not be undone.”
All of this was completely ridiculous and wrong. With
even a little context, it was obvious what Kushner was saying: States shouldn’t
be drawing on the federal stockpile just to hold ventilators in their own
reserves while hard-pressed cities were running low.
This was obvious from the very next sentence from
Kushner: “So we’re encouraging the states to make sure that they’re assessing
the needs, they’re getting the data from their local — local situations and
then trying to fill it with the supplies that we’ve given them.”
The proximate reason for Kushner’s comment about the
state stockpiles was a dispute between the Trump administration and New York
governor Andrew Cuomo. New York City was running out of ventilators. The
administration had sent 4,400 but learned that 2,000 of them were being held by
the state and hadn’t made their way to the city.
The controversial sentence was part of a long answer
setting out the administration’s strategy on ventilators that has, despite all
the hue and cry, clearly worked. The emphasis — with Jared Kushner and his team
in the middle of it, and capable leadership from Rear Admiral John Polowczyk at
FEMA and Admiral Brett Giroir at HHS — was on data and shrewd allocation, so
that ventilators did not go to states simply on request.
There’s no doubt that the lockdowns, in bending the curve
of cases downward, have played a role in averting any shortage — one of the
points of the lockdowns in the first place, of course. But there was no
guarantee that we would get to this place where we are today, with ventilators
no longer a significant worry.
At the outset, the country was looking at a daunting,
perhaps impossible challenge. A chilling briefing at FEMA early on posited that
the U.S. could be short 130,00 ventilators by April 1. The federal government
had about 16,000 ventilators on hand in its stockpile and several thousand more
from the Veteran’s Administration and the Department of Defense.
It was possible the government could perform at the
highest level — and still fall short. A couple of insights drove the
administration’s effort to get its arms around the problem.
Officials realized, as one White House adviser puts it,
that there was “too much guesstimating” going on. New York, for instance, said
it needed 40,000 ventilators. Then, the administration interrogated the
request. What was that based on? It’s coming from public-health officials.
Okay, how are they getting that number? Models. Plus, we don’t want to be
short.
It became clear that many governors didn’t know how many
ventilators their states had, and they were driven by early models that were
“doomsday scenarios,” as one senior administration official puts it. Governors
were also acting on the normal impulse to want to be safe, and have more than
enough ventilators on hand, just in case. “If you are a governor, which is
natural, you are going to over-ask because you want to be over-prepared,” the
official explains.
A data team drawn from various government agencies and at
the White House was created to get to the truth on the ground. It used hospital
billings at the Centers for Medicare & Medicaid Services to estimate how
many ventilators were in each state and how many were being utilized on any
day, giving administration officials a more granular picture of what was happening
in states than many governors had themselves.
Another important realization was that FEMA could do
just-in-time delivery. It could get states and hospitals ventilators within 24
or 48 hours. This created a lot of flexibility. The administration could wait
to see how things really played out rather than making decisions based on
models that forecast what the demand might be two weeks in the future. “When
you started looking at it like that,” the official says, “the numbers went down
dramatically.”
And this is the key thing: The strategy was based on not
sending states what they requested on their say-so. That was the opposite of
the normal FEMA operating procedure. Usually, state and counties ask for things
in a natural disaster, and FEMA sends them along as a matter of course. With an
epidemic threatening the entire country, that way of doing things would have
exhausted the federal resources immediately.
This also meant that much of the press coverage get it
exactly backward. The media portrayed as an inherent failure the fact that the
administration gave states a portion of their requests. (“Trump sent Arizona a
fraction of the ventilators it sought,” a Vox headline said.
“Republicans still framed it as a big win.”) In reality, not giving governors
what they wanted was integral to the success of the overall operation.
If, for instance, the administration had tried to fulfill
New York’s initial stated need for 40,000 ventilators, everything would have
gone out the door to New York, and for no good reason. There was immense
political pressure to send the ventilators anyway, although it would have been
a mistake. “In the moment, that wasn’t 100 percent clear,” says the senior
administration official. “There was a lot of pressure to send them all, because
the pressure is basically, ‘How is it going to look if you’re holding in a
stockpile and people need them?’”
None of this is to say there weren’t real needs in New
York and New Jersey. Some 8,000 ventilators were sent out from the reserve,
many of them to those two places, which were at times operating on very thin
margins.
Another insight was that most ventilators out in the
country weren’t being used, since the virus hot-spots were geographically
limited. That meant there was a tremendous capacity to be tapped. This led to
the Dynamic Ventilator Reserve. States and hospitals with a safe margin of
ventilators not in use could lend them to places that needed them.
The lubricant for the system was a federal guarantee that
a hospital lending a ventilator would get a replacement in 24 or 48 hours if it
turned out that it needed it back. This removed the fear and the risk of giving
up ventilators. It also allowed the administration to effectively leverage in
the here and now the ventilators that it will have in the future, when
production ramps up. “A ventilator today is more valuable than a future
ventilator,” the White House adviser explains.
As for the future ventilators, FEMA acted quickly — much
faster than is possible in the regular process — to get so-called notifications
to purchase to ventilator manufacturers, so they could start work and hold
their inventory, which ensured it wasn’t lost to foreign countries. The Defense
Production Act was invoked with General Motors to get production moving as
quickly as possible, and not back-loaded later in the summer.
Last year, according to administration figures, the
country produced 30,000 ventilators. This year, it’s going to produce something
on the order of 200,000, and they are already coming in. “The balance now is
growing daily,” the White House adviser says of the federal stockpile. “We are
going to be swimming in ventilators.”
By any measure, that’s a success, certainly compared with
where we thought we’d be less than a month ago. If the media weren’t so devoted
to gotcha idiocy, more people might know about it.
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