A U.S. National Guard soldier wearing personal protective equipment (PPE) wait for patients to arrive to a drive-thru testing center for coronavirus at Lehman College on March 28, 2020 in the Bronx, New York City. The center, opened March 23 at Lehman College, can test up to 500 people per day for COVID-19.
Nursing home workers raise alarm about lack of supplies
03:41 - Source: CNN
CNN  — 

The Trump administration’s highly publicized effort for expediting critically needed medical supplies from overseas in response to the coronavirus pandemic will have cost taxpayers upwards of $122 million and only served a fraction of states’ needs when it ends in the coming weeks.

US Navy Rear Admiral John Polowczyk announced this month that the initiative, known as “Project Airbridge,” is preparing to wind down, marking an end to an effort that launched on March 29. But while cited by the administration as a success, the deliveries made up a small share of supply needs and the final destination of some supplies remain difficult to account for.

In late March, the federal government partnered with six major US distributors to rush equipment overseas to the United States. The Federal Emergency Management Agency covered the cost of flights, averaging between $750,000 to $800,000 each, and six companies – Cardinal Health, Concordance, Owens and Minor, McKesson, Medline, and Henry Schein – distributed the equipment in the US.

Project Airbridge accelerated the shipment of supplies from weeks to days and got supplies straight to the frontline workers, according to FEMA Administrator Pete Gaynor. It was intended to expedite products at a time when the country faced dire supply shortages. Half of the supplies flown in went to designated hotspot areas and the other half went to distributors’ customers, some of whom might also be in those critical areas.

CNN requested documents, through the Freedom of Information Act, regarding FEMA’s prioritized hotspot areas and the agreements between the federal government and US distributors. FEMA has not responded.

President Donald Trump repeatedly heralded Project Airbridge, a nod to transporting via air, and listed off the number of chartered flights and supplies coming in during regular news conferences.

Trump has described the initiative as an “amazing success,” “incredible to watch,” “a military operation,” “very successful,” and a “sweeping airlift operation.”

During a news conference on April 15, Vice President Mike Pence said the average daily delivery through Airbridge was 22 million facial masks. But according to a FEMA advisory released a day prior, 25.7 million surgical masks had been delivered in a span of weeks, from March 29 to April 13, not in one day.

Gaynor has said Airbridge was intended to “supplement, not supplant America’s PPE supply chain.”

Over the course of 163 flights, the initiative has brought in nearly 1.4 million N95 respirators, 937 million gloves, 103.8 million surgical masks, 23.3 million gowns, more than 2.4 million thermometers, more than 2 million face shields, 654,000 coveralls, 109,000 stethoscopes, 370,000 oxygen masks and more than 160,000 cannulas, according to FEMA.

There are an additional 56 flights scheduled or in transit as of May 22, according to the Department of Homeland Security.

Still, the effort continues to be a point of a contention between the administration, lawmakers and governors given concerns over the lack of transparency into the effort. Products didn’t pass through state hands instead going directly to health systems, making supplies difficult to track at a time when states were pleading for equipment.

‘We have no visibility on delivered PPE’

Illinois Gov. J.B. Pritzker, a critic of the administration, repeatedly expressed concern over Project Airbridge.

“What they are taking credit for, the White House, is that the distributors have customers in Illinois that they are sending goods to because those customers ordered those items of PPE, so that’s a far cry from delivering to the states so that we can distribute,” said Pritzker, a Democrat, in late April.

Weeks later, the state is still not aware of what’s been brought in through the initiative, said Rebecca Clark, communications manager of Illinois’ Emergency Management Agency.

The lack of clarity has been a source of frustration among lawmakers and some states.

Democratic Sens. Elizabeth Warren and Richard Blumenthal called on the companies involved in the effort to provide “an explanation for how these supplies are obtained, priced, and distributed through Project Air Bridge.”

In a statement to CNN, Democratic Rep. Ted Deutch of Florida, who’s previously raised concerns about the initiative, said, “I’m still hearing from doctors and nurses who are having to reuse protective gear day after day. We have to make sure that this life-saving PPE is actually getting into the hands of people who need it.”

“We shouldn’t have to take FEMA’s word for it. Transparency should be driving everything we do so that the public has confidence that it’s being done right,” Deutch added.

As of May 21, Project Airbridge had delivered a total of nearly 1.4 million N95 respirators, which pales in comparison to some requests made by individual states. Michigan, for example, requested roughly 20 million N95 respirators from the federal government in late March.

“As state government was not involved in receiving or distributing items shipped via Project Airbridge, we have no visibility on delivered PPE,” said Dale R. George, public information officer for Michigan’s Emergency Management and Homeland Security, in a recent email.

During a press conference on April 23, Trump said Pence would provide governors with an “exhaustive county-by-county breakdown” of the PPE distributed by private companies in each state.

“This way, the governor should know exactly what’s being delivered through a private-sector supply chain within their states, as well as through the Project Airbridge,” Trump said.

But the breakdown of PPE deliveries provided to the states by the administration didn’t specify what exactly came in through Airbridge.

“The spreadsheet we have received includes both Project Airbridge and ‘additional commercial supply chain acquisitions,’ and does not distinguish between the two,” said Casey Katims, federal liaison for Washington state.

Asked why data was not split between commercial PPE distribution and Airbridge, FEMA said, “Airbridge supplies are commercially procured PPE. Data provided to states included Airbridge supplies in addition to other commercially procured PPE.”

Airbridge prepares to ramp down

Polowczyk announced this month that the initiative, launched in late March, will come to a close in the coming weeks.

“We believe we’ve gotten the volume that we’ve needed to effectively — what I call, prime the pump — to get more supplies here to beat the ocean-going method,” Polowczyk told reporters, adding that there may be items needed in the future that they’ll consider flying in on an individual basis.

The volume of supplies, cited by Polowczyk, includes all the ways personal protective equipment has been procured by the federal government and the private sector, combined, according to FEMA.

Distributors involved in the effort are preparing for Airbridge to wind down. At least two of the major distributors have pending deliveries of personal protective equipment coming through Airbridge until the first week of June, according to sources familiar with the schedules.

Sources say demand is high but has become manageable.

“Demand continues to be high across many categories, PPE especially. However, we have seen a leveling off from the initial Covid-19 spikes,” according to a source familiar with Project Airbridge.

According to the source familiar with Airbridge, distributors received county-level data every few days. “They do provide those major geographic areas as well a long list of counties that are most impacted within those,” the source said, referring to hotspots.​ FEMA has said that it determines hotspot areas based on CDC data.

Another source concurred, noting that “supplies are in a much better place” than they were weeks ago, allowing distributors to revert back to transporting goods by sea versus air.

Addressing supply distribution generally, Gaynor has said the agency’s “strategy includes using quantitative data, down to the county level provided by FEMA, HHS and the Centers for Disease Control and Prevention, FEMA’s National Resources Prioritization Cell combined…and analyzes the available Covid-19 disease activity to determine current and potential future areas that most urgently require resources.”

The origins of Airbridge

The framework for what’s now known as Project Airbridge was originally conceived in late March by an assistant professor at the Massachusetts Institute of Technology and member of the Covid-19 Policy Alliance amid growing concerns over supply shortages.

The proposal, put together by Valerie Karplus, outlined how employing US passenger and freight aircraft to bring in supplies would shorten the time it takes for them to arrive.

“Within four weeks, with doubled aircraft capacity relative to pre-virus levels and additional production ramp up in China, we could meet 50% of projected U.S. demand for masks and suits,” the memo reads.

Karlpus sent the memo, titled “Proposal: A Medical Supply Airlift to Protect the U.S. from COVID-19,” to airlines, lawmakers, and the administration.

“I spoke by phone with Admiral Polowczyk and we talked in detail through the elements of the plan and he sounded really receptive,” she said. Five days later, Karplus learned the plan was being put in motion, but the allocation of product would be done by distributors, instead of the federal government working closely with states.

On March 29, senior executives from major distributors met with Trump and Pence to discuss the response to coronavirus. That day the first flight arrived via Project Airbridge.