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US Manufacturers Seek U.S. Help in Deciding Where to Ship Scarce Medical Goods

05:01  30 march  2020
05:01  30 march  2020 Source:   online.wsj.com

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Producers and distributors of medical supplies across the country are raising red flags about what they say is a lack of guidance from the federal government Company executives say they are ill-equipped to make decisions about which hospitals and states should first receive their medical supplies and

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WASHINGTON—Producers and distributors of medical supplies across the country are raising red flags about what they say is a lack of guidance from the federal government about where to send their products, as hospitals compete for desperately needed masks and ventilators to combat the spread of the novel coronavirus.

The issue is taking on greater urgency as supplies run short in hard-hit regions. New York City Mayor Bill de Blasio, for example, said the city could run out of supplies after a week, saying in a CNN interview the city would “need a re-enforcement” after that to address a crisis that is certain to last much longer.

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limiting medical services within predetermined levels which results in scarcity of medical resources. What trade-offs cannot be avoided in allocating scarce medical resources? focus on how some ppl fare relative to others → just when the is equal access to certain goods , when acces is necessary to

Company executives say they are ill-equipped to make decisions about which hospitals and states should first receive their medical supplies and are calling on the government to step in.

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“It’s really the allocation piece that’s most important to us right now because we just cannot and never will have a window into what the most urgent need is,” said Scott Whitaker, chief executive of the Advanced Medical Technology Association, a trade association that represents producers of medical devices.

Charlie Mills, chief executive of Medline Industries Inc., a large privately held manufacturer and distributor of medical supplies, said as the company works to ramp up its production of supplies, it is being inundated with orders. He said he would welcome the government having a “strong say” in how to respond.

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Manufacturing masks at a factory in Shanghai. The overwhelming demand for medical supplies has set off a race for much-needed goods from The White House is arranging for air transport to help expedite the shipping of personal protective equipment purchased by these companies overseas, the

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“All of our customers are wanting more,” Mr. Mills said. “The federal government might be in a better position to decide where it would go.”

Mr. Trump on Sunday met with executives from about a half-dozen medical supplies producers and distributors—including Mr. Mills—as well as executives from United Parcel Service Inc. and FedEx Corp., to discuss how to address the shortage of supplies.

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So far, the Trump administration hasn’t provided the companies with formal guidance about where to distribute their products, leaving them to make such decisions on their own. Hundreds of companies last week sent a breakdown of their inventories of masks, ventilators and other medical supplies to the Federal Emergency Management Agency, according to a document reviewed by The Wall Street Journal, and have been waiting for the agency to advise them on which areas are most urgently in need of supplies.

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loading goods from one means of carriage onto another. break-bulk. packing goods in small, separable units (упаковывать груз поштучно). bringing goods back to the manufacturer because of defects or for recycling. The supplier then creates a customized kit that is assembled and shipped as one unit.

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The White House referred a request for comment to FEMA. A spokeswoman for FEMA declined to give a timeline for when the agency would provide allocation guidance to companies. “We have been able to make connections with multiple companies, but due to the large volume of response, the task force is still reading through the offers,” she said.

Hospitals across the U.S. are running out of the masks, gowns, ventilators and other equipment they need to treat patients diagnosed with coronavirus and protect staff, say hospital officials, doctors and others in the industry. New York Gov. Andrew Cuomo has said that the state needs at least 30,000 ventilators. The Trump administration has prepared a protocol for how to split ventilators among multiple Covid-19 patients, according to two doctors working on it.

The administration has faced criticism in recent weeks from governors and health-care workers for its reluctance to make full use of the Defense Production Act, a Korean War-era law that allows the president both to order companies to prioritize the production of certain goods and to control where those goods are distributed.

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Governors have called on Mr. Trump to invoke the law to ensure not just production, but also the efficient distribution of scarce supplies to areas most in need, and to keep states from competing against each other for lifesaving equipment.

Producers and distributors of those supplies say that in the absence of guidance from the federal government, they have continued to send their regular shipments of medical supplies, without knowing whether those supplies are more urgently needed elsewhere.

The administration has broad authority to direct the allocation of such supplies. It could invoke the Defense Production Act to do so—but some companies say the law isn’t needed. They are prepared to follow the government’s guidelines without the law’s mandates, but so far such guidance has been scarce.

  Manufacturers Seek U.S. Help in Deciding Where to Ship Scarce Medical Goods © John Moore/Getty Images

On Friday, Mr. Trump for the first time during this pandemic invoked the DPA to order General Motors Co. to sharply ramp up the production of ventilators to treat coronavirus patients, saying GM was “wasting time” in negotiations. GM said it already was moving to make the machines as soon as possible. The president also appointed trade adviser Peter Navarro to oversee the government’s role in directing private-sector help in fighting the virus.

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But the president’s order to GM on Friday focused on production, not distribution. Earlier in the week, the Trump administration announced that Rear Adm. John Polowczyk would head up a supply-chain task force at FEMA intended to bolster the supply of medical equipment. He said the agency was working with companies to “make better allocation decisions and understand where it is and where it needs to go.”

FEMA officials told congressional committees in a telephone briefing on Wednesday that they had sought the data from distributors of medical supplies but suggested they lacked total control over whether to invoke the DPA to issue prioritization guidance to companies, saying the White House task force on coronavirus was involved in those decisions, according to a congressional aide.

On the call, administration officials said the White House had opted not to invoke the Defense Production Act to acquire and direct the distribution of supplies and equipment to certain areas because it hadn’t found the need, echoing remarks by the president in recent days. When officials were asked what the administration viewed as the threshold for invoking the law, they were unable to answer, the aide said.

“The Trump Administration’s refusal to use all the tools at its disposal to get critical supplies to frontline medical workers is its latest failure to address this public health and economic crisis,” said Sen. Ron Wyden (Ore.), the top Democrat on the Senate Finance Committee.

In a letter to FEMA administrator Peter Gaynor on Thursday, the head of the Health Industry Distributors Association asked the federal government to designate specific ZIP Codes, jurisdictions or care facilities as priorities to receive medical supplies.

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“I am writing to urge FEMA to provide the strategic direction needed to more effectively target PPE supplies based on greatest need,” wrote Matthew Rowan, the association’s president and CEO, referring to personal protective equipment. “The private sector is not in a position to make these judgments. Only the federal government has the data and the authority to provide this strategic direction to the supply chain and the healthcare system.”

“We understand prioritization is on your agenda,” he added, “but urge you to expedite the work.”

FEMA last weekend sent a spreadsheet to producers and distributors, asking them to identify their inventory of more than two dozen types of personal protective equipment—including N-95 masks, gloves, protective eyewear and hand sanitizer—as well as of ventilators, inhalers, tubing sets and Food and Drug Administration-approved testing materials. Among the information FEMA sought about the companies’ inventory was its current location and the destination of its planned shipments.

Company executives said they didn’t fault the federal government for not yet providing guidance on allocation, adding that they expected clarity soon. They said administration officials have been communicative and responsive to their concerns.

“The administration has been tremendous to work with on this,” Mr. Whitaker, of the Advanced Medical Technology Association, said, “and I think every company would echo that.”

Write to Rebecca Ballhaus at Rebecca.Ballhaus@wsj.com and Andrew Restuccia at Andrew.Restuccia@wsj.com

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