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A Depleted Strategic National Stockpile in a Time of Need

The Strategic National Stockpile was born out of bioterrorism fears and initially included supplies to respond to such an event but evolved to include supplies for other disasters like floods, tornadoes and pandemics.

As states resort to a variety of means and sources to procure the necessary equipment needed to respond to the coronavirus, questions about the role of the Strategic National Stockpile have arisen.

Washington state, like so many other states, has experienced a “dire shortage” of life-saving medical supplies and has loosened contracting rules and recruited volunteers from the private sector to aid with procurement, according to a Seattle Times story today.

Stockpile experts have said for years the country is not ready for a pandemic and would face shortages of equipment as is the case now. So where does the Strategic National Stockpile come into play?

“The stockpile, when it was developed, was as a supplement to state and local supplies during different types of public health emergencies. It was never meant to be the sole source of supplies,” said Deborah Radi, manager of public health emergency preparedness for the Minnesota Department of Health. “It wasn’t designed for a whole pandemic like we’re facing now.”

The Strategic National Stockpile was born out of bioterrorism fears and initially included supplies to respond to such an event. It evolved over the years to include supplies that might be needed to respond to disasters like floods and tornadoes and included equipment for pandemics, such as ventilators and masks.

It was tapped after the H1N1 flu virus response on 2009 but not restocked.
“People who somehow believed it was a bottomless pit filled with everything they can imagine were not paying attention,” Tara O’Toole, a physician and former Department of Homeland Security official, told CNN this week.
Like other issues in emergency preparedness and homeland security, interest, and thus funding, spikes after an event and then wanes as the public loses interest. This happens to the stockpile resources as well.

“Every time we have a really large incident, whether it’s COVID-19 today or the H1N1 and everything in between, everyone starts thinking about having stockpiles and caches in our warehouses,” Radi said. “States will do that for a while, but they’ve run into the same problem in that it’s expensive to maintain caches.”

“You have an increase in funding when you have a national event and then it goes back down, which depending on which state you’re in and how much funding you get isn’t always something you can maintain,” she said.

The competition in the United States for personal protective equipment during the coronavirus pandemic is such that if one first responder gets an N-95 mask, it means that someone elsewhere, a first responder or health-care worker, missed out on it.

“It’s a quandary when people say, ‘Well the federal government should buy all this stuff,” Radi said. “That is an option but then that takes it out of the supply chain for hospitals and other health-care facilities that would be purchasing. Which is better, not buying everything up and keeping the supply chain going for health care or do what they’re trying to do now which is a combination of alternate sources that may be outside of the supply chain?”