On Monday, the Government Accountability Office released a Covid-19 report that found several problems in the current federal effort to combat the pandemic, including shortages in the medical supply chain and inconsistent reopening guidelines.
As of the report’s publication, the Federal Emergency Management Agency has open requests for more than 139 million nitrile gloves, 11 million surgical gowns, and 6 million N95 respirators. These supply gaps won’t be filled immediately — the supply of N95 respirators, for one, isn’t expected to catch up to demand until January 2021.
The report finds that these shortages have led to dangerously short supplies in at least 20 percent of nursing homes and that more than 80 percent of nurses in these facilities have reused masks. Nursing homes have experienced some of the most serious outbreaks, with long-term care facilities accounting for more than three-fifths of all coronavirus deaths in the country.
Shortages also extend to testing equipment. Seven of eight state officials whom the GAO interviewed in July and August identified previous or ongoing shortages of testing supplies. Testing supply shortages have contributed to delays in processing test results, which in turn have delayed contact tracing and isolating those who tested positive, exacerbating outbreaks.
Yet as these constraints persist, the GAO found that FEMA and the Department of Health and Human Services have not developed plans for federal actions to help mitigate remaining medical supply gaps. HHS officials even disagreed with some of the report’s recommendations and said they could not take corrective action without knowing the identities of the officials quoted in the report. The GAO responded that HHS should focus broadly on filling supply-chain gaps.
States have also struggled to obtain existing supplies from the federal government. Officials from multiple states described challenges such as not knowing when supplies would be delivered, not being able to track deliveries (with the federal government not providing information about which facilities received which supplies), and even supplies going to the wrong place. According to the report, state officials have also been given unclear directions regarding reimbursements for purchasing supplies, which makes it difficult for them to budget for ongoing needs.
States are also struggling to create coronavirus containment plans due to inconsistent and even conflicting guidance from the Centers for Disease Control and Prevention. For example, on the topic of reopening K-12 schools, some CDC guidance recommends daily symptom screenings, while others do not. Similarly, one guidance says not to close the entire school if a student or staff member tests positive, while another advises schools to close for two to five days.
Finally, the CDC lacks a comprehensive mechanism to assess the long-term health outcomes of people who have had the coronavirus. Although the CDC is funding several studies, the report notes that they “are limited to specific groups and time frames, so they are not able to identify long-term health outcomes across other population subgroups that are not included” — especially important given that coronavirus case disparities between different racial groups have been well documented.
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