Due to the pandemic, a handful of acronyms known mostly to infectious disease specialists have now become household terms: PPE, PRC tests, and for those who follow politics, the DPA (Defense Production Act).
The DPA is a vital tool in helping the U.S. create a national strategy to respond to an emergency. It gives the President power to make private businesses produce supplies that can protect and defend American people, such as PPE. It can also be used to prevent price gouging on these supplies, such as the shocking 300% markups on N95 masks seen in California.
Can businesses make more PPE without the DPA? Yes, but they’re unlikely to do so if they don’t believe it’s profitable. Also, it’s hard for private businesses to know what types of PPE to make and how much, if there isn’t a central tracking system directing the effort. You can’t make enough gloves if one hand doesn’t know what the other is doing.
A recent article in the New York Times investigated the use of the DPA to respond to the coronavirus and found that it was not being used to its full capacity to fix the nation’s PPE shortage. As reported by the Washington Post, millions of dollars dispersed to the Pentagon through the DPA were given to defense contractors rather than to medical supply companies, as originally intended. What’s more, the DPA was deployed too late. In its reporting, the New York Times cited our PPE Shortage Index data for August, which showed that 77% of facilities reported that they have run out of at least one type of PPE — a huge problem as the country anticipates a second wave of coronavirus infections.
We created this quick DPA FAQ to clarify how the DPA can help get PPE production back on track, why PPE is crucial for national security, and what you can do to help.
What is the Defense Production Act?
The DPA was enacted in 1950, during the Korean War, but it has been used during the Cold War and for other means of defense, such as developing new technologies and combatting cyberespionage.
Can the DPA be used to increase PPE production?
Absolutely. PPE is one of the best weapons we have in the fight against coronavirus. And with the recent outbreak in the White House, which has now reached Pentagon leadership, it’s clear that PPE is an important national security tool.
It’s why Congressman Andy Kim, a member of the House Select Committee on the Coronavirus Crisis, asked Get Us PPE founder Dr. Megan Ranney to advise him on his report, The Way Forward: Preparing America For a Second Wave. This report proposes a national plan to address a number of challenges in advance of a widely predicted second wave of coronavirus outbreaks across the country. The report covers testing, contact tracing, and increasing the quality and production of PPE.
In the section “Utilize the Defense Production Act Effectively,” Congressman Kim writes:
“The federal government routinely invokes the Defense Production Act (DPA) to ensure the production and distribution of vital defense equipment. In May 2020, demand for PPE outpaced supply dramatically with two-thirds of front line health care workers unable to secure lifesaving face masks. Although private-sector companies began to voluntarily produce and supply equipment, these donations were inconsistent and haphazard. In order to ensure sustained and equitable access to vital defense equipment, the government should continue to leverage and more frequently invoke the DPA for the production of PPE. Increased use of the DPA for PPE production would strengthen domestic capacity to produce standardized, vital equipment and meet the needs of the population.”
Is there still a PPE shortage from the first wave?
Yes. It’s why we’re still here. Our PPE Shortage Index is following trends in these shortages, based on requests that our organization has received from all 50 states. Again, from the New York Times:
“Although the dire shortages of medical gear have eased since the early months of the pandemic, nursing homes, hospitals chains and doctors in private practice say they are still struggling to obtain the masks and gowns that can shield workers and patients from infection. Health experts fear a rise in coronavirus infections this fall and the return of seasonal flu could intensify demands for personal protective equipment, or P.P.E., most of which is produced in China.”
How much PPE do healthcare workers need?
Last May, Megan Ranney testified before the Select Subcommittee on the Coronavirus, to offer expertise as an emergency physician at the Brown University Hospital system in Rhode Island. During her testimony, she described how her hospital rapidly ran out of protective equipment:
“…we had done our best to build up our pre-existing stores of masks and gowns. However, by mid-March, as sick patients poured into our doors, our PPE ‘burn rate’ had gone through the roof and the supply chain had dried up. In normal times, we would dispose of our PPE — our gowns, gloves, masks, and so on — in between each potentially infectious patient, to keep ourselves and our patients safe. As our ERs and ICUs filled with patients, however, this meant that the average doctor or nurse would go through 40 or more masks in a day.”
By Dr. Ranney’s estimate, frontline healthcare workers needed at least 40 masks per day. But according to reports from around the country, clinicians were advised to reuse their PPE until it broke or became visibly dirty.
Leaders are now looking at plans to build up state and national PPE stockpiles to last up to 90 days. But if the next pandemic is managed like the current one, 90 days won’t cover it. In order to avoid shortages like this in the future, we have to build up our state and national PPE stockpiles: another good opportunity to use the DPA.
What happens when a hospital runs out of PPE?
When masks ran out at Dr. Ranney’s hospital, she and her colleagues were told to use bandannas, which don’t actually protect them against coronavirus. The National Nurses Union estimates that over 1,700 healthcare workers have died of COVID-19.
PPE shortages also resulted in difficult decisions about patient care. Again, from Dr. Ranney’s congressional testimony:
“Overnight, our emergency department was full of really, really sick patients for whom we had few treatments. Our patients were alone: no visitors were allowed. We healthcare workers were scared, both of getting sick ourselves and of failing our patients. Because of shortages of PPE, we couldn’t sit at the bedside and hold their hands. Because of lack of scientific knowledge and lack of supplies, we often couldn’t save them.”
And it’s not only hospitals that are affected by these shortages. Without enough PPE, other clinicians simply can’t work, which means that other important procedures, such as cancer screenings or other important exams, are off the table until the clinic obtains enough PPE.
What can we do?
There’s still time to use the DPA to get ahead of another crisis. Call your representatives and demand that the DPA be used to ramp up production of PPE. You can also donate to Get Us PPE, so that we can keep fulfilling requests from healthcare workers and providing donated PPE to those most in need. We also use your donations to fund local PPE makers, so that they can get supplies to essential workers in their community fast.
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