Giving Compass' Take:

• Sean Illing interviews Andrew Lakoff about the history of the national stockpile and why it was not appropriately prepared for COVID-19.

• How can funders work to fill the gaps left by the stockpile? What can be done to better prepare the stockpile for future emergencies? 

• Read about strengthening public healthcare

Sean Illing
The entire world has known something like coronavirus or a comparable flu pandemic was inevitable for decades. Why weren’t we prepared for this?

Andrew Lakoff
On the one hand, there are a range of different threats that come to the center of planners’ attentions at different moments and there are different factors as to why one threat rather than another is prioritized. A tremendous amount of money has been spent on things like having enough doses of smallpox vaccine to inoculate the entire United States population, or on acquiring thousands of caches of nerve gas antidote.

So choices are constantly being made about which are the most dire threats given a limited amount of resources. Then as it turned out, the event was not a smallpox attack, it was not nerve gas. It was a coronavirus and it wasn’t pandemic influenza. And in terms of pandemic preparedness, a lot of the effort focused on rapid vaccine development and on stockpiling antiviral medications that are known to be effective against influenza.

Sean Illing
But pandemic influenza would require medical equipment like ventilators and masks just as a coronavirus pandemic does, so it still boggles the mind that we weren’t prepared.

Andrew Lakoff
Right, and there were strong recommendations that the stockpile increase its supply of those things for years but it just didn’t happen.

One thing that happened is that after the 2009 H1N1 pandemic there were a lot of masks distributed to states and localities and they simply weren’t replenished. Then there was a plan to purchase thousands more ventilators. A contract was signed with a small medical equipment company in Southern California. That company was then bought by a different medical equipment company, and in the end the contract wasn’t fulfilled. The new ventilators never came in.

So there are these matters of prioritization and inattention that can affect whether in fact we have the supplies that have been recommended in the stockpile.

Sean Illing
Again, who’s responsible for that failure? Who decided not to replenish those supplies?

Andrew Lakoff
There are probably different stories in each case. In the case of ventilators, it’s partly about how the medical industry changed over the last decade. But more generally, it is up to the officials who manage the stockpile to make decisions about where to invest their resources and whether they have enough of a given item. I imagine that we’ll be learning more in the coming weeks and months about how certain decisions were made.

Read the full article about the national stockpile by Sean Illing at Vox.