When the coronavirus pandemic took hold in an unprepared U.S., many states like Ohio scrambled for masks and other protective gear. Supplies were so limited in 2020 that the state bought millions of medical gowns from a marketing and printing company and spent about $20 million to try to get personal protective equipment made in-state.
Three years later, as the grips of the pandemic have loosened, Ohio and other states are now trying to deal with an excess of protective gear, ditching their supplies in droves.
With expiration dates passing and few requests to tap into the stockpile, Ohio auctioned off 393,000 gowns for just $2,451 and ended up throwing away another 7.2 million, along with expired masks, gloves and other materials. The now expiring supplies had cost about $29 million in federal money.
A similar reckoning is happening around the country. Items are aging, and as a deadline to allocate federal COVID-19 cash approaches next year, states must decide how much to invest in maintaining warehouses and supply stockpiles.
An Associated Press investigation found that at least 15 states, from Alaska to Vermont, have tossed some of their trove of PPE because of expiration, surpluses and a lack of willing takers.
Into the trash went more than 18 million masks, 22 million gowns, 500,000 gloves, and more. That’s not counting states that didn’t give the AP exact figures or responded in cases or other measurements. Rhode Island said it shredded and recycled 829 tons of PPE; Maryland disposed of over $93 million in supplies.
“What a real waste. That’s what happens when you don’t prepare, when you have a bust-and-boom public health system,” where a lack of planning leads to panicked over-purchasing in emergencies, said Dr. Georges Benjamin, executive director of the American Public Health Association. “It shows that we really have to do a better job of managing our stockpiles.”
The AP sent inquiries about PPE stockpiles to all 50 states over the past several months. About half responded.
States emphasize that they distributed far more gear than they discarded and have gone to lengths to donate the leftovers. Washington state sent hundreds of thousands of supplies to the Marshall Islands last year. Pennsylvania says it offered PPE to 10,000 cities, heath facilities and more throughout the pandemic. Both states still ended up throwing out loads of expired items.
Some states found limited post-expiration uses, such as training exercises.
Many states are keeping at least a portion, and sometimes all, of their remaining protective gear. Some, such as Minnesota, even plan to update their stockpiles.
But others say the vagaries of the pandemic and the PPE supply left no choice but to acquire the items, and now to throw them out, however reluctantly. Expiration dates are set to ensure the protection works as intended, and the Federal Emergency Management Agency has set the fair market value of expired supplies at zero dollars.
“Anytime you’re involved in a situation where you’re recalling how difficult it was to get something in the first place, and then having to watch that go or not be used in the way it was intended to be used, certainly, there’s some frustration in that,” said Louis Eubank, who runs the South Carolina health department’s COVID-19 coordination office. The state has discarded over 650,000 expired masks.
Before the coronavirus pandemic, health care product distributors typically kept 20 to 30 days of supplies. That wasn’t enough when the pandemic struck and demand skyrocketed for N95 masks, gloves and gowns. They became so scarce that some health care workers wore homemade masks and used trash bags for gowns.
The explosive demand triggered a surge — and ultimately a hard crash — for American PPE manufacturers. The AP found in 2020 that states spent over $7 billion in a few months on PPE, ventilators and some other high-demand medical devices in a seller’s market. Ultimately, the federal government paid for many of the supplies.
“There was no way to know, at the time of purchase, how long the supply deficit would last or what quantities would be needed,” Ohio Department of Health spokesperson Ken Gordon said.
Ohio distributed more than 227 million pieces of protective equipment during the pandemic. But as the supply crunch and the health crisis eased, demand faded, especially for gowns.
Now, “states, hospitals, manufacturers – everybody in the whole system — has extra product,” said Linda Rouse O’Neill of the Health Industry Distributors Association.
Given the glut, stockpiled items are selling for bargain prices, if at all. Vermont got $82.50 for 105,000 boot covers and 29 cents apiece for thousands of safety goggles.
The glut extends beyond states. Georgia’s Fulton County, which encompasses Atlanta, dispensed gloves, hand sanitizer and other supplies by the dozens of boxes at a public PPE giveaway in March.
New York City said it auctioned a heap of “non-medical-grade” PPE that was expiring or supplanted by better versions. Health Commissioner Dr. Ashwin Vasan told local lawmakers in May that officials would focus on enhancing supply contracts for future emergencies, rather than prioritizing “a static stockpile of commodities.”
Missouri’s mental health department planned but scrapped an auction of thousands of extra masks, gowns and other protective items bought with federal coronavirus relief money. The agency cited a belief that federal rules barred such a sale, but the U.S. Treasury Department later told the AP that states can sell excess PPE.
Supply chain chaos prompted some governments to place multiple orders, resulting in surpluses when the shipments belatedly arrived.
A New York state-run veterans’ home was so deluged by PPE deliveries in early 2021 that it stashed them under tarps in a parking lot. By the time a warehouse was arranged four months later, between $560,000 and $1.6 million of supplies were too damaged to use — and cost another $21,000 to incinerate, according to a state inspector general’s office report. Another $779,000 in expired items have been discarded.
Striking a balance between preparedness and surpluses is “a major dilemma” for governments, said Scott Amey of the Project on Government Oversight, a Washington, D.C.-based watchdog group. And while politicians vowed in 2020 never to be caught off guard again, “memories are short, budgets are tight,” Amey noted.
In Wisconsin, a legislative committee axed from the budget $17.2 million that would have funded a warehouse with an ongoing 60-day supply of PPE for two years.
The state Department of Health Services said it is now “demobilizing the warehouse” and trying to donate the supplies. Already, Wisconsin has tossed nearly 1.7 million masks and almost 1 million gowns.
In Michigan, a 2021 state law requires the state health department to keep a stockpile of up to two months of medical supplies, and the department’s website shows more than 38 million items on hand.
But one of the law’s sponsors, Republican state Rep. John Roth, said he now thinks “we have to take another look at it,” suggesting a one-month supply might mean less waste.
The Health Industry Distributors Association recommends that product distributors maintain a 60-to-90-day supply to guard against demand spikes. But the group says it’s probably unnecessary for everyone in the system — from manufacturers to doctors’ offices — to have such a large cushion.
Some government officials concur.
“It’s not really practical for most local health departments to have a large stockpile of materials for ‘just in case,’” said Adriane Casalotti of the National Association of County and City Health Officials. “They have limited budgets. They also have limited space.”
Pennsylvania officials are aiming for a 15-day stockpile after frank conversations about what they can afford not only to keep, but to keep replacing. Tens of thousands of cases of PPE already have expired and been slated for disposal.
“If we had unlimited federal funding, or even significantly more federal funding, for public health preparedness, that 60-day stockpile or 90-day stockpile would be a fantastic idea,” said Andy Pickett, the Health Department’s emergency preparedness and response director.
Meanwhile, Missouri’s health department has maintained a 90-day supply of PPE, based on the highest-demand months of the pandemic. It’s keeping even expired materials, presuming the federal government will OK their use in an emergency as it did for COVID-19. Missouri has insured the stockpile at $19 million.
“If you don’t make the investment – and perhaps the investment that is never used – then you may not be prepared to assist the public when it’s needed,” Missouri health director Paula Nickelson said.
Minnesota’s Department of Health was allocated some money this year for retaining and restocking PPE and is figuring out how much, while trying to condense the cache. For now, emergency response official Deb Radi says the agency expects to dispose of a few expiring gowns — items once so elusive that the state bought disposable raincoats instead.
“People might be critical that we have some excess supply right now, but they would have been way more critical if we were not trying to procure supplies at the time we needed them,” Radi said.
She hopes the federal government will examine how expiration dates are determined and whether they can be extended.
Chris Emory, who runs New Mexico’s Bureau of Health Emergency Management, suggests incentivizing suppliers to expand their stocks. Still, his state is hanging onto its PPE cache, after using masks left over from fighting the H1N1 flu when COVID-19 struck.
Nevada, meanwhile, can’t give its aging PPE away fast enough. Pallets of it are at or approaching expiration in a leased warehouse, Department of Administration Director Jack Robb lamented.
Nevada is endeavoring to shed expiring supplies safely and efficiently and not waste money, “but the bulk of this is going to end up in a landfill,” he said. Some already did.
But Robb said officials “made the best decisions that they could” when confronted with a disease that has killed nearly 7 million people worldwide, including some of his close friends.
“And I hope we never see anything like that again in our lifetime,” he said.
The mother of a transgender girl sobbed in federal court Wednesday as she contemplated having to move away from her Navy officer husband to get health care for her 12-year-old if Florida’s ban on gender dysphoria treatments for minors is allowed to take affect.
The woman, who testified as Jane Doe to protect the identity of her child, said her daughter went from being anxious and upset to a thriving, happy straight-A student after being allowed to live as a girl about eight years ago, a decision she made with her husband after multiple visits to their family’s doctor.
But as the girl approaches puberty, she fears she will start turning into a boy. Without treatment, she and her family will be devasted, the mother said.
“I will go to the end of the Earth to get my daughter the help she needs,” the woman testified through sobs as she pulled facial tissues from a box. “I think about, will our family get torn apart? Will we have to live somewhere else away from my husband?”
“This all started with the governor.” said Thomas Redburn, a lawyer representing trans adults and the families of trans children.
He noted other laws DeSantis has pushed to show the governor and Republican lawmakers have attacked transgender rights, including restricting the use of pronouns in schools that don’t match peoples’ sex at birth.
But lawyer Mohammad Jazil, representing the state, said the law is a matter of protecting people. He said in one case, a person was prescribed hormones after a 30-minute telehealth appointment. And other people have decided to detransition back to their birth sex and learned their treatment has caused permanent damage, he said.
“This case isn’t about overregulation, it’s about under-regulation,” Jazil said.
At least 22 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors, and many of those states face lawsuits. Courts have issued mixed rulings, with the nation’s first law, in Arkansas, struck down by a federal judge who said the ban on care violated the due process rights of transgender youth and their families.
Enforcement is blocked in two states besides Florida, and enforcement is currently allowed in or set to go into effect soon in seven other states.
Redburn said in opening arguments that the Florida law is unconstitutional because it singles out an entire group of people. He pointed out that non-transgender adults can receive the same treatments, such as estrogen and testosterone, without having to jump through hoops.
“The state of Florida has decided that people should not be transgender,” Redburn said. “The fewer transgender people, the better.”
The girl’s mother testified that their family’s pediatrician diagnosed her daughter with gender dysphoria after she began gravitating towards girls’ toys and clothes as a 3-year-old. She described her daughter screaming and tearing off her clothes in her car seat while being driven to preschool. She and her husband have made four-hour roundtrips to the University of Florida so their daughter can get care from experts.
As for risks like infertility that Jazil noted in opening statements, the woman said, “The benefits for my daughter far outweigh the potential of the risks. Her biggest fear is what she calls turning into a boy. I’ve assured her that won’t happen.”
Jazil only questioned the girl’s mother briefly, including pointing out that the University of Florida health records didn’t list a height and weight for Jane Doe’s daughter.
Redburn said gender dysphoria is real and not something people choose because of social media and the influence of the internet, as policymakers have argued. He pointed out that Republican lawmakers who pushed for the law described transgender people as evil and a cult. He noted that the bill’s sponsor argued that God doesn’t make mistakes.
Separately Wednesday, a lawsuit was filed by three educators challenging the law restricting pronoun use in schools, saying that transgender and nonbinary teachers are prohibited from being themselves.
Ironically, Jazil consistently referred to Jane Doe’s daughter as “her” and “she” despite the state forcing others to use pronouns that match birth sex in schools.
The trial over trans health care is expected to last five days.
Hunger remains a chronic problem in Asia, with 55 million more people undernourished in 2022 than before the COVID-19 pandemic, the U.N. Food and Agriculture Organization says in its latest assessment of food security in the region.
Most of those living without enough to eat are in South Asia, and women tend to be less food secure than men, the report says.
The FAO’s study focuses on food supply, consumption and dietary energy needs and is designed to capture a state of chronic energy deprivation that stunts growth and saps productivity and quality of life.
The share of people in the region suffering from such undernourishment fell to 8.4% in 2022 from 8.8% the year before. But that’s higher than the 7.3% of people who were undernourished before the pandemic began, sending some economies into a tailspin and depriving millions of people of their livelihoods.
Natural disasters and disruptions to food supplies, often linked to climate change, have added to those pressures.
The FAO data show the share of people in the region facing moderate food insecurity, uncertain of their ability to obtain food and having to sometimes eat less or poorer food due to a lack of money, or those experiencing hunger that puts their well-being at serious risk, still hovers near 30% for the world and above 25% for Asia and the Pacific.
The problem is worst for women: more than one in five women in Asia, excluding East Asia, face moderate or severe food insecurity. The rates are slightly lower for men in most regions, but in Southern Asia the gap grows to more than 42% for women and more than 37% for men.
Higher food, fuel, fertilizer and livestock feed prices mean that progress has stagnated after the pandemic reversed a longstanding trend beginning in the early 2000s toward alleviation of hunger.
It’s a global problem, made worse by disruptions to supplies of grain, edible oil and fertilizer partly due to the war in Ukraine.
Worldwide, the number of people having precarious access to food rose to nearly 2.4 billion in 2022 from just over 1.6 billion in 2015, the report said.
In Africa, the United Nations says at least three of every four Africans can’t afford a healthy diet because of an “unprecedented food crisis.”
More than half of the 735 million people who are nourished worldwide live in the Asia-Pacific, most of them in South Asia. But North Korea has the largest regional share of people who are undernourished, the report says, at about 45%, followed by Afghanistan at 30%.
The world average for undernourishment is 9.2%, while in the Pacific islands of Oceania, excluding Australia and New Zealand, it was nearly 21%, or more than one in five people. In Southern Asia, about 16% of people are undernourished, the report says.
Former U.K. Prime Minister Boris Johnson defended his efforts to balance the health and economic impacts of COVID-19 as he gave a second day of testimony Thursday to Britain’s public inquiry into the government’s response to the pandemic.
Johnson was grilled about his government’s “Eat Out to Help Out” program, which supported the hospitality industry by subsidizing restaurant meals, and delays in imposing a second national lockdown as infection rates began to rise toward the end of 2020.
Leading scientists have testified that they weren’t part of the discussions on the program and that it was obvious it would increase transmission risks. Johnson said he had no reason to question the restaurant initiative.
“I must emphasize, it was not at the time presented to me as something that would add to the budget of risk,” he said.
Johnson, who is testifying under oath, admitted Wednesday that he made mistakes in grasping the extent of the pandemic and that his advisers failed to sound a “loud enough klaxon of alarm” about the virus.
His remarks came after weeks of testimony by other ministers, including former Health Secretary Matt Hancock, who said they sought to raise the alarm inside the government. Hancock argued that thousands of lives could have been saved by putting the country under a lockdown a few weeks earlier than the eventual date of March 23, 2020.
The United Kingdom went on to have one of Europe’s longest and strictest lockdowns, as well as one of the continent’s highest COVID-19 death tolls, with the virus recorded as a cause of death for more than 232,000 people.
The inquiry is designed to uncover the lessons of COVID-19 to help officials better respond to future pandemics, but its revelations could further tarnish Johnson’s battered reputation.
Johnson was celebrated for delivering a landslide victory for his Conservative Party in 2019 but forced to resign as prime minister last year following a series of scandals, including revelations about boozy parties at his Downing Street offices while the country was locked down during the pandemic.
Four out of five people in Mexico who got influenza shots so far this year turned down the government’s recommendation that they get Russian or Cuban COVID-19 boosters at the same time, officials said Tuesday.
Assistant Health Secretary Ruy López Ridaura attributed the high refusal rate to people being reluctant to get two vaccines at the same time.
“People have a certain reluctance to get simultaneous vaccinations,” López Ridaura said.
But the population eligible for flu and COVID-19 shots — people over 60 and people with underlying health problems — are considered high-risk, and Mexicans in those groups had extremely high take-up rates for Covid vaccines in 2021 and 2022, according to the Health Department.
Some people appear to simply distrust the Russian Sputnik and Cuban Abdala vaccines, both designed in 2020 for variants prevalent at the time.
“It is an old antigen, it’s as if they were going to give me an influenza vaccine from 2020,” said Andreu Comas, a professor of medicine at the Autonomous University of San Luis Potosi. “There are no studies regarding the effectiveness of both of these vaccines against the (current) variants.”
Mexico has bought millions of doses of the Russian and Cuban vaccines. The original plan was to administer around 20 million shots, but only about 1.9 million people, or 9.5% of those eligible, have agreed to take them since the vaccination campaign started in mid-October.
In contrast, 10 million people got the influenza shot in the same period.
President Andrés Manuel López Obrador has been a big supporter of Cuba, hiring Cuban doctors, buying vaccines and construction materials from Cuba and supplying oil to the island.
Meanwhile, Mexico has held up approval for Pfizer and Moderna COVID-19 boosters, both of which were designed to work against the COVID variants currently circulating. While those shots have been approved for use in the United States since September, they may not be available for Mexicans until 2024.
Britain’s government was too late in taking action against the coronavirus during the first wave of the pandemic in 2020, the U.K.’s chief medical adviser said Tuesday.
Responding to questions about the U.K.’s actions in handling the early days of the COVID-19 pandemic, Chris Whitty told a public inquiry he felt he was more wary than others about the negative impacts of “shielding,” or isolation policies, school closures and lockdowns.
Whitty said he was concerned in particular about the longer-term impact such policies would have on the poorest people and those living alone, and described the difficulties in balancing the risks of introducing decisive measures “too early” or “too late.”
But he rejected suggestions by the inquiry’s lawyer, Huge Keith, that he had warned the government against “overreacting.” Rather, he said he made it clear to policymakers that “without action, very serious things would occur.”
“With the benefit of hindsight, we went a bit too late on the first wave,” Whitty conceded.
He said the U.K. should perhaps have “cottoned on” to a national lockdown being a possibility in the early days of the pandemic, but added that “there were no good options.”
“All the options were very bad, some are a bit worse, and some were very, very bad,” Whitty said.
Whitty, who remains the U.K.’s top medical official, was the latest to give testimony to the independent COVID-19 inquiry. The probe was ordered by former Prime Minister Boris Johnson in 2021 to scrutinize and learn lessons from the U.K.’s response to the pandemic.
Whitty became a household name during the pandemic, when he often appeared alongside Johnson and senior officials at daily televised government briefings on COVID-19.
The U.K. has one of the highest COVID-19 death tolls in Europe, with the virus recorded as a cause of death for more than 232,000 people. Many bereaved families say they were failed by politicians and policymakers whose actions contributed to unnecessary deaths and suffering during the pandemic.
The lengthy inquiry’s current phase focused on pandemic decision-making, and Johnson and current Prime Minister Rishi Sunak, who was Treasury chief during the pandemic, are both expected to give evidence at a later date.
The U.K. imposed a national lockdown, with a mandatory stay-at-home order, in March 2020, shortly after France, Spain and Italy imposed similar measures.
