S.C. medical stockpiles big enough for future health emergencies?

June 12, 2020

Investigative Reports

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By RICK BRUNDRETT

Whether South Carolina has enough medical supplies to deal with the next possible wave of the coronavirus – or other future health emergencies – is a matter of debate.

As of early last month, the federal government had provided nearly 154 million personal protective equipment items – mostly surgical and exam gloves, along with medical masks, face shields and gowns – to South Carolina in response to the COVID-19 outbreak, U.S. Congressman Joe Wilson listed in a tweet.

At the same time, many South Carolinians were scrambling to find basic things such as hand sanitizer and masks.

A Federal Emergency Management Agency spokeswoman confirmed Congressman Wilson’s numbers, and provided records to The Nerve showing that nearly all of items provided by the federal government to the state were purchased through the “global market place,” with less than 1% supplied from the Strategic National Stockpile.

But what’s still not publicly known after three months of the coronavirus outbreak in South Carolina is exactly how much of the federally provided personal protective equipment (PPE) made it down to the local level, and how much of it is being kept in reserves by the state.

In COVID-19’s wake, the S.C. Emergency Management Division (SCEMD) has fielded more than 2,700 requests – mostly for PPE items – an agency spokesman recently told The Nerve, though noting most hospitals currently can get needed items through normal supply channels.

President Donald Trump in early April called on states to build their own PPE reserves. In its final report released on May 28, an advisory committee called “accelerateSC,” created by Gov. Henry McMaster to make recommendations about the state’s coronavirus response, proposed a “coordinated effort to purchase PPE in bulk quantities and maintain a backup supply in the case those resources are exhausted.”

The report, however, gave no specifics about what or much was needed for a state stockpile.

In a letter Wednesday to legislative leaders, McMaster recommended that up to $17 million of $1.9 billion in federal coronavirus aid to the state be used by the SCEMD to create a 28-day state PPE stockpile for “front-line health care workers and first responders of state agencies and local governments.”

Lawmakers are planning to return to Columbia later this month, reportedly to decide how to spend the $1.9 billion in federal aid. It’s unclear whether they also will decide then to tap a special $155 million state fund, created out of an existing state surplus, to respond to the COVID-19 outbreak.

FEMA spokeswoman Debra Young in an email response last week to The Nerve said the SCEMD and state public health officials helped to “prioritize” distribution of the provided federal supplies to “local governments, public health offices and communities.”

In his May 20 tweet, Congressman Wilson said “President Trump and Congress are delivering for South Carolina,” listing the following federally sourced PPE items as of May 8:

  • 147,206,600 surgical and exam gloves;
  • 4,108,700 surgical and procedural masks;
  • 2,013,200 isolation and surgical gowns;
  • 355,900 N95 masks;
  • 124,200 eye and face shields.

As of Tuesday, the state Department of Health and Environmental Control (DHEC) had the following medical supplies on hand, according to records released under the state Freedom of Information Act:

  • 32,350 surgical masks;
  • 7,598 goggles;
  • 6,220 N95 masks;
  • 5,500 gloves;
  • 4,283 coveralls;
  • 2,324 full face shields;
  • 1,450 gowns;
  • 1,000 safety glasses;
  • 4 gallons of hand sanitizer.

DHEC noted it had no ventilators on hand.

Unanswered questions

S.C. Emergency Management Division chief spokesman Derrec Becker didn’t respond to written questions this week from The Nerve asking, among other things, how many of the federally provided PPE items were distributed to state agencies or counties, and the planned size of a state PPE reserve.

The accelerateSC report noted the Strategic National Stockpile (SNS) was “not able to meet South Carolina’s needs during the COVID-19 pandemic,” recommending that the state “contract out for an analysis of various options to develop a state-level strategic stockpile of personal protective equipment, testing supplies, and other appropriate material.”

The State Fiscal Accountability Authority last month provided The Nerve with records showing a total of $49.5 million in projected expenditures – mostly PPE items – by the SCEMD in response to the coronavirus outbreak. Becker said $9.1 million of that amount had actually been spent.

But Becker declined then to give any specifics on the spent $9.1 million, referring The Nerve to the state Comptroller General’s Office. He also declined – even after a formal open-records request was submitted – to identify which counties in the provided records had requested or received PPE items from the state, directing The Nerve to contact individual county emergency management officials.

The provided records show that the Louis Berger Group, based in New Jersey and described on its website as a “top-20 ranked, global professional services corporation that helps clients solve their most complex infrastructure and development challenges,” would receive the single-largest projected amount – $22 million – out of the $49.5 million in overall estimated costs.

Becker in a May 26 written response to The Nerve said the SCEMD had made no payments to the company, and described the business as a “disaster contracting firm that supports emergency logistics as needed,” adding it “would have been the main firm building emergency hospitals and transporting patients as needed.”

The company did not respond to a written request this week from The Nerve seeking comment.

The S.C. Comptroller General’s Office released records to The Nerve showing a total of $9.6 million in coronavirus-related payments by the EMD to more than 50 vendors as of May 27. Of that amount, more than $2.1 million – the single-largest amount – was paid to Florida-based Aventura Engineering LLC, followed by $1.4 million paid to the COVID-19 Response MFG LLC, based in New York, records show.

Aventura Engineering is described in state records as providing, among things, cleaning services at parks and rest areas, while the COVID-19 firm was listed as supplying PPE items.

In a written response Wednesday, Vadim Gordin of the COVID-19 Response firm, also known as Response PPE, said the company manufactures and sells clinical face shields, noting, “On several occasions, SCEMD reached out to us to purchase other types of difficult to find PPE that we could source on account of being located in NYC.”

Representatives of Aventura Engineering did not respond to a phone message this week seeking comment.

Big PPE spender

Statewide, a total of $77.8 million was spent on PPE items as of May 27, according to the accelerateSC report. Of that amount, $56.8 million, or about 73%, was spent by the Medical University of South Carolina Health system, with the remainder split among cities, towns, counties and special purpose districts, universities and other state agencies.

In a written response Monday to The Nerve, MUSC spokeswoman Heather Woolwine said MUSC Health “pursued all avenues of acquiring these needed items, both domestically and internationally,” noting that allocations from the Strategic National Stockpile were “not able to meet the needed levels.”

Lisa Goodlett, MUSC Health’s chief financial officer, said in an email Tuesday that the two SNS distributions were “significantly less than one percent of what was needed to build MUSC’s strategic reserves.”

Woolwine said to build its strategic reserves, the health system estimated it needed up to – and in some cases more than – 1 million PPE items in each of 18 categories, including such things as ventilators, masks and face shields, gloves, gowns and hand sanitizer. She said the items were needed across the system’s three markets, described as the Charleston tri-county, Florence and Lancaster areas.

Asked how MUSC paid for the $56.8 million in PPE expenses, Woolwine replied, “At this point, MUSC has funded through reserves and looks forward to potential state funding to offset this unplanned expense.”

FEMA spokeswoman Young said Thursday in a written response that all PPE items provided by FEMA between April 15 and Saturday is funded fully by the agency, while other items and services that fall under the agency’s largest public-assistance grant program will be paid 75% by FEMA and 25% by the state.

What counties sought

“At this point in time no one has been paid yet,” Dusty Owens, the Florence County Emergency Management director, said in a written response last week. “In fact, we do not yet have invoices from the state.”

Typically in disasters, Owens said, if local governments don’t have adequate manpower, equipment or supplies to respond to a crisis, they can ask their respective county emergency agencies for help, which can turn to the SCEMD if needed.

“This situation was very unique,” Owens said about the statewide COVID-19 outbreak, noting the state was “compiling requests from all the counties and ordering massive amounts of PPE from any vendor who could supply the need.”

Owens said he doesn’t know which vendors were selected by the state to provide PPE items to the county. The Nerve’s review of records provided by Owens show that more than a total of 720,000 PPE items – mostly gloves, masks and gowns – were requested as of May 27 by mainly public or private health care providers in the county, including MUSC Health.

In Richland County, 38 of the 238 PPE requests forwarded to the SCEMD as of June 2 were filled through the SNS, mostly for masks, face shields, gowns and gloves, according to county records. County spokeswoman Beverly Harris in an email response last week the SCEMD and DHEC obtained PPE items from the SNS, and delivered them to local emergency management agencies or the requesting facilities.

Greenville County Emergency Management (GCEM) director Jay Marett told The Nerve last week that “many supplies” were provided to local agencies and organizations in the county from the SNS through requests to the GCEM. But he also said in his written response that county officials “recognized that requests for PPE would exceed supplies received from the SNS shipments,” and decided to provide his department with funding to “purchase additional supplies from vendors.”

The Nerve’s review of records provided by Marett show that of at least 146,500 PPE items requested – mostly masks, gloves and gowns – as of May 28, more than 83,000 items were provided mainly to health care providers and first responders.

Charleston County provided records to The Nerve showing that more than 297,000 PPE items had been requested as of Wednesday, mainly by health care providers and local government agencies. Of the 101 total requests to the county’s Emergency Management Department, 86 were listed as “completed.”

Brundrett is the news editor of The Nerve (www.thenerve.org). Contact him at 803-254-4411 or rick@thenerve.org. Follow him on Twitter @RickBrundrett. Follow The Nerve on Facebook and Twitter @thenervesc.

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