By the time the coronavirus pandemic peaked in Philadelphia on April 14, the city had placed 62 orders for more than $6 million worth of masks, gloves, hand sanitizer, and other medical supplies.
But only about one-fourth of those orders had come in, as the pandemic caused panic over equipment shortages for frontline workers, drove up prices, and strained supply chains. And by May 15, a full two months after the city’s first confirmed case of COVID-19, fewer than a third of Philadelphia’s 100 orders — for $8 million in supplies — had been filled, according to city spending data.
As a result, in Philadelphia and across the state, nurses and doctors have said they have risked their own health by reusing masks to ration supplies. Now, even as the rate of infection slows, securing equipment continues to be a challenge — one that looms even larger as officials fear a potential second surge of the virus.
Mayor Jim Kenney said Friday that he had spoken to Gov. Tom Wolf about stockpiling personal protective equipment for the months to come. "I’d rather have some in stock then try to scramble for it in October, November, if we have something bad happen,” Kenney said.
The state has had similar struggles. Despite approving nearly $58 million in emergency spending for personal protective equipment, medical supplies, and hand sanitizer since March 4 — mostly for distribution to health systems, first responders, and care facilities — it has secured only $14.5 million worth of the ordered supplies, according to data from the Department of General Services.
Some of the money spent by the city and state is for products that have yet to be shipped or even produced, officials said.
“We are not shy about begging at this point,” Brian Abernathy, the city’s managing director, said last week of the city’s search for hospital supplies. “We’re not borrowing or stealing yet, but it has been challenging, to say the least.”
Nationwide, officials have struggled to secure supplies needed to protect doctors, nurses, and other essential workers as state and local governments bid against each other, driving up prices. From California to Louisiana to Texas, reports of inflated prices and profiting middlemen have accompanied the often-desperate search for masks, gloves, testing swabs, isolation gowns, and other materials.
Two-thirds of frontline workers reported shortages of N95 masks through early May, and 42% said they lacked enough surgical masks, according to a Washington Post-Ispos poll of health-care workers released this week.
To increase their purchasing power, Pennsylvania and six other states, including New Jersey and Delaware, this month formed a seven-state regional consortium for buying personal protective equipment.
But identifying just how severe the problem may be has been difficult. A nationwide “snapshot” of the personal protective equipment shortages does not exist, hindering the country’s ability to match needs “with existing or emerging PPE stockpiles,” researchers wrote this week in the medical journal The Lancet.
It’s been easier to identify shortages than surpluses. Of 39 emergency orders for personal protective equipment, test kits, thermometers, ventilators, and other supplies approved by Pennsylvania Emergency Management Agency and other agencies between March 4 and May 13, just 16 had been completely filled as of Thursday.
“A series of partial orders allows us to at least get some goods and services to those who desperately need them," Pennsylvania Department of General Services spokesperson Troy Thompson in a statement.
The state’s missing or partial orders include: $3.6 million in face shields; $1 million in personal protective equipment to be used at primary election polling places on June 2; and nearly all of a $30.4 million order of disinfectant, hand sanitizer, and other unspecified supplies.
Still, the state has successfully received millions of dollars’ worth of hand sanitizer, goggles, surgical masks, and other items. It has also secured other emergency materials: refrigerated trailers to hold the bodies of the deceased; contractors to help the state with long-term care facilities; and food to distribute to hungry residents.
Similarly, Philadelphia has spent $7.7 million of the $22.7 million allocated for coronavirus-related supplies and contracts, including on testing sites, tractor-trailers, cleaning supplies, and public messaging.
City officials are optimistic that some of their missing orders may still arrive as they wait “in the line” for new supplies to be made. While the city does not normally agree to advance payments for goods not yet manufactured, city spokesperson Kelly Cofrancisco said, “these are not normal times.”
“Some delays have left us with few options but to wait, hope, and continue to search to come up with ideas on where to source PPE,” she said.
‘The entire globe’
It is not yet clear the extent to which the city and state governments may have overpaid for materials. Philadelphia and state officials declined to provide records of the price per item or number of items in their orders.
But Thompson, the state spokesperson, said it’s common to pay higher prices during emergencies.
“The reality is that during a global pandemic, your purchasing competition isn’t just the states that surround you — but the entire globe,” Thompson said.
In a memo to City Council in late March, the Kenney administration said N95 masks, which previously were about $1 each, were selling for between $4 and $8 per mask. The city placed one order for 500,000 masks from BJ’s Wholesale Club at a price of $5.65 per mask. It never arrived and was ultimately canceled.
Philadelphia has focused on emergency orders to help the city’s hospitals get masks and other supplies. But the city has also had to protect its own workforce. The COVID-19 spending data show that 17 orders were placed for the Streets Department, for example, between March 17 and May 6. None have been paid, as of May 15, meaning the orders have not arrived. Nor have about two dozen different orders of hand sanitizer.
Abernathy said the city now has enough cloth masks for its essential employees. But finding N95 masks and surgical gowns, which the city wants to purchase for distribution to hospitals, remains especially difficult, Abernathy said. N95 masks are generally not being sold to local governments, he said.
PEMA placed a $3.2 million order for the masks that arrived in two shipments worth only $358,000. The state received three smaller shipments of the masks in April and May, but an additional two emergency N95 orders have not arrived and one was canceled.
On April 6, Philadelphia placed another order for the masks, this one for $3.8 million from a New Jersey company. The city handed over $2.1 million to cover half its order of N95 masks plus a full order of surgical masks.
As of Friday, the city was still waiting. The N95 masks were still being manufactured.