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  4. What's in the Strategic National Stockpile, the US reserve of life-saving materials stashed in secret warehouses that experts worry isn't big enough

What's in the Strategic National Stockpile, the US reserve of life-saving materials stashed in secret warehouses that experts worry isn't big enough

Don Reisinger,Don Reisinger   

What's in the Strategic National Stockpile, the US reserve of life-saving materials stashed in secret warehouses that experts worry isn't big enough
Workers carry boxes of supplies at a Strategic National Stockpile warehouse in an undisclosed location in Oklahoma City on April 7, 2020.
  • Under President Bill Clinton, the US government began stockpiling antitoxins and vaccines in case of a large-scale bioterror attack. Medical equipment was added in 2003, when the reserve was renamed the Strategic National Stockpile.
  • Stored in secret warehouses around the US, SNS supplies can be deployed via "push packages" containing more than 50 tons of drugs, masks, ventilators, and other life-saving equipment.
  • SNS assets have been used to address 9/11, Hurricane Katrina, and the 2009 H1N1 pandemic. But analysts say now the depleted reserves aren't nearly enough to address the coronavirus pandemic.
  • Adequately funding and supplying the stockpile, former SNS director Greg Burel told Business Insider, is "ultimately is a matter of national security."
  • Visit Business Insider's homepage for more stories.

The Strategic National Stockpile is a federally controlled repository of pharmaceuticals and medical equipment that's designed to save American lives in times of crisis.

But as the coronavirus pandemic depletes its reserves, experts question whether it has enough supplies - and funding - to achieve that mission.

The SNS started as the National Pharmaceutical Stockpile in 1999 after President Bill Clinton directed $51 million to the Centers for Disease Control and Prevention to amass a supply of antitoxins and vaccines to combat a possible bioterror attack.

bill clinton

The government had previously kept supplies of antibiotics for troops to use, but this marked the first time it gathered a stockpile for civilians. Clinton had read Richard Preston's bioterror thriller "The Cobra Event" and wanted to move swiftly to prepare the country for a possible real-world incident, Time magazine reported.

The reserve was renamed the Strategic National Stockpile in 2003, when the Bush administration placed it under the joint management of the Department of Health and Human Services and Homeland Security and expanded it to include medical equipment.

A year later, it was returned to HHS oversight with the passing of the Project Bioshield Act, which approved $5 billion in vaccines to thwart a bioterrorism attack. Since 2018, Robert Kadlec, HHS Assistant Secretary for Preparedness and Response, has overseen the SNS.

The Strategic National Stockpile wasn't formed to address a global pandemic

"The primary purpose of the Strategic National Stockpile is to be prepared to respond to chemical, biological, radiological, and nuclear (CBRN) events," Greg Burel, the director of the SNS for 12 years until his retirement in January, told Business Insider.

Many drugs that would need to be used to respond to CBRN events, Burel said, "cannot be rapidly moved from commercial sources and administered in highly compressed timeframes - often less than 48 hours after an exposure to an agent."

Fearing a global influenza pandemic, the Bush administration in 2005 requested personal protective equipment be added to the reserves. A year later, Congress approved the purchase of 52 million surgical masks and 104 million N95 masks.

Where is the stockpile kept?

The SNS is spread out in a series of secret warehouses around the US that are protected by armed guards. Supplies are constantly being added and removed but the SNS warehouse in Oklahoma, for example, houses roughly 4 million pairs of gloves, 900,000 surgical and medical masks, 173,000 face shields and goggles, and 120,000 gowns, the AP reported.

The SNS has 12 "push packages," each equipped with more than 50 tons of drugs, sera, IV fluids, bandages, ventilators, and other life-saving equipment. They require 12,000 square feet of floor space - enough to support 300,000 people for up to 10 days - and can be shipped out within 12 hours by unmarked planes and trucks.

The federal government deployed push packs to New York and Washington following the 9/11 attacks.

At the start of 2020 the SNS had barely 1% of the N95 masks that healthcare workers are expected to need during the coronavirus pandemic.

There are also caches of nerve agent antidotes, known as CHEMPACKs, strategically placed in more than 1,340 locations nationwide, mostly in hospitals and fire stations.

SNS assets have been deployed following Hurricane Katrina, Superstorm Sandy, and other natural disasters. The SNS was used to fight the H1N1 pandemic in 2009, when tens of millions of masks and other PPE were shipped out across the country.

But those supplies were never replenished.

HHS reported that, as of April 7, 2020, 10,628 tons of SNS cargo has shipped to support US repatriation efforts and state PPE needs during the pandemic.

The stockpile is facing dangerous shortages

At the start of 2020, the SNS had approximately 13 million N95 masks - barely 1% of what healthcare workers are expected to need before the coronavirus pandemic is under control.

In a statement Wednesday to the House Oversight Reform Committee, HHS officials said 90% of the stockpile's protective equipment has already been used to fight COVID-19. According to federal purchasing records obtained by the Associated Press, HHS bought more N95 masks in March, but they won't be delivered until the end of April.

The Federal Emergency Management Agency has also acknowledged there aren't enough ventilators in the stockpile to meet current needs.

Ventilators at a government warehouse in Brooklyn are shipped out for distribution on March 24, 2020.

While masks and ventilators can be stored for an extended period, vaccines, antibiotics, and other drugs have a limited shelf life.

"SNS material is constantly managed and rotated for disposal when it is ultimately expired," Burel said. "The goal is to have acquisitions in place to fill-behind expiring product as it is cycled out due to expiry."

In March, pharmaceutical companies donated 30 million doses of hydroxychloroquine sulfate to the SNS for clinical trials or use in treating COVID-19 patients. Early studies in France and China have suggested the drug may be beneficial in combating the coronavirus, but experts warn of its side effects and say much more testing is needed.

There are also questions about the quality of the equipment in the reserves: At an April 7 press briefing, President Donald Trump said the SNS had more than 10,000 ventilators (FEMA puts the number at 8,044), with thousands already deployed to states in need.

In March, Business Insider reported that some of the 4,000 ventilators delivered to New York were damaged and missing parts.

Chicago Mayor Lori Lightfoot said she has "serious questions as to whether or not there is a robust stockpile at the federal level."

Disagreements about the stockpile's purpose

The Trump administration has argued that the SNS wasn't intended to supply states with everything they need.

"You also have a situation where, in some states, FEMA allocated ventilators to the states," Senior White House adviser Jared Kushner said in his first coronavirus task force briefing. "And you have instances where, in cities, they're running out but the state still has a stockpile. And the notion of the federal stockpile was it's supposed to be our stockpile - it's not supposed to be state stockpiles that they then use."

Jared Kushner

The HHS website originally described the stockpile as designed to help "when state, local, tribal, and territorial responders request federal assistance to support their response efforts."

After Kushner's comments, though, that text changed to more closely reflect his view.

"The Strategic National Stockpile's role is to supplement state and local supplies during public health emergencies. Many states have products stockpiled, as well," it now reads. "The supplies, medicines, and devices for life-saving care contained in the stockpile can be used as a short-term stopgap buffer when the immediate supply of adequate amounts of these materials may not be immediately available."

'An urgent need to fund public health at all levels'

The SNS's budget has been slow to grow for more than a decade. In the wake of the 2009 swine flu pandemic, the CDC urged the federal government to boost funding to prepare for "future events."

The Obama administration requested $655 million for the stockpile in 2011, up from roughly $600 million the year prior. Congress ultimately approved $534 million.

In the 2020 federal budget, HHS was allocated $620 million to replenish the reserves, up from $610 million in 2019. And Congress's $340 billion stimulus bill, passed in March, included a $16 billion cash infusion for the SNS.

"There is an urgent need to fund public health at all levels from federal to state and local levels," Burel said. That's especially true, he added, if the stockpile "is expected to respond to emerging infectious disease, whether pandemic or not."

"This ultimately is a matter of national security and needs to be taken as seriously as funding the Department of Defense to prepare our nation from an enemy attack."

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