Because officials weren’t as worried about pandemic flu, they stocked fewer basic medical supplies, like masks, that would come in handy during an infectious-disease outbreak. Officials thought the stockpile should have bioweapon antidotes and other drugs that aren’t easily available on store shelves, rather than common items you can buy at CVS. “The Strategic National Stockpile was built to respond primarily to chemical, biological, radiological, and nuclear events, whether by a terrorist, or a state actor, or something that might happen along those same lines that was accidental,” Burel told me.
Since then, other changes to the stockpile might have made it less capable to handle crises like the one we’re living through. In 2018, the stockpile was moved out of the jurisdiction of the CDC and into a different domain of the Health and Human Services Department—the assistant secretary for preparedness and response. While some of the experts I spoke with saw this as a harmless change, most worried that institutional memory was lost in the process. The CDC, they say, was better at doing operational things like mobilizing a stockpile. Having it at the CDC “puts everybody who’s working on different aspects of being prepared and able to respond together,” Levy said. (HHS did not immediately respond to a request for comment, and I will update this story if I hear back.)
Still, the fundamental mission of the stockpile remained the same: A stopgap, not a safety net. Jared Kushner drew opprobrium last week for appearing to say that the states were on their own when it comes to medical supplies. “The notion of the federal stockpile was, it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use,” he said.
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Although Kushner’s wording was undeniably inartful, the former stockpile directors said he sort of has a point. “Kushner doesn’t know exactly how to phrase it, but the stockpile was never designed to be for everybody all at once, anything that you might need for as long as you need,” Levy said.
The stockpile, Burel and Levy told me, was never meant to provide masks for the entire nation for months at a time. The idea was instead that hospitals and states would create their own stockpiles, and under extenuating circumstances—when they ran out of supplies, or if they were incapacitated for some reason—they could fall back on the national stockpile.
One could argue that we are living through just such an extenuating circumstance—states are running out of supplies, after all. But the former stockpile directors I talked to said that if anything, governors and hospitals should have been warned sooner about how few masks were in the national stockpile and told to make their own arrangements. “It was never viewed as something that would supply the whole nation with medical supplies for a long period of time,” said Richard Besser, who led the CDC office that oversaw the stockpile during Hurricane Katrina. “If you just look at the number of masks and gowns the nation is churning through, it would be impossible and cost-prohibitive to store that in perpetuity for a global pandemic.”