On April 8, 2020

State’s “most likely scenario” for COVID-19 cases show sufficient supply of ventilators, most PPE

Staff report

On Sunday, April 5, the state of Vermont released a summary of ventilators and personal protective equipment (PPE) available as part of the coordinated fight against COVID-19.

Under the “most likely scenario” modeling the state currently has a sufficient supply of N95 FFP respirators, surgical masks and gloves. It does not have a sufficient supply of body protection — according to forecasts its current quantity on hand will run out May 26 under the “most likely scenario” model.

Under the “worst case scenario” model the state does not have a sufficient supply of any PPE equipment and will begin to run out as soon as mid-April.

The total expenditure of Vermont state funds to support PPE, ventilator and sterilization equipment, as of April 4, exceeded $20 million, according to the state report.

Ventilators

The state does not stock ventilators in Vermont, hospitals do. There are 176 known critical care ventilators and 32 other ventilators in Vermont. There were three patients currently using ventilators in the state on Monday, April 6, Governor Phil Scott stated at the press conference.

Vermont has made a request to the Federal Emergency Management Agency (FEMA) for 600 more ventilators. FEMA has asked states to advise when they see a 72-hour critical need that will outstrip state capacity. State planners are monitoring that daily to model if/when the 72-hour critical period comes into view. No deliveries have occurred or been promised to Vermont at this point in time.

However, the state has supported hospital ventilator surge capacity by initiating purchase, in conjunction with hospitals, of 452 units from eight separate sources/suppliers. Approximately 50 have begun arriving or are in transit. Due to global supply chain challenges, for most orders, shipping and arrival dates are not yet known.

The state is in close contact with, and prepared to support, two efforts to construct ventilators in state. Those efforts are led by innovative engineers and clinicians who are working quickly to get viable units into production.

Scott said Monday that this production could put the state in the fortunate position of leading mutual aid to other states in need, but that Vermont wouldn’t give up any PPE supplies until it was sure there wouldn’t be a need for them to care for in-state cases.

Personal protective equipment (PPE)

The state, in close collaboration with hospitals and clinicians, is sourcing PPE and has, as of April 4, placed orders for more than 3.7 million items, primarily masks, from 10 vendors.

Close coordination with hospitals is underway to begin sterilization for re-use of N95 masks using at least two methods. Vetted sterilization procedures were released on April 3 by the U.S. Food and Drug Administration and the Vermont Health Department.

Prioritization and assignment of PPE requests and distribution is being led by the Vermont Department of Health. PPE is available primarily in hospital stock, which is receiving orders through supply chains, supplemented by the state’s Strategic National Stockpile (SNS) warehouse and ongoing state procurement.

Since March 18, the state has fulfilled 708 orders for PPE, 49 are pending, and eight were unable to be fulfilled because they were for items not stocked by the SNS warehouse.

FEMA is not taking quantity orders for PPE from states. Rather, it is sending allocations of PPE on a rolling basis. Vermont’s allocations have included:

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