Sedgwick County’s dash for supplies to protect against COVID-19 tangled in red tape

Wichita hospitals are facing a shortage of personal protective equipment as the coronavirus pandemic continues its community spread in Sedgwick County.

But a worldwide scramble for supplies, layers of red tape and a lack of coordination are making it increasingly difficult for those supplies to get to the front lines of the fight against COVID-19, according to local and state officials.

To gear up for a surge of patients, estimated to reach Kansas later this month, Sedgwick County is pushing the Robert J. Dole Veteran’s Affairs hospital to hand over a stockpile of respiratory protective gear and medical supplies to help local hospitals and first responders fight the coronavirus.

But the request is caught up in “red tape,” said Sedgwick County Commissioner David Dennis.

A county representative was turned away from Wichita’s VA about a week ago after trying to gain access to the stockpile, Dennis said. The medical supplies could not be provided because the transfer had not been authorized through the proper channels.

For Sedgwick County to tap the stockpile in its own back yard, it has to go through multiple layers of bureaucracy from Topeka to Kansas City to Washington, D.C., involving multiple federal and state agencies. The state of Kansas confirmed Friday afternoon it has requested supplies from VA facilities, but so far none have been provided.

A nationwide shortage of medical equipment for doctors, nurses and first responders threatens to expose those workers to COVID-19.

“We know more supplies will be needed and we are aggressively seeking vendors nationwide and have established contracts for more personal protective equipment,” said Angee Morgan, Gov. Laura Kelly’s authorized representative in the Kansas Division of Emergency Management.

The World Health Organization last month said a shortage of personal protective equipment caused by rising demand, panic buying, hoarding and misuse is endangering the lives of health workers worldwide. That shortage also applies to Sedgwick County, where the number of cases continues to climb every day.

County Manager Tom Stolz and Commissioners Lacey Cruse and Pete Meitzner have been holding weekly conference calls with leaders from Wichita hospital systems Wesley Medical Center and Via Christi Ascension.

Wichita hospital leaders told county officials that they are concerned about running out of supplies, including test swabs, haz-mat-style face guards, N-95 masks, surgical masks, test kits and reagents. The County Health Department is facing a shortage as well, a written summary of the call says.

Wichita hospital leaders “are unsure if they have proper bed space, ICU resource, or ventilators to handle the coming surge. They are VERY concerned about it,” according to the summary.

While the county grapples with its own coordination issues with other government agencies, hospitals have their own set of problems getting everyone on the same page.

Wichita hospital leaders “are bothered by the lack of statewide coordination of hospitals working together,” a summary of the conference call says.

Even with the statewide stay-at-home order, Stolz noted, Wichita’s hospitals are offering no guarantees that they’ll have adequate bed space or ventilators to treat severely ill patients.

Wichita’s hospitals also are frustrated that Kansas “seems to be on the short stick of attaining equipment and supplies when compared to other states,” the memo says. “They are concerned that federal monies coming from the COVID bills will not make it to them.”

State stockpile running low

Hospital patients in Kansas could exceed ICU bed capacity within three weeks, according to projections by the University of Washington.

One of Kansas Secretary of Health and Environment Lee Norman’s proposed solutions to a bed shortage is to open two of the state’s VA hospitals to COVID-19 patients to help handle a surge of patients. The state’s third VA hospital would be dedicated to non-coronavirus patients.

That plan has not been completed and it’s unclear if it will ever come to fruition.

The number of beds isn’t the only concern.

Hospitals could face staffing shortages if healthcare workers become sick due to a lack of protective equipment that shields them from the virus while they interact with potentially infected people.

Gov. Laura Kelly said Friday that Kansas received its final delivery from the strategic national stockpile at 11 p.m. Thursday. The state will disburse supplies to county officials over the next few days.

The supplies that Kansas has gotten from the stockpile include personal protective equipment and other materials.

Kelly said Kansas had been receiving shipments from the federal Department of Health and Human Services. Kansas has now received 90% of its allocation, she said, adding the state has been told it won’t receive the final 10%.

Kelly said the state has put in five or six requests with FEMA for additional supplies but hasn’t received them.

“We are hoping that they will come in because we plan to really clear out our inventory by next Tuesday,” Kelly said, adding that everything will have been sent down to local health officials.

“That’s got to get restocked,” she said.

VA stockpiles unknown

It’s unclear what the Robert J. Dole VA has in its stockpile or how far it could go in helping the county address a surge of patients. A 2018 Veterans Affairs inspector general report found that most VA medical facilities contain caches of 38 drugs and 44 medical supplies, though the kinds of supplies weren’t listed.

Eighty-five people have tested positive for COVID-19 in Sedgwick County in the past 15 days. Only a fraction of those patients have required hospitalization, but as cases grow so does the need to stock up on protective equipment.

Sedgwick County is looking at all options, including the private sector, donations and the VA stockpile.

“I learned last Friday that the VA has 340 full sets of PPE available for emergency operations,” Dennis said at Wednesday’s commission meeting. “I also understand they have a warehouse full of emergency equipment.”

Recent reports suggest the Department of Veteran’s Affairs may be overestimating its supplies because emergency stockpiles have deteriorated in storage and can’t be used.

A spokesperson for Wichita’s VA would not say how much protective equipment it has in storage.

“The Robert J. Dole VA Medical Center is equipped with essential items and supplies to support VA operations,” Akeam Ashford said in an email. “We are continually monitoring the status of those items to ensure an adequate supply chain to care for our Veterans and staff.”

Even if it has enough supplies to cover the entire region, private hospitals such as Wesley Medical Center and Ascension Via Christi would not be able to directly tap into the VA’s stockpile, nor would county health departments.

Requests for supplies from those stockpiles would ultimately have to come through the state, Ashford said.

“The Robert J. Dole VAMC has not, and would not, receive requests for PPE from any community hospital or state and local emergency management. That is not the process in place for requests and responses in emergency situations,” he said.

“Requests for support would come from a state, county, or city emergency management,” Ashford said. “They know to route all requests for Federal support through their respective states.”

The state has requested resources from the Veterans Administration Hospital caches of equipment across the country, Jane Welch, director of public affairs for the Kansas Adjutant General’s Department, confirmed Friday.

Even so, Sedgwick County is unlikely to get top priority by the federal agency charged with doling out resources. Kansas will have to compete with other areas of the country that have been hit harder by the coronavirus.

“Kansas, like any other state, has the ability to ask for those same resources if available and then have the request prioritized by FEMA (Federal Emergency Management Agency),” Welch said in an email.

Kate Flavin, a county spokesperson, said Sedgwick County has made requests to the Kansas Department of Emergency Management but has no information on what it will receive compared to what it requested.

Right now, the county has some supplies on hand, but is able to provide only small quantities of on-hand items as needs arise, Flavin said.

“We continue to work through our purchasing and acquisition process to locate and buy supplies,” she said. “However, trusted source PPE is in high demand and short supply nationwide, and we find ourselves in competition with government and private sector entities, including the Federal government.”

“If we don’t receive regular and recurring shipments to our (Emergency Operations Center), our sustainability is in question,” she said.

Contributing: Dion Lefler of The Wichita Eagle reported from Wichita.

This story was originally published April 5, 2020 at 5:51 AM.