Washington Has Enough Ventilators, But Needs More COVID-19 Test Kits, Inslee Says

Medical personnel run tests on patients while wearing personal protective equipment outside Mary's Corner Medical Clinic Monday afternoon in Chehalis.

OLYMPIA — Washington state has returned 400 ventilators and 300 hospital beds to the federal Strategic National Stockpile to help other states, but Gov. Jay Inslee said Tuesday that the state needs more test kits for COVID-19 and an expanded ability to analyze them.

"We have hundreds of people that we would like to test today -- including some in our long-term care facilities that have had people infected in their facility -- that cannot get tested and the reason is that there simply are not enough test kits," Inslee said at a press briefing.

The governor said he spoke with a company Tuesday morning that makes swabs needed to run the tests and was hopeful the state could acquire them.

Noting that there's a "world shortage" of test kits, Inslee repeated his request for President Donald Trump to invoke the Defense Production Act for a national effort to manufacture personal protective equipment.

"The kits are not the only issue. We also have to dramatically increase the ability to analyze these samples, meaning the analytic capacity has to increase several-fold. This is something I don't believe yet the federal government has come to terms with how much we have to increase testing capability.

"We are going to have to increase it dramatically as we come through this epidemic to allow people to safely return to work," Inslee added.

Dr. Kathy Lofy, the state health officer and chief science officer, said the state over the past several days has struggled to acquire test kit material.

"We have been very short of swabs. It has been difficult to acquire swabs and we've had some difficulty with the viral transport media that the swab goes into," she said.

In a sign of how quickly the state's response to COVID-19 changes, Lofy said the state on Tuesday had obtained "tens of thousands" of test kits.

"We are going to be deploying a lot of these test kits to our local health jurisdictions to help with a lot of the testing that needs to happen within congregate care settings," she said.

Lofy made her comment 90 minutes after Inslee's press conference. A spokesperson for the Joint Information Center, which is coordinating the state's COVID-19 response, did not immediately return a call seeking more details on Lofy's statement.

The state has a sufficient number of ventilators to treat COVID-19 patients, said Dr. Raquel Bono, director of Washington state's COVID-19 Health System Response Management.

Before making the decision to return ventilators to the federal Strategic National Stockpile, the state determined it had 1,000 ventilators and 500 more that could be used from ambulatory surgery centers if needed, Bono said.

"At the same time, we had already initiated our procurement for about 354 ventilators and an additional 800 ventilators. The delivery of those are expected in the next couple of weeks," she said.

The demand for personal protective equipment for health care workers -- N95 respirators, surgical masks, face shields, surgical gowns and gloves -- exceeds supply, said John Wiesman, the state Secretary of Health.

The state is using several strategies to reduce the demand for personal protective equipment, including Inslee's order to halt elective surgeries and dental services, encourage the use of telemedicine, and discarding N95 respirators or surgical masks when they become soiled, Wiesman said.

"Standard practice would be changing them after each patient encounter," he said.

Wiesman offered a snapshot at Washington's supply of personal protective equipment and its procurement effort, which has involved looking for supplies from around the world.

Of the 6 million personal protective equipment items that the state has received, 591,720 were donated and 1,526,438 were from the federal Strategic National Stockpile, Wiesman said.

"The stock we have is intended to fill the gaps that the health care providers themselves can't get through their supply chain or the pieces of [personal protective equipment] that the state needs for its work," he said.

The state has 31.6 million N95 masks and 33 million surgical masks on order, he said.

"We are targeting orders for 6 million N95 masks, 24 million surgical masks, 18 million gowns, and 108 million gloves per week for 12 weeks. In order to tap into many of the supply chains out there, we needed to commit to a set order every week through June.

"That really is how competitive right now the market is for these products," Wiesman added.

Since March 16, the state has shipped to health care providers 2.2 million items, including 393,794 N95 respirators, 664,600 surgical masks, 873,690 gloves and 67,610 face shields.

Wiesman said in the state warehouse, there are 3.8 million items that are being processed for shipment from Monday through Wednesday, including about 554,000 N95 masks and 782,000 surgical masks.

"The N95 masks are being prioritized for our hospitals and the surgical masks for our long-term care facilities," he said.

As of April 5, the state had identified 126 long-term care facilities around Washington with residents who were infected with COVID-19, Lofy said.

Inslee's chief of staff, David Postman, said the governor issued a directive on April 2 to the heads of the state Department of Enterprise Services -- the state's purchasing agency -- and the Emergency Management Division on procurement of personal protective equipment.

The directive states: "DES is authorized to take appropriate risks in fulfilling these emergency procurement goals that would not otherwise be acceptable outside this emergency."

"Frankly, there are some scams around [personal protective equipment] flying around. We're working very hard to vet those, but the Governor also wanted people to understand that in an emergency situation, we may not be able to do everything exactly how it happens in the quiet of the regular turn of business," Postman said.