Wash your damn hands

With Covid-19 cases spreading across the globe , there ’ s never been a better time to brush up on one of the easiest ways to avoid the spread of infectious disease : proper , consistent hand hygiene .
Everyone from the WHO to the US Centers for Disease Control and Prevention has repeatedly emphasized regular hand-washing ( or hand sanitizer if water and soap aren ’ t available ) as a way to prevent the spread of the new coronavirus .
Dozens of studies show hand-washing can prevent life-threatening diseases , and even save lives .
Reviews of the @ @ @ @ @ @ @ hand-washing on respiratory diseases , have found the practice cut infections by around 15 to 20 percent .
And it ’ s not just respiratory diseases like Covid-19 : A 2008 review of the research looked at some of the best evidence for diarrhea-causing illnesses ; they found that stringent hand-washing protocols , on average , reduced incidents of diarrhea by 29 percent in high-income countries and 31 percent in low- and middle-income countries .
Those decreases matter : More than 2,000 children die from diarrhea-related diseases every day , and respiratory diseases @ @ @ @ @ @ @ every year .
Hygiene interventions can also reduce the number of sick days in schools .
In a study of elementary school students in Denmark , researchers required the children to use hand sanitizer three times a day .
Compared to the year before , there were 66 percent fewer schoolchildren with four or more sick days and 20 percent more with zero sick days .
” There ’ s more science behind hand hygiene than there is for other forms of infection control , ” says Elaine Larson , associate dean for @ @ @ @ @ @ @ ’ re probably not doing it right A study in the Journal of Environmental Health found only 5 percent of Americans wash their hands properly .
Although the CDC recommends 20 seconds of hand-washing , people on average wash their hands for about six seconds .
Obviously , hand-washing isn ’ t going to prevent disease if people aren ’ t doing it right .
Here are four tips for proper hand-washing , from Larson and the CDC : 1 ) Wash your hands for at least 20 seconds .
The amount of @ @ @ @ @ @ @ explains , to thoroughly cover and scrub every surface of both hands .
To do this right , the CDC provides a step-by-step guide : Wet your hands with clean water , lather soap on every surface , scrub your hands together for at least 20 seconds , and rinse before drying .
If you need a timer , the CDC recommends humming the “ Happy Birthday ” song from beginning to end twice .
2 ) Wash your fingertips and under your nails .
“ If you think about it , most @ @ @ @ @ @ @ germs are on your fingertips and maybe under your fingernails , ” Larson says .
“ That ’ s a part of the hand that ’ s often skipped when people wash their hands.
” 3 ) Wash your hands after every trip to the bathroom , blowing your nose , coughing , or sneezing , and before eating .
Even if you think you didn ’ t get anything on your hands , wash them .
There are always germs on your hands , and , at the very least , the @ @ @ @ @ @ @ sure some of those germs are cleaned off .
4 ) Wash your hands quickly after coughing , sneezing , or dealing with sick people .
A previous study co-authored by Larson found that the flu virus can survive on hands and other surfaces for five to 10 minutes before it dissipates .
During that time frame , people risk contaminating others as long as they don ’ t wash their hands .
There ’ s plenty of evidence to back it up : Dozens of studies show hand-washing can prevent life-threatening diseases @ @ @ @ @ @ @ cleaning one ’ s hands doesn ’ t just reduce the spread of disease , it can save lives .
Don ’ t touch your face , particularly your mouth , nose , or eyes We don ’ t yet know everything about how SARS-CoV-2 — the virus that causes the Covid-19 disease — spreads , but we do have a lot of data on how MERS , SARS , and other respiratory viruses move from person to person .
And that ’ s mainly through exposure to droplets from coughing or sneezing @ @ @ @ @ @ @ sneezes , they let out a spray , and if these droplets reach the nose , eyes , or mouth of another person , they can pass on the virus , said Jennifer Nuzzo , an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security .
In rarer cases , a person might catch a respiratory disease indirectly , “ via touching droplets on surfaces — and then touching mucosal membranes ” in the mouth , eyes , and nose , she added .
There ’ s also @ @ @ @ @ @ @ through poop — known as the “ fecal-oral ” route of disease transmission .
That ’ s why it ’ s not just hand-washing that ’ s important ; not touching your nose , mouth , and eyes is , too .
The CDC had these other , related tips for avoiding Covid-19 : • Avoid close contact with people who are sick .
• Stay home when you are sick .
• Cover your cough or sneeze with a tissue , then throw the tissue in the trash .
• Clean and @ @ @ @ @ @ @ a regular household cleaning spray or wipe .
• Everyone should wear cloth face coverings in certain public settings like grocery stores and pharmacies .
You should also wear a mask if you have symptoms of Covid-19 or you ’ re a health worker or taking care of someone who is sick .
Wash instead of sanitizing whenever possible As for hand sanitizer , Larson says it ’ s important to know that sanitizers are only active as long as they ’ re on your hands .
So even if it makes your @ @ @ @ @ @ @ sanitizer on for at least 10 seconds .
A multiyear study from the University of Michigan found that requiring students in residence halls to use surgical masks and alcohol-based sanitizers could reduce the spread of flu-like symptoms by up to 75 percent .
Importantly , the study found masks alone played no statistically significant role , indicating that the hand sanitizer was responsible for the results .
On the question of whether to hand-wash or sanitize , there ’ s a simple solution , according to the CDC : Hand-wash on most occasions @ @ @ @ @ @ @ and soap aren ’ t available .
Larson says that , for the typical healthy person , that should cover most hygiene needs .
“ Hand-washing is better for cleaning off stuff , ” Larson says .
“ If you have sputum , or if someone coughs , or if you have vomit , crap , or urine on your hands , soap and water are better cleaners .
Alcohol is a better antiseptic .
But in most cases , you can get the germs off your hands either way .
”

With Covid-19 cases spreading across the globe, there’s never been a better time to brush up on one of the easiest ways to avoid the spread of infectious disease: proper, consistent hand hygiene.
Everyone from the WHO to the US Centers for Disease Control and Prevention has repeatedly emphasized regular hand-washing (or hand sanitizer if water and soap aren’t available) as a way to prevent the spread of the new coronavirus.
"There are 10 basic things that you should know.
1⃣clean your regularly with an alcohol-based hand rub, or wash them with & .
Touching your face after touching contaminated surfaces or sick people is one of the ways the #coronavirus can be transmitted"-@DrTedros pic.twitter.com/Ty8J0zoGKS — World Health Organization (WHO) (@WHO) February 28, 2020
Dozens of studies show hand-washing can prevent life-threatening diseases, and even save lives. Reviews of the research, looking at the impact of hand-washing on respiratory diseases, have found the practice cut infections by around 15 to 20 percent.
And it’s not just respiratory diseases like Covid-19: A 2008 review of the research looked at some of the best evidence for diarrhea-causing illnesses; they found that stringent hand-washing protocols, on average, reduced incidents of diarrhea by 29 percent in high-income countries and 31 percent in low- and middle-income countries.
Those decreases matter: More than 2,000 children die from diarrhea-related diseases every day, and respiratory diseases, such as pneumonia, kill millions every year.
Hygiene interventions can also reduce the number of sick days in schools. In a study of elementary school students in Denmark, researchers required the children to use hand sanitizer three times a day. Compared to the year before, there were 66 percent fewer schoolchildren with four or more sick days and 20 percent more with zero sick days.
”There’s more science behind hand hygiene than there is for other forms of infection control,” says Elaine Larson, associate dean for nursing research at Columbia University.
You’re probably not doing it right
A study in the Journal of Environmental Health found only 5 percent of Americans wash their hands properly. Although the CDC recommends 20 seconds of hand-washing, people on average wash their hands for about six seconds.
Obviously, hand-washing isn’t going to prevent disease if people aren’t doing it right. Here are four tips for proper hand-washing, from Larson and the CDC:
1) Wash your hands for at least 20 seconds. The amount of time spent hand-washing is important, Larson explains, to thoroughly cover and scrub every surface of both hands. To do this right, the CDC provides a step-by-step guide: Wet your hands with clean water, lather soap on every surface, scrub your hands together for at least 20 seconds, and rinse before drying. If you need a timer, the CDC recommends humming the “Happy Birthday” song from beginning to end twice.
2) Wash your fingertips and under your nails. “If you think about it, most of the touching and most of the germs are on your fingertips and maybe under your fingernails,” Larson says. “That’s a part of the hand that’s often skipped when people wash their hands.”
3) Wash your hands after every trip to the bathroom, blowing your nose, coughing, or sneezing, and before eating. Even if you think you didn’t get anything on your hands, wash them. There are always germs on your hands, and, at the very least, the bathroom is a convenient place to make sure some of those germs are cleaned off.
4) Wash your hands quickly after coughing, sneezing, or dealing with sick people. A previous study co-authored by Larson found that the flu virus can survive on hands and other surfaces for five to 10 minutes before it dissipates. During that time frame, people risk contaminating others as long as they don’t wash their hands.
There’s plenty of evidence to back it up: Dozens of studies show hand-washing can prevent life-threatening diseases, particularly in developing countries. And cleaning one’s hands doesn’t just reduce the spread of disease, it can save lives.
Don’t touch your face, particularly your mouth, nose, or eyes
We don’t yet know everything about how SARS-CoV-2 — the virus that causes the Covid-19 disease — spreads, but we do have a lot of data on how MERS, SARS, and other respiratory viruses move from person to person. And that’s mainly through exposure to droplets from coughing or sneezing.
Related 12 things everyone needs to know about the coronavirus pandemic
When an infected person coughs or sneezes, they let out a spray, and if these droplets reach the nose, eyes, or mouth of another person, they can pass on the virus, said Jennifer Nuzzo, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security. In rarer cases, a person might catch a respiratory disease indirectly, “via touching droplets on surfaces — and then touching mucosal membranes” in the mouth, eyes, and nose, she added. There’s also emerging evidence showing that SARS-CoV-2 could spread through poop — known as the “fecal-oral” route of disease transmission.
That’s why it’s not just hand-washing that’s important; not touching your nose, mouth, and eyes is, too. The CDC had these other, related tips for avoiding Covid-19:
Avoid close contact with people who are sick.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Everyone should wear cloth face coverings in certain public settings like grocery stores and pharmacies. You should also wear a mask if you have symptoms of Covid-19 or you’re a health worker or taking care of someone who is sick.
Wash instead of sanitizing whenever possible
As for hand sanitizer, Larson says it’s important to know that sanitizers are only active as long as they’re on your hands. So even if it makes your hands feel annoyingly wet, keep the sanitizer on for at least 10 seconds.
A multiyear study from the University of Michigan found that requiring students in residence halls to use surgical masks and alcohol-based sanitizers could reduce the spread of flu-like symptoms by up to 75 percent. Importantly, the study found masks alone played no statistically significant role, indicating that the hand sanitizer was responsible for the results.
On the question of whether to hand-wash or sanitize, there’s a simple solution, according to the CDC: Hand-wash on most occasions and use an alcohol-based sanitizer when water and soap aren’t available. Larson says that, for the typical healthy person, that should cover most hygiene needs.
“Hand-washing is better for cleaning off stuff,” Larson says. “If you have sputum, or if someone coughs, or if you have vomit, crap, or urine on your hands, soap and water are better cleaners. Alcohol is a better antiseptic. But in most cases, you can get the germs off your hands either way.”


vox--2020-04-03--Your coronavirus grocery questions, answered by experts

In our collective attempt to flatten the curve , grocery shopping has become a minefield .
We are not supposed to leave our homes , yet we have to keep feeding ourselves ; as a result , what used to be a comforting annoyance now feels dangerous .
Can you touch that cereal box ?
Why is that person standing so close ?
There is a lot of guidance on how to handle the store , and a lot of it is confusing , if not contradictory .
It ’ s okay to get groceries , we ’ re told @ @ @ @ @ @ @ probably aren ’ t going to get coronavirus from touching the wrong avocado , or at least , scientists say transmission from food is unlikely .
Maybe it ’ s harder to find pasta now , but you shouldn ’ t panic about shortages .
To help us navigate this unsettling new world of grocery shopping — Can you reuse your bags ?
Why isn ’ t there yeast ?
— we turned to the experts .
What is the safest way to shop in a grocery store ?
While it may be @ @ @ @ @ @ @ with the virus , the main way the virus spreads is thought to be person-to-person contact , according to the CDC .
The big threat here isn ’ t pasta boxes ; it ’ s other people .
So the first thing you want to do is minimize your shopping trips ( or consider delivery ) .
“ If you can get it down to once every week or every two weeks , that ’ s great , ” says Anne-Marie Gloster , a lecturer in the nutritional science program at the University @ @ @ @ @ @ @ possible , shop at off-peak times , says Joshua Petrie , an assistant research professor of epidemiology at the University of Michigan ’ s School of Public Health .
Some stores are limiting the number of shoppers inside at once , or marking every 6 feet along the checkout line , to show customers how far apart to stand .
This is good .
The emptier , the better .
Which means that , if you can : Go alone , and — again , if possible — without children , who love @ @ @ @ @ @ @ worth doing some planning before you go , says Gloster , both so you can move quickly once you ’ re in the store and so you don ’ t forget anything .
This is your big biweekly chance .
The No .
1 priority is keeping physical distance from other people .
At the same time , we know the virus can live on surfaces for at least some amount of time , so you do want to avoid touching stuff as much as possible .
Gloster “ strongly suggests ” wiping @ @ @ @ @ @ @ with disinfectant wipes ; at this point , many stores have them by the carts .
Consider leaving your phone in your pocket , because your phone is gross .
“ It ’ s truly a spit vector , ” she says .
We spit on it , we fondle it , we put it down on stuff , we pick it up and rub it on our faces .
Now is the time to revive the paper list .
Should I wear a mask to the store ?
Yes .
Given the @ @ @ @ @ @ @ respirators should be reserved for medical workers , but as of April 3 , the CDC “ recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain ( e.g.
, grocery stores and pharmacies ) especially in areas of significant community-based transmission.
” This represents a major change in the country ’ s approach to fighting the spread of the coronavirus .
Until now , the CDC had been advising healthy people not wear masks unless they were showing symptoms or had reason to believe they @ @ @ @ @ @ @ as many other experts have been pointing out for weeks — one problem with that guidance is that there ’ s no way to know who has it .
As many as a quarter of coronavirus cases are asymptomatic , CDC director Robert Redfield said in the week leading up to the new guidance , and even people who do eventually get sick can transmit the virus before showing any symptoms .
The logic here is pretty straightforward : Since coronavirus mostly spreads when germ-containing droplets make their way into a person ’ @ @ @ @ @ @ @ , it makes sense to try to limit how many droplets are floating around in crowded spaces .
The big caveat is that , as noted , traditional medical masks still should go to medical professionals first .
While a cloth mask isn ’ t as good as a medical one , it still offers some protection .
Widespread face coverings don ’ t mean we ’ ll be able to ease up on other recommendations like social distancing and frequent hand-washing ; cloth masks just offer one more layer of protection .
@ @ @ @ @ @ @ , here ’ s how .
While we ’ re talking about protective gear , gloves — which have the potential to carry the virus more or less the same way hands do — are still mostly not recommended for grocery shopping .
It ’ s more important to wash your hands after your trip and avoid touching your face .
Is it okay to bring my own reusable bag , or is it better to just get paper or plastic ones and throw them away ?
Reusable bags are fine — assuming @ @ @ @ @ @ @ .
Under more normal circumstances , once a week would be okay .
Right now , Gloster advises : “ Wash them after you come back , every single time.
” ( Some experts , however , have expressed less concern about washing bags after each use . )
As cleaning expert Jolie Kerr wrote for Vox , nylon and cotton grocery bags can be machine-washed in cold water and air-dried .
If you have reusable bags that can ’ t be machine-washed , you can wipe them down with a disinfecting wipe @ @ @ @ @ @ @ towel .
You can refer to the Environmental Protection Agency ’ s list of Disinfectants for Use Against SARS-CoV-2 to determine if a cleaning agent meets the agency ’ s criteria for use against the coronavirus .
What about checkout ?
Should I use cash or credit ?
Is self-checkout safer ?
If you have a contactless option like Apple Pay , that ’ s probably the best , Gloster says .
( Keep your phone in your pocket until then . )
As for cash versus credit ?
“ There ’ s @ @ @ @ @ @ @ continues .
Paying with plastic often means touching a pin pad ; cash isn ’ t known for being especially clean .
Self-checkout should reduce contact with a cashier — good for everyone !
— but it requires you to touch surfaces other people are also touching .
However you pay , Petrie says , “ the most important thing is washing your hands when you ’ re done.
” Should I be sanitizing my groceries once they ’ re at my house ?
Probably not .
There ’ s a lot we @ @ @ @ @ @ @ coronavirus , but touching infected surfaces “ doesn ’ t seem to be the major way this virus spreads , ” Petrie says .
“ I am not recommending disinfecting your groceries , ” Don Schaffner , a professor of food microbiology at Rutgers School of Environmental and Biological Sciences and host of the podcasts Food Safety Talk and Risky or Not ?
, told Vox .
“ This seems like being overly cautious .
We don ’ t know of any cases of Covid-19 transmitted by food , nor of any cases @ @ @ @ @ @ @ s pretty much what the FDA is saying , too .
In a statement on March 24 , Frank Yiannas , the FDA ’ s deputy commissioner for food policy and response , noted that “ there is no evidence of human or animal food or food packaging being associated with transmission of the coronavirus that causes Covid-19.
” “ I ’ m doing the same things I ’ ve always done in terms of washing my produce , ” says Petrie .
“ I ’ m not wiping down my packaging , @ @ @ @ @ @ @ , like I ’ ve seen in some stories.
” While it likely isn ’ t necessary to sanitize your groceries , you do want to wash your hands after handling packages and when you have finished putting items away .
A lot of stores have special hours reserved for people likely to be more vulnerable to the virus — older people , or people with compromised immune systems .
Are those a good idea ?
Opinions here vary , and there are , again , no simple answers .
In an ideal @ @ @ @ @ @ @ have someone who could do their shopping for them — whether a friend or a delivery service — so they wouldn ’ t have to leave the house at all .
( If you ’ re the one doing that shopping , great !
Follow the steps above . )
Given the world that exists , though , special shopping hours likely have benefits , assuming they ’ re not so popular that stores actually get busier during those times .
“ But if those people are able to come in when there @ @ @ @ @ @ @ can get help from the staff more easily , then I would think that would be a good thing , ” Petrie says .
There ’ s another benefit , too , Gloster points out : Usually , these special hours are first thing in the morning , which means that the shelves are likely to be fully stocked .
If it ’ s especially risky for you to go out at all , then it ’ s important you ’ re actually able to get what you need when you do .
@ @ @ @ @ @ @ — I could definitely eat for a few more days — but it would really be better if I had more garlic and something other than beans .
Does that justify shopping ?
No .
“ Put it off , absolutely , as long as you can , ” Gloster says .
She recommends digging through your cabinets and pulling out all the older stuff you meant to use and never did ( canned pineapple , weird ancient grains , etc. )
.
This is a great time to experiment , because you @ @ @ @ @ @ @ not a great time to get food poisoning , so err on the side of caution and toss what ’ s expired .
Is it safer for me to get my groceries delivered , even though there are still people involved in this process ?
Yes .
If you can swing it financially , it may be your best option , Petrie says , simply because you ’ re coming into contact with fewer people — and potentially , in the case of contactless delivery , no people at all .
Okay , @ @ @ @ @ @ @ just asking other people to shoulder the risk for me ?
On the one hand : Yes , to avoid going out , where you might contract coronavirus , you are paying someone else to be out , where they might contract coronavirus .
At the same time , not ordering groceries — many of which are delivered by gig workers — means those delivery people don ’ t get paid , as Saru Jayaraman , director of the Food Labor Research Center at UC Berkeley , told Wired .
And by getting @ @ @ @ @ @ @ ’ re helping cut down on crowds in stores .
One thing you can do is order from companies with better sick-leave policies for delivery workers .
( Some independent contractors in Instacart ’ s fleet planned a strike on March 30 over the company ’ s policies . )
Another thing you can do : not be a jerk , as Jason Del Rey outlines at Recode .
Opt for contactless delivery .
Don ’ t dock ratings .
Tip generously .
When does preparation cross over into hoarding ?
According to @ @ @ @ @ @ @ more than “ two to three weeks ” worth of food , you ’ re entering hoarding territory .
( If you would like to watch other people hoard , it is a robust subgenre on TikTok . )
Ethical considerations aside , that ’ s just not necessary : The country is not about to run out of food .
I keep hearing there ’ s plenty of food , so why does it feel like grocery stores are suddenly out of everything ?
First of all , says Yossi Sheffi , @ @ @ @ @ @ @ and the director of the MIT Center for Transportation , they ’ re not really out of everything — stores , for the most part , are still pretty well-stocked .
“ If you go in the morning , you ’ ll see stores that are full of stuff , ” he says .
It ’ s just that some of that stuff is selling out very , very quickly , and it takes suppliers time to respond to the change in demand .
And the demand is changing , explains Sunil Chopra @ @ @ @ @ @ @ Northwestern ’ s Kellogg School of Management .
Consider the parable of toilet paper .
Generally , toilet paper consumption is extremely consistent , and because everyone knows how much is selling every week , supply chains don ’ t need a lot of spare inventory sitting around — why would they ?
The demand is always the same .
Except now , it isn ’ t .
Suddenly , everyone panics , and that manifests in the mass buying of toilet paper , which leads to a shortage , which leads to @ @ @ @ @ @ @ .
However , “ just because people have more toilet paper at home doesn ’ t mean they ’ re going to use more toilet paper .
Your toilet paper consumption stays basically the same.
” It ’ s an artificial shortage , and it should stabilize — he doesn ’ t see the mania for toilet paper lasting too long .
Suppliers , however , aren ’ t sure yet when rolls will be plentiful again .
“ The products for which you will see the biggest shortages are products where normal @ @ @ @ @ @ @ says .
An efficient supply chain won ’ t have lots of extra — if people consistently buy 100 jars of peanut butter a week , then that ’ s what they ’ ll make .
But the thing about peanut butter is that , unlike toilet paper , if you have more of it , you ’ re likely to eat more of it .
“ There will be some products where consumption actually goes up , ” he says , “ and peanut butter will be one of those products.
” @ @ @ @ @ @ @ increased demand is real — we should expect the shortages to go on slightly longer , until consumption dies down or supply chains adapt .
We ’ re already starting to see that happening , as food and supplies that would have once gone to restaurants , stadiums , and universities get redirected to grocery stores or sold straight to consumers .
Are there any specific foods , or types of food , that are going to be especially hard to get ?
Potentially .
To continue with peanut butter : It ’ @ @ @ @ @ @ @ , an assistant professor of supply chain management at Michigan State University , that in some cases , demand could stay high , and manufacturers might decide not to ramp up production .
It ’ s expensive to drastically increase capacity , and it may only make sense if they expect the current , quarantine-level demand to go on for years .
But if they don ’ t expect that — if they expect kids will go back to school and stop eating so much peanut butter at home , let ’ s @ @ @ @ @ @ @ not worth it .
He anticipates that there indeed may be certain items that stay hard to get until life goes back to something like normal .
If a particular region producing a particular product were hit particularly hard by the virus , that could also temporarily cause problems .
While we might see that an item is more scarce than usual , he ’ s not predicting bare shelves .
The biggest risk to the health of the supply chain may be if workers start to get sick .
“ If the @ @ @ @ @ @ @ Times reports , “ there could be a slowdown in production and distribution.
” Even that , though , would likely happen in waves , Chopra says , stressing that policymakers need to prioritize the health and safety of front-line food workers — always , and especially now .
Everyone recommends getting groceries delivered , except slots are always full .
Will capacity ever be added ?
Probably someday ?
Last week , Instacart announced plans to hire 300,000 more shoppers over the next three months to meet drastically increased demand ; Amazon @ @ @ @ @ @ @ for warehouse and delivery jobs ; and the New York-based delivery service FreshDirect is both hiring and adding delivery slots .
Still , Scott doesn ’ t see it happening overnight .
“ You can ’ t ramp that up in a couple of days , ” he says .
“ It ’ s a longer-term thing .
You ’ ve got to buy the trucks , you ’ ve got to hire the drivers , you ’ ve got to get them in your systems .
Of course , you can add @ @ @ @ @ @ @ but to really scale ?
I ’ d think it would be a matter of months , ” he says .
Unlike the rush on toilet paper , though , Scott suggests the demand for delivery could be here to stay .
“ I think you ’ ll see long-term changes in behavior from this , ” he says .
Some number of people are trying these services for the first time , and liking them .
“ Obviously , we don ’ t know the future , but I don ’ t @ @ @ @ @ @ @ We want to hear from you What questions do you have about the coronavirus pandemic and the surrounding news ?
Let us know in the form below , and we might answer your question in an upcoming article , podcast episode , or video .
( You can also access the Google form here . )

In our collective attempt to flatten the curve, grocery shopping has become a minefield. We are not supposed to leave our homes, yet we have to keep feeding ourselves; as a result, what used to be a comforting annoyance now feels dangerous. Can you touch that cereal box? Why is that person standing so close?
There is a lot of guidance on how to handle the store, and a lot of it is confusing, if not contradictory. It’s okay to get groceries, we’re told, but not too often. You probably aren’t going to get coronavirus from touching the wrong avocado, or at least, scientists say transmission from food is unlikely. Maybe it’s harder to find pasta now, but you shouldn’t panic about shortages.
To help us navigate this unsettling new world of grocery shopping — Can you reuse your bags? Why isn’t there yeast? — we turned to the experts.
What is the safest way to shop in a grocery store?
While it may be possible to get sick by touching surfaces with the virus, the main way the virus spreads is thought to be person-to-person contact, according to the CDC. The big threat here isn’t pasta boxes; it’s other people.
So the first thing you want to do is minimize your shopping trips (or consider delivery). “If you can get it down to once every week or every two weeks, that’s great,” says Anne-Marie Gloster, a lecturer in the nutritional science program at the University of Washington. And as much as possible, shop at off-peak times, says Joshua Petrie, an assistant research professor of epidemiology at the University of Michigan’s School of Public Health. Some stores are limiting the number of shoppers inside at once, or marking every 6 feet along the checkout line, to show customers how far apart to stand. This is good. The emptier, the better.
Which means that, if you can: Go alone, and — again, if possible — without children, who love touching things. It’s also worth doing some planning before you go, says Gloster, both so you can move quickly once you’re in the store and so you don’t forget anything. This is your big biweekly chance.
The No. 1 priority is keeping physical distance from other people. At the same time, we know the virus can live on surfaces for at least some amount of time, so you do want to avoid touching stuff as much as possible. Gloster “strongly suggests” wiping down the handle of your shopping cart with disinfectant wipes; at this point, many stores have them by the carts.
Consider leaving your phone in your pocket, because your phone is gross. “It’s truly a spit vector,” she says. We spit on it, we fondle it, we put it down on stuff, we pick it up and rub it on our faces. Now is the time to revive the paper list.
Should I wear a mask to the store?
Yes. Given the current shortages, surgical masks and N95 respirators should be reserved for medical workers, but as of April 3, the CDC “recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
This represents a major change in the country’s approach to fighting the spread of the coronavirus. Until now, the CDC had been advising healthy people not to wear masks unless they were showing symptoms or had reason to believe they’d been exposed. But — as many other experts have been pointing out for weeks — one problem with that guidance is that there’s no way to know who has it. As many as a quarter of coronavirus cases are asymptomatic, CDC director Robert Redfield said in the week leading up to the new guidance, and even people who do eventually get sick can transmit the virus before showing any symptoms.
The logic here is pretty straightforward: Since coronavirus mostly spreads when germ-containing droplets make their way into a person’s mouth, nose, or eyes, it makes sense to try to limit how many droplets are floating around in crowded spaces.
The big caveat is that, as noted, traditional medical masks still should go to medical professionals first. While a cloth mask isn’t as good as a medical one, it still offers some protection. Widespread face coverings don’t mean we’ll be able to ease up on other recommendations like social distancing and frequent hand-washing; cloth masks just offer one more layer of protection. If you want to make your own, here’s how.
While we’re talking about protective gear, gloves — which have the potential to carry the virus more or less the same way hands do — are still mostly not recommended for grocery shopping. It’s more important to wash your hands after your trip and avoid touching your face.
Is it okay to bring my own reusable bag, or is it better to just get paper or plastic ones and throw them away?
Reusable bags are fine — assuming you’re diligent about cleaning them. Under more normal circumstances, once a week would be okay. Right now, Gloster advises: “Wash them after you come back, every single time.” (Some experts, however, have expressed less concern about washing bags after each use.)
As cleaning expert Jolie Kerr wrote for Vox, nylon and cotton grocery bags can be machine-washed in cold water and air-dried. If you have reusable bags that can’t be machine-washed, you can wipe them down with a disinfecting wipe or an all-purpose spray and a paper towel. You can refer to the Environmental Protection Agency’s list of disinfectants for use against the SARS-CoV-2 virus to determine if a cleaning agent meets the agency’s criteria for use against the coronavirus.
What about checkout? Should I use cash or credit? Is self-checkout safer?
If you have a contactless option like Apple Pay, that’s probably the best, Gloster says. (Keep your phone in your pocket until then.)
As for cash versus credit? “There’s no good answer here,” Gloster continues. Paying with plastic often means touching a pin pad; cash isn’t known for being especially clean. Self-checkout should reduce contact with a cashier — good for everyone! — but it requires you to touch surfaces other people are also touching.
However you pay, Petrie says, “the most important thing is washing your hands when you’re done.”
Should I be sanitizing my groceries once they’re at my house?
Probably not. There’s a lot we don’t yet know about the coronavirus, but touching infected surfaces “doesn’t seem to be the major way this virus spreads,” Petrie says.
“I am not recommending disinfecting your groceries,” Don Schaffner, a professor of food microbiology at Rutgers School of Environmental and Biological Sciences and host of the podcasts Food Safety Talk and Risky or Not?, told Vox. “This seems like being overly cautious. We don’t know of any cases of Covid-19 transmitted by food, nor of any cases transmitted by food packaging.”
That’s pretty much what the FDA is saying, too. In a statement on March 24, Frank Yiannas, the FDA’s deputy commissioner for food policy and response, noted that “there is no evidence of human or animal food or food packaging being associated with transmission of the coronavirus that causes Covid-19.”
“I’m doing the same things I’ve always done in terms of washing my produce,” says Petrie. “I’m not wiping down my packaging, or leaving it outside for three days, like I’ve seen in some stories.”
While it likely isn’t necessary to sanitize your groceries, you do want to wash your hands after handling packages and when you have finished putting items away.
A lot of stores have special hours reserved for people likely to be more vulnerable to the virus — older people, or people with compromised immune systems. Are those a good idea?
Opinions here vary, and there are, again, no simple answers. In an ideal world, people in high-risk groups would have someone who could do their shopping for them — whether a friend or a delivery service — so they wouldn’t have to leave the house at all. (If you’re the one doing that shopping, great! Follow the steps above.)
Given the world that exists, though, special shopping hours likely have benefits, assuming they’re not so popular that stores actually get busier during those times.
“But if those people are able to come in when there’s fewer people, and they can get help from the staff more easily, then I would think that would be a good thing,” Petrie says.
There’s another benefit, too, Gloster points out: Usually, these special hours are first thing in the morning, which means that the shelves are likely to be fully stocked. If it’s especially risky for you to go out at all, then it’s important you’re actually able to get what you need when you do.
Technically, I “have groceries” — I could definitely eat for a few more days — but it would really be better if I had more garlic and something other than beans. Does that justify shopping?
No. “Put it off, absolutely, as long as you can,” Gloster says. She recommends digging through your cabinets and pulling out all the older stuff you meant to use and never did (canned pineapple, weird ancient grains, etc.).
This is a great time to experiment, because you have no other choice. This is not a great time to get food poisoning, so err on the side of caution and toss what’s expired.
Is it safer for me to get my groceries delivered, even though there are still people involved in this process?
Yes. If you can swing it financially, it may be your best option, Petrie says, simply because you’re coming into contact with fewer people — and potentially, in the case of contactless delivery, no people at all.
Okay, but is it ethical? Am I just asking other people to shoulder the risk for me?
On the one hand: Yes, to avoid going out, where you might contract coronavirus, you are paying someone else to be out, where they might contract coronavirus.
At the same time, not ordering groceries — many of which are delivered by gig workers — means those delivery people don’t get paid, as Saru Jayaraman, director of the Food Labor Research Center at UC Berkeley, told Wired. And by getting delivery, it’s possible you’re helping cut down on crowds in stores.
One thing you can do is order from companies with better sick-leave policies for delivery workers. (Some independent contractors in Instacart’s fleet planned a strike on March 30 over the company’s policies.)
Another thing you can do: not be a jerk, as Jason Del Rey outlines at Recode. Opt for contactless delivery. Don’t dock ratings. Tip generously.
When does preparation cross over into hoarding?
According to Petrie, if you’ve got more than “two to three weeks” worth of food, you’re entering hoarding territory. (If you would like to watch other people hoard, it is a robust subgenre on TikTok.) Ethical considerations aside, that’s just not necessary: The country is not about to run out of food.
I keep hearing there’s plenty of food, so why does it feel like grocery stores are suddenly out of everything?
First of all, says Yossi Sheffi, a professor of engineering systems at MIT and the director of the MIT Center for Transportation, they’re not really out of everything — stores, for the most part, are still pretty well-stocked. “If you go in the morning, you’ll see stores that are full of stuff,” he says. It’s just that some of that stuff is selling out very, very quickly, and it takes suppliers time to respond to the change in demand.
And the demand is changing, explains Sunil Chopra, a professor of operations management at Northwestern’s Kellogg School of Management. Consider the parable of toilet paper. Generally, toilet paper consumption is extremely consistent, and because everyone knows how much is selling every week, supply chains don’t need a lot of spare inventory sitting around — why would they? The demand is always the same.
Except now, it isn’t. Suddenly, everyone panics, and that manifests in the mass buying of toilet paper, which leads to a shortage, which leads to more panic, and the cycle repeats. However, “just because people have more toilet paper at home doesn’t mean they’re going to use more toilet paper. Your toilet paper consumption stays basically the same.” It’s an artificial shortage, and it should stabilize — he doesn’t see the mania for toilet paper lasting too long. Suppliers, however, aren’t sure yet when rolls will be plentiful again.
“The products for which you will see the biggest shortages are products where normal consumption is pretty stable,” Chopra says. An efficient supply chain won’t have lots of extra — if people consistently buy 100 jars of peanut butter a week, then that’s what they’ll make.
But the thing about peanut butter is that, unlike toilet paper, if you have more of it, you’re likely to eat more of it. “There will be some products where consumption actually goes up,” he says, “and peanut butter will be one of those products.” In those cases — foods where the increased demand is real — we should expect the shortages to go on slightly longer, until consumption dies down or supply chains adapt. We’re already starting to see that happening, as food and supplies that would have once gone to restaurants, stadiums, and universities get redirected to grocery stores or sold straight to consumers.
Are there any specific foods, or types of food, that are going to be especially hard to get?
Potentially. To continue with peanut butter: It’s also possible, explains Alex Scott, an assistant professor of supply chain management at Michigan State University, that in some cases, demand could stay high, and manufacturers might decide not to ramp up production. It’s expensive to drastically increase capacity, and it may only make sense if they expect the current, quarantine-level demand to go on for years. But if they don’t expect that — if they expect kids will go back to school and stop eating so much peanut butter at home, let’s say — then it’s likely not worth it. He anticipates that there indeed may be certain items that stay hard to get until life goes back to something like normal.
If a particular region producing a particular product were hit particularly hard by the virus, that could also temporarily cause problems. While we might see that an item is more scarce than usual, he’s not predicting bare shelves.
The biggest risk to the health of the supply chain may be if workers start to get sick. “If the illnesses surge,” the New York Times reports, “there could be a slowdown in production and distribution.” Even that, though, would likely happen in waves, Chopra says, stressing that policymakers need to prioritize the health and safety of front-line food workers — always, and especially now.
Everyone recommends getting groceries delivered, except slots are always full. Will capacity ever be added?
Probably someday? Last week, Instacart announced plans to hire 300,000 more shoppers over the next three months to meet drastically increased demand; Amazon announced it was hiring 100,000 more people for warehouse and delivery jobs; and the New York-based delivery service FreshDirect is both hiring and adding delivery slots.
Still, Scott doesn’t see it happening overnight. “You can’t ramp that up in a couple of days,” he says. “It’s a longer-term thing. You’ve got to buy the trucks, you’ve got to hire the drivers, you’ve got to get them in your systems. Of course, you can add incrementally week to week to week, but to really scale? I’d think it would be a matter of months,” he says.
Unlike the rush on toilet paper, though, Scott suggests the demand for delivery could be here to stay. “I think you’ll see long-term changes in behavior from this,” he says. Some number of people are trying these services for the first time, and liking them. “Obviously, we don’t know the future, but I don’t see delivery and e-commerce going down.”
We want to hear from you
What questions do you have about the coronavirus pandemic and the surrounding news? Let us know in the form below, and we might answer your question in an upcoming article, podcast episode, or video. (You can also access the Google form here.)


vox--2020-04-03--America’s emergency medical stockpile is almost empty. Nobody knows what happens next.

The Strategic National Stockpile , which is a relatively obscure office in the federal government that manages the country ’ s emergency medical supplies , exists to respond to a crisis like the coronavirus pandemic .
As the United States faces hundreds of thousands of Covid-19 cases , a widespread shortage of medical supplies is reaching a critical point .
States lacking essential equipment like ventilators and masks need relief quickly .
But as President Trump struggles to coordinate a cohesive response to the pandemic and fights with state governors over how these supplies will be distributed , the stockpile @ @ @ @ @ @ @ It ’ s also starting to run out of supplies .
That ’ s why Senior advisor to the president Jared Kushner prompted controversy when he made a rare public appearance at the April 2 coronavirus task force briefing and commented on the federal stockpile .
When asked about states ’ needs for supplies , Kushner said that the stockpile was “ supposed to be our stockpile.
” The president ’ s son-in-law added , “ It ’ s not supposed to be states ’ stockpiles that they then use.
” Then , @ @ @ @ @ @ @ Stockpile website had been changed to de-emphasize its commitment to helping states and to downplay the size of its inventory .
This particular description online now refers to the federal stockpile as “ a short-term stopgap buffer.
” Part of this new definition of the Strategic National Stockpile does reside in the general vicinity of reality .
The stockpile is running low .
The Trump administration admits it .
And no , this is not the states ’ fault .
But it ’ s not entirely clear what will happen when it ’ @ @ @ @ @ @ @ Strategic National Stockpile anyway ?
The United States ’ Strategic National Stockpile , like its nuclear arsenal , is something the US hoped it would never need to use .
Formed in 1999 as anxiety over Y2K mounted , this federal stockpile was designed to prevent an interruption to hospital supply chains , if all the computers ended up melting down on New Years Eve .
That never happened , but because biological attacks were becoming a growing threat , the US government outfitted the stockpile in the interest of national security .
@ @ @ @ @ @ @ , for example , officials could quickly access vaccines and antitoxins to fight back against nerve agents or diseases like small pox .
These biological countermeasures still exist and are stored in six warehouses located in strategic , undisclosed locations across the country , where they are maintained by a staff of about 200 .
The exact inventory of the Strategic National Stockpile is classified , though journalists have reported that it contains over 1,000 categories of drugs and medical items worth about $ 8 billion .
In the 20 years since the @ @ @ @ @ @ @ mobilized after 9/11 and the anthrax attacks that followed .
Later , the US government deployed it in response various major hurricanes , as well as the H1N1 pandemic , during which the stockpile sent flu medication to all 50 states .
Since then , the Strategic National Stockpile has been preparing for the next outbreak , though it obviously didn ’ t know when or what it would be .
With an annual budget of about $ 600 million , the stockpile has maintained a large supply of personal protective equipment , @ @ @ @ @ @ @ and surgical gowns , as well as medical equipment like the ventilators that hospitals so urgently need now to treat Covid-19 patients .
A significant challenge is that many of these items have a shelf life .
“ Part of stockpiling is not just accruing the necessary equipment , but also maintaining it and replacing it as needed , ” Andrew Lakoff , a professor of sociology at the University of Southern California who studies health preparedness , told Recode .
“ So it ’ s sort of an ongoing , indefinite process @ @ @ @ @ @ @ may or may not prove to be necessary.
” While the Strategic National Stockpile was originally part of the Centers for Disease Control ( CDC ) , the Trump Administration moved it to a different part of the Health and Human Services Department in 2018 .
At the time , this concerned certain experts and lawmakers , who worried that the move could disrupt the delicate process of managing the stockpile .
As The Washington Post reported at the time , some even worried then that the Trump administration ’ s plan would @ @ @ @ @ @ @ the stockpile.
” It ’ s important to note that the mission of the Strategic National Stockpile is ultimately of limited scope .
As spelled out in the law that established it , the federal stockpile is intended “ to provide for and optimize the emergency health security of the United States.
” The word “ emergency ” does a lot of work in that sentence .
Richard Branson , a respiratory care specialist and professor at the University of Cincinnati Medical Center who advises the federal government on ventilator supplies , explained @ @ @ @ @ @ @ designed to meet initial needs in a crisis , until industry could ramp up production .
Because ventilators are such specialized pieces of equipment with parts sourced from all over the world , quickly manufacturing more is a uniquely difficult challenge .
“ This is the first time in 20 years ventilators from the stockpile have been used , ” Branson told Recode .
“ If last year , you had known that fact and there were 80,000 ventilators in the stockpile that had never been deployed , you would be asking me @ @ @ @ @ @ @ went without healthcare.
” But there aren ’ t actually 80,000 ventilators in the federal stockpile .
As of early March , the Strategic National Stockpile only had 16,600 ventilators .
It has even fewer now : On April 3 , the Federal Emergency Management Agency ( FEMA ) told Recode that the federal government has just 9,800 ventilators available .
There are 9,054 remaining in the Strategic National Stockpile , and the Department of Defense has 900 .
New York governor Andrew Cuomo said that just his state , which is the @ @ @ @ @ @ @ as many as 37,000 ventilators at the peak of the outbreak .
After waiting for relief from the Trump administration , Cuomo ultimately enlisted the National Guard to relocate ventilators from upstate facilities to New York City .
As far as the rest of the country ’ s concerned , it ’ s safe the say that the Strategic National Stockpile isn ’ t even close to meeting the overall demand that ’ s expected during the coronavirus pandemic .
“ It ’ s like being on eBay with 50 other states ” @ @ @ @ @ @ @ is running low on other urgently needed supplies as well .
On April 1 , the Washington Post reported that the federal stockpile ’ s stock of personal protective equipment , including N95 masks , was almost depleted .
A Department of Homeland Security official told the paper that the stockpile was only “ designed to respond to a handful of cities , ” pointing to a global shortage of these products .
And experts and lawmakers are concerned that the Trump administration ’ s uneven distribution of supplies is driven by political @ @ @ @ @ @ @ Washington State requested 233,000 N95 respirators and 200,000 surgical masks , the Strategic National Supply sent them less than half that amount .
Illinois , Massachusetts , and Maine also said they received fractions of what they requested from the federal government .
But on March 10 , after Washington ’ s request , Florida asked for 430,000 surgical masks , 180,000 N95 respirators , and other equipment .
The full order arrived three days later .
One anonymous official told The Washington Post , “ The president knows Florida is so important @ @ @ @ @ @ @ to what Florida wants.
” Trump ’ s brazen behavior isn ’ t going unnoticed .
Adam Schiff , chair of the House Intelligence Committee , said that in the distribution of medical supplies there should be “ no favoritism in terms of political allies , no discrimination against states or governors based on lack of presidential flattery.
” Sen. Cory Gardner of Colorado sent a letter to the Health and Human Services inspector general requesting an investigation into the Strategic National Stockpile ’ s supply of ventilators .
Gardner told Politico that @ @ @ @ @ @ @ needs to be rooted out and those responsible held accountable.
” And Connecticut Gov .
Ned Lamont called the state of the stockpile “ disturbing.
” After President Trump declared a national emergency over the novel coronavirus crisis on March 13 , he told states to order their own medical supplies , kicking off a process that has led to governors entering bidding wars with each other and even with the federal government over essential goods like ventilators and N95 masks .
“ It ’ s like being on eBay with 50 other @ @ @ @ @ @ @ ” Gov .
Cuomo said in a daily press briefing at the end of March .
“ What we ’ re seeing now is a sort of competition on the open market among states trying get ahold of stuff that the stockpile doesn ’ t have enough of — or is running out of , ” said Lakoff , the USC professor .
“ Everyone ’ s scrambling to try to figure out how to get ahold of this stuff.
” What happens when the stockpile is emptied We don ’ t really @ @ @ @ @ @ @ Stockpile runs out of essential supplies .
But we might learn soon enough .
“ FEMA planning assumptions for COVID-19 pandemic response acknowledged that the Strategic National Stockpile ( SNS ) alone could not fulfill all requirements at the state and tribal level , ” a FEMA spokesperson told Recode .
“ Therefore , the federal government will exhaust all means to identify and attain medical and other supplies needed to combat the virus.
” The agency added that it would meet additional demand through the private sector or the Pentagon .
This @ @ @ @ @ @ @ Airbridge which will include 20 flights transporting supplies from Asia to various cities in the United States in early April .
FEMA says these flights are transporting masks , gloves , goggles , and surgical gowns , all of which go first to medical distributors and then to hospitals and health care facilities .
President Trump has also invoked the Defense Production Act to order GM to begin producing ventilators and 3M to produce more N95 masks domestically , as well as ordering 3M to cease exports of these products .
( 3M @ @ @ @ @ @ @ , has warned that ceasing exports will actually make the mask shortage in the US worse . )
Meanwhile , private corporations and everyday Americans have been making an enormous effort to fill in the gaps that the government has failed to close .
Elon Musk has promised that his companies , Tesla and Space X , will start building ventilators .
Hobbyists are coming up with new designs for cheap breathing machines that can be built out of simple materials .
Automotive parts factories have changed their workflows to start producing face @ @ @ @ @ @ @ movement of people sewing face masks out of leftover fabric is taking the country by storm .
Put quaintly , everybody is doing their best .
The federal government , on the other hand , seems to be getting worse at dealing with the Covid-19 crisis .
After spending the first two months of the year denying the severity of the coronavirus outbreak , it ’ s now clear that the Trump Administration has settled on deflecting blame and settling into the posture of unaccountability .
As Vox ’ s Matthew Yglesias puts @ @ @ @ @ @ @ led by Donald Trump , has essentially abdicated its traditional role of spearheading a coordinated response.
” Coming up with a response , it seems , is the states ’ problem .
This is what makes the shifting role of the Strategic National Stockpile so frustrating for so many people right now .
Before Kushner ’ s appearance at the coronavirus task force briefing , the stockpile ’ s website said the “ Strategic National Stockpile is the nation ’ s largest supply of life-saving pharmaceuticals and medical supplies for use in a @ @ @ @ @ @ @ local supplies to run out.
” The following morning it read , “ The Strategic National Stockpile ’ s role is to supplement state and local supplies during public health emergencies.
” So that stockpile that was designed to help the entire nation in an emergency is now a backup plan .
Also , it ’ s basically gone .
What Kushner said about the federal government not being there to help out with supplies ?
Unfortunately , that ’ s true .
The states are on their own , and that reality @ @ @ @ @ @

The Strategic National Stockpile, a relatively obscure office in the federal government that manages the country’s emergency medical supplies, exists to respond to a crisis like the coronavirus pandemic.
As the United States faces hundreds of thousands of Covid-19 cases, a widespread shortage of medical supplies is reaching a critical point. States lacking essential equipment like ventilators and masks need relief quickly. But as President Donald Trump struggles to coordinate a cohesive response to the pandemic — fighting with state governors over how these supplies will be distributed and reportedly seizing shipments from private companies before distributing supplies to political allies — the stockpile is becoming a contentious subject. It’s also starting to run out of supplies.
That’s why Jared Kushner, senior adviser to the president, prompted controversy when he made a rare public appearance at the April 2 coronavirus task force briefing and commented on the federal stockpile. When asked about states’ needs for supplies, Kushner said the stockpile was “supposed to be our stockpile.” The president’s son-in-law added, “It’s not supposed to be states’ stockpiles that they then use.”
Then, the following morning, the Strategic National Stockpile website had been changed to deemphasize its commitment to helping states and to downplay the size of its inventory. This particular description online now refers to the federal stockpile as “a short-term stopgap buffer.”
Part of this new definition of the Strategic National Stockpile does reside in the general vicinity of reality. The stockpile is running low. The Trump administration admits it. And no, this is not the states’ fault. But it’s not entirely clear what will happen when it’s emptied out.
What is the Strategic National Stockpile, anyway?
The Strategic National Stockpile, like the nuclear arsenal, is something government officials hoped they would never need to use. Formed in 1999 as anxiety over Y2K mounted, this federal stockpile was designed to prevent an interruption to hospital supply chains, if all the computers ended up melting down on New Year’s Eve. That never happened, but because biological attacks were becoming a growing threat, the US government outfitted the stockpile in the interest of national security. If a bioweapon struck an American city, for example, officials could quickly access vaccines and antitoxins to fight back against nerve agents or diseases like smallpox.
These biological countermeasures still exist and are stored in six warehouses located in strategic, undisclosed locations across the country, where they are maintained by a staff of about 200. The exact inventory of the Strategic National Stockpile is classified, though journalists have reported that it contains over 1,000 categories of drugs and medical items worth about $8 billion.
In the 20 years since the stockpile was established, it was first mobilized after 9/11 and the anthrax attacks that followed. Later, the US government deployed it in response to various major hurricanes, as well as to the H1N1 pandemic in 2009-2010, during which the stockpile sent flu medication to all 50 states.
Since then, the office of the Strategic National Stockpile has been preparing for the next outbreak, though no one knew when or what it would be. With an annual budget of about $600 million, the stockpile has maintained a large supply of personal protective equipment, including N95 masks, face shields, and surgical gowns, as well as medical equipment like the ventilators that hospitals so urgently need now to treat Covid-19 patients.
A significant challenge is that many of these items have a shelf life.
“Part of stockpiling is not just accruing the necessary equipment, but also maintaining it and replacing it as needed,” Andrew Lakoff, a professor of sociology at the University of Southern California who studies health preparedness, told Recode. “So it’s sort of an ongoing, indefinite process that takes a lot of resources that may or may not prove to be necessary.”
While the Strategic National Stockpile was originally part of the Centers for Disease Control and Prevention (CDC), the Trump administration moved it to a different part of the Health and Human Services Department in 2018. At the time, this concerned certain experts and lawmakers, who worried that the move could disrupt the delicate process of managing the stockpile. As the Washington Post reported at the time, some even worried then that the Trump administration’s plan would “politicize decision-making about products bought for the stockpile.”
It’s important to note that the mission of the Strategic National Stockpile is ultimately of limited scope. As spelled out in the law that established it, the federal stockpile is intended “to provide for and optimize the emergency health security of the United States.” The word “emergency” does a lot of work in that sentence.
Richard Branson, a respiratory care specialist and professor at the University of Cincinnati Medical Center who advises the federal government on ventilator supplies, explained to Recode that the federal stockpile was designed to meet initial needs in a crisis, until industry could ramp up production. Because ventilators are such specialized pieces of equipment with parts sourced from all over the world, quickly manufacturing more is a uniquely difficult challenge.
“This is the first time in 20 years ventilators from the stockpile have been used,” Branson told Recode. “If last year, you had known that fact and there were 80,000 ventilators in the stockpile that had never been deployed, you would be asking me why this money was wasted while people went without health care.”
But there aren’t actually 80,000 ventilators in the federal stockpile. As of early March, the Strategic National Stockpile only had 16,600 ventilators. It has even fewer now: On April 3, the Federal Emergency Management Agency (FEMA) told Recode the federal government has just 9,800 ventilators available. There are 9,054 remaining in the Strategic National Stockpile, and the Department of Defense has 900.
New York Gov. Andrew Cuomo said that just his state, which is currently at the epicenter of the pandemic, will need as many as 37,000 ventilators at the peak of the outbreak. After waiting for relief from the Trump administration, Cuomo ultimately enlisted the National Guard to relocate ventilators from upstate facilities to New York City. As far as the rest of the country is concerned, it’s safe to say that the Strategic National Stockpile isn’t even close to meeting the overall demand that’s expected during the coronavirus pandemic.
“It’s like being on eBay with 50 other states”
Besides ventilators, the Strategic National Stockpile is running low on other urgently needed supplies as well. On April 1, the Washington Post reported that the federal stockpile’s stock of personal protective equipment, including N95 masks, was almost depleted. A Department of Homeland Security official told the paper that the stockpile was only “designed to respond to a handful of cities,” pointing to a global shortage of these products.
And experts and lawmakers are concerned that the Trump administration’s uneven distribution of supplies is driven by political goals. In early March, when Washington state requested 233,000 N95 respirators and 200,000 surgical masks, the Strategic National Stockpile sent them less than half that amount. Illinois, Massachusetts, and Maine also said they received fractions of what they requested from the federal government.
But on March 10, after Washington’s request, Florida asked for 430,000 surgical masks, 180,000 N95 respirators, and other equipment. The full order arrived three days later. One anonymous official told the Washington Post, “The president knows Florida is so important for his reelection … He pays close attention to what Florida wants.”
Trump’s brazen behavior isn’t going unnoticed. Adam Schiff, chair of the House Intelligence Committee, said that in the distribution of medical supplies there should be “no favoritism in terms of political allies, no discrimination against states or governors based on lack of presidential flattery.”
Sen. Cory Gardner of Colorado sent a letter to the Health and Human Services inspector general requesting an investigation into the Strategic National Stockpile’s supply of ventilators. Gardner told Politico that “any kind of mismanagement or abuse needs to be rooted out and those responsible held accountable.” And Connecticut Gov. Ned Lamont called the state of the stockpile “disturbing.”
After Trump declared a national emergency over the novel coronavirus crisis on March 13, he told states to order their own medical supplies, kicking off a process that has led to governors entering bidding wars with each other and even with the federal government over essential goods like ventilators and N95 masks. “It’s like being on eBay with 50 other states, bidding on a ventilator,” Cuomo said in a daily press briefing at the end of March.
“What we’re seeing now is a sort of competition on the open market among states trying get ahold of stuff that the stockpile doesn’t have enough of — or is running out of,” said Lakoff, the USC professor. “Everyone’s scrambling to try to figure out how to get ahold of this stuff.”
What happens when the stockpile is emptied
We don’t really know what happens when the Strategic National Stockpile runs out of essential supplies. But we might learn soon enough.
“FEMA planning assumptions for Covid-19 pandemic response acknowledged that the Strategic National Stockpile alone could not fulfill all requirements at the state and tribal level,” a FEMA spokesperson told Recode. “Therefore, the federal government will exhaust all means to identify and attain medical and other supplies needed to combat the virus.” The agency added that it would meet additional demand through the private sector or the Pentagon.
This effort includes a public-private partnership called Project Airbridge which will include 20 flights transporting supplies from Asia to various cities in the US in early April. FEMA says these flights are transporting masks, gloves, goggles, and surgical gowns, all of which go first to medical distributors and then to hospitals and health care facilities. The new project is not without its own controversy. In the days after its launch, several state and local governments as well as private hospitals reported that the federal government was confiscating their shipments of medical supplies in order to redistribute them as it saw fit. This practice would directly contradict the Trump administration’s earlier statements about states fending for themselves.
Trump has also invoked the Defense Production Act to order GM to begin producing ventilators and 3M to produce more N95 masks domestically, as well as ordering 3M to cease exports of these products. (3M has warned, for what it’s worth, that ceasing exports will actually make the mask shortage in the US worse.)
Meanwhile, private corporations and everyday Americans have been making an enormous effort to fill in the gaps the government has failed to close. Elon Musk has promised that his companies, Tesla and SpaceX, will start building ventilators. Hobbyists are coming up with new designs for cheap breathing machines that can be built out of simple materials. Automotive parts factories have changed their workflows to start producing face shields and other supplies, and a movement of people sewing face masks out of leftover fabric is taking the country by storm. Put quaintly, everybody is doing their best.
The federal government, on the other hand, seems to be getting worse at dealing with the Covid-19 crisis. After spending the first two months of the year denying the severity of the coronavirus outbreak, it’s now clear that the Trump administration has settled on deflecting blame and establishing a posture of unaccountability. As Vox’s Matthew Yglesias puts it, the “federal government, led by Donald Trump, has essentially abdicated its traditional role of spearheading a coordinated response.” Coming up with a response, it seems, is the states’ problem.
This is what makes the shifting role of the Strategic National Stockpile so frustrating for so many people right now. Before Kushner’s appearance at the coronavirus task force briefing, the stockpile’s website said the “Strategic National Stockpile is the nation’s largest supply of life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out.” The following morning it read, “The Strategic National Stockpile’s role is to supplement state and local supplies during public health emergencies.”
So the stockpile that was designed to help the entire nation in an emergency is now a backup plan. Also, it’s basically gone. What Kushner said about the federal government not being there to help out with supplies? Unfortunately, that’s true. The states are on their own, and that reality is starting to sink in.
Update, April 7, 11:15 am ET: This piece has been updated to include reports of the federal government confiscating medical supplies from state and local governments.