As more states mandate that people stay home for all but their essential needs, offices around the country will finally have to confront their squeamishness about remote work.
For some offices, those reservations may be institutional. Managers who believe employees are more productive at the office are now testing that hypothesis at scale, or will soon have to, and companies that value their office culture will have to try replicating it virtually. Along the way, they may find that remote work isn’t as detrimental as they thought.
But there’s also a more mundane reason that working from home could become a lasting option for office workers: Companies are finally investing in the technology they’ve always needed to make remote work possible. Investments that might’ve seemed superfluous before have now become necessary to keep their businesses running.
“We once assumed this shift would take place over 5 to 10 years, but now we are seeing that it is happening much, much faster,” says Sagi Gidali, the cofounder and chief product officer for Perimeter 81, a company that helps businesses secure their networks for remote workers.
THE SCRAMBLE TO SUPPORT REMOTE WORK
It’s easy to assume that sending workers home is trivial from a technical standpoint. Cloud services such as Slack and Google’s G Suite are designed to be accessible from anywhere, so you might think workers could simply access those same services from their computers at home.
But for many office workers, it’s not that simple. Companies in the financial and insurance sectors, for instance, are dealing with sensitive data that can’t leave their own internal servers, and some companies use proprietary apps that they only offer from within their office networks. While remote workers can sometimes use corporate virtual private networks, or VPNs, to access their office networks, sending everyone home requires more network bandwidth and expanded hardware to encrypt the connections.
WE ONCE ASSUMED THIS SHIFT WOULD TAKE PLACE OVER 5 TO 10 YEARS.”
SAGI GIDALI, PERIMETER 81
“These offices don’t necessarily have or pay for the network bandwidth to assume that everybody’s coming in from the outside,” says Thomas Hatch, an IT infrastructure expert who is the founder and CTO of SaltStack.
Simon Migliano, the head of research at Top10VPN.com, says he’s heard anecdotally that some teams were caught unprepared and have been rushing to stress-test their VPNs to make sure they can handle the load.
“We know of at least one company whose VPN capacity is 8,000 users,” Migliano says via email. “Now, they have over five times as many employees as that trying to connect, with predictably frustrating results.”
Rob Smith, an analyst with Gartner, says he’s been inundated with calls from companies that are now trying to put remote work solutions in place. He estimates that roughly one-third of all companies were ill-equipped to send all their employees home, while another third had no remote work plan in place at all.
“My number one inquiry call is, ‘We have X number of employees who have never worked from home before, who are now forced to work from home. What do we do?’” Smith says.
The irony, Smith says, is that corporate VPN is an aging technology, and before the coronavirus pandemic, he believed it was on its way out as more companies migrated to cloud-based services. As a result, companies weren’t really interested in beefing up their VPNs so that more employees could work at home.
THEY JUST DIDN’T CARE. IT WASN’T EVEN A COST ISSUE.”
ROB SMITH, GARTNER
“They just didn’t care,’ Smith says. “‘It wasn’t even a cost issue. It was, ‘We don’t need it, or it’s good enough what we have.’”
Gidali’s company, Perimeter 81, has also seen an uptick in demand. The company presents itself as a hybrid solution, allowing workers to access a company’s internal networks and cloud-based services through a single secure platform. While it was onboarding about 70 to 80 new clients per month before the coronavirus outbreak, its rate of new clients has roughly quadrupled since.
“There was a hesitancy to begin that process of using a cloud service, of migrating to the cloud. And now the reality is here that we have to be prepared for these kinds of scenarios,” says Karen Mesoznik, Perimeter 81’s corporate marketing director.
WHAT HAPPENS NEXT?
Now that companies are making these investments, experts believe they’ll be much more likely to stick with remote work—at least as a part-time option—even after the threat of COVID-19 subsides. Both Perimeter 81’s Sagi Gidali and Gartner’s Rob Smith say workers are more productive when they can stay at home, and severalstudiesback this up.
“It’s an old-school mentality to think you have to have a presence in an office and that people only work within the office,” Smith says. “Once people adjust to working from home, they actually do more work and work longer because they’re not dealing with commutes, they’re not dealing with being interrupted.”
That’s not to say some institutional hurdles won’t remain. In addition to counseling companies on how to make the technological shift, Smith says he’s been giving companies cultural pointers, advising them, for instance, to factor some “water cooler” time into conference calls so workers can talk about other things.
“You’ve got to be able to budget that human element into working from home,” Smith says. “It’s not just the technology. It’s so much more than that.”
ABOUT THE AUTHOR
Jared Newman covers apps and technology from his remote Cincinnati outpost. He also writes two newsletters, Cord Cutter Weekly and Advisorator.
Pa governor Wolf tests negative for coronavirus, issues stay-at-home order for Philly and its suburbs. Other regional and national coronavirus stories below.
New Jersey now has at least 2,844 coronavirus cases with 27 deaths as officials announced Monday 935 new positive tests on the same day the second state-run testing site opened in Monmouth County and quickly hit capacity due to overwhelming demand.
“There’s clearly community spread going on,” Gov. Phil Murphy said at a news briefing in Trenton Monday. “There’s also a lot more testing going on. As the testing regime expands, we’re going to see these numbers go up in a big way. We are getting a clearer and better sense of how far the coronavirus has already spread.”
The seven new deaths reported Monday five men and two women ranging in age from 57 to 91. Two of those who died were from Bergen County and there was one death each in Warren, Somerset, Union, Passaic and Essex counties. One of the deaths was associated with a longterm care facility and two cases have confirmed to have involved patients with underlying health conditions.
Murphy also announced Monday that residents should expect New Jersey schools to remain closed for “an extended period of time.” No decision has been made on a timetable, he said.
Murphy took sweeping steps Saturday to slow the outbreak by signing executive orders shutting down non-essential retail businesses, canceling all public gatherings and instructing people to “quite simply stay at home.”
“Unless you are needed as part of our front line efforts, please stay home,” Murphy said. “I know the numbers you hear every day are worrying. Each number is a fellow New Jerseyan who needs us. Let’s all do our part.”
The new orders calls for nearly all New Jersey residents to stay in and refrain from travel — except for obtaining food and medicine, seeking medical attention, visiting family and close friends, exercise, and reporting to work at a business that is still open.
The non-essential business shutdown took effect Saturday night. The list of essential businesses that are allowed to keep operating is, according to the state website.
Manufacturing, industrial, logistics, ports, heavy construction, shipping, food production, food delivery, and other commercial operations; and medical facilities where a sick or injured person is given care or treatment, such as doctor’s offices, hospitals, dentist offices, long-term care facilities and other medical offices.
On Sunday, Murphy said he’s “really damned unhappy” to hear stories about New Jersey residents not abiding by his stay-at-home order to combat the coronavirus outbreak and warned Sunday to expected a law enforcement crackdown.
“There’s too many people not paying attention to this. We’ve about had it. We’re not happy,” Murphy said Sunday.
From the Philadelphia Inquirer
TOM GRALISH / STAFF PHOTOGRAPHER A sign at the 8th Street ramp to westbound I-676 (Vine Street Expressway) Mar. 22, 2020 reflect Philadelphia’s order that all residents stay in their homes except when engaging in life-sustaining activities beginning at 8 a.m. Monday because of the coronavirus crisis.
Gov. Tom Wolf is expected to issue a “stay-at-home” order today for Philadelphia and its suburbs, as well as Monroe and Allegheny Counties, taking the fight against the coronavirus to a new level by requiring residents to remain inside except for essential trips such as buying food or seeking medical help.
The order will apply to Philadelphia, Bucks, Chester, Delaware, and Montgomery Counties in the southeast, Monroe County in the northeast, and Allegheny County in Western Pennsylvania, according to four sources with knowledge of the governor’s plans.
It was not immediately known when the order will take effect, how long it will last, or what enforcement might entail. Wolf is expected to make the announcement this afternoon, according to the sources, who requested anonymity because they were not authorized to discuss the plan.
Wolf’s order comes a day after Philadelphia Mayor Jim Kenney issued a similar order for the city’s 1.6 million residents, which began at 8 a.m. on Monday.
Coronavirus frauds spread, preying on Medicare recipients, feds say
Scam artists are preying on older people’s fears by peddling fake tests for the coronavirus to Medicare recipients, a federal law enforcement agency warned on Monday.
The Health and Human Services inspector general’s office said it’s seeing marketing schemes rapidly pivot to offering tests for COVID-19 and “Senior Care Packages” with hand sanitizer or even tout a vaccine, which doesn’t exist. Some marketers falsely claim that President Donald Trump has ordered that seniors get tested.
It’s all a trick to get personal information that can be used to bill federal and state health programs, said Christian Schrank, assistant inspector general for investigations.
“It’s a straight-up ruse to get your Medicare number or your Social Security number under the guise of having a test kit or a sanitary kit sent to you,” Schrank said. Often the caller will hang up as soon as that number is provided.
Gov. Tom Wolf tests negative for coronavirus after exposure concern
COMMONWEALTH MEDIA SERVICES / COMMONWEALTH MEDIA SERVICESGovernor Tom Wolf speaking by video feed while Secretary of Health Dr. Rachel Levine stands at the podium during the virtual press conference.
Gov. Tom Wolf recently tested negative for the coronavirus after being alerted to a potential exposure, his office said Monday.
The governor was tested after his office was contacted by someone who had been near Wolf and who was showing symptoms of the illness, a spokesperson said. That person was also tested and found to be negative, according to the office.
“The measure was taken out of an abundance of caution,” the spokesperson, Lyndsay Kensinger, said. “We do not have any evidence that the governor has been in contact with a person who has tested positive for COVID-19.”
The governor is working remotely but is not in quarantine.
— Angela 1 hour ago11:45 AM – March 23, 2020
Klobuchar’s husband tests positive, senator says she won’t miss vote on recovery package
Klobuchar said she won’t be tested for coronavirus or placed in self-quarantine because her husband has been back home in Minnesota, while she’s been working in Washington, D.C.
“I love my husband so very much and not being able to be there at the hospital by his side is one of the hardest things about this disease,” Klobuchar wrote.
My husband has coronavirus. I love him & not being able to be by his side is one of the hardest things about this disease. So many are going through this & much worse. I pray for him & you & meanwhile I will do all I can to get help to the American people.https://medium.com/@Amy_Klobuchar/statement-from-senator-amy-klobuchar-c4195302844 …
– Sen. Rand Paul (R., Ky.).Paul tested positive for coronavirus on Sunday after attending an event in Kentucky two weeks ago where several attendees have tested positive
– Sens. Mitt Romney (R., Utah) and Mike Lee (R., Utah). Both Romney and Lee announced on Sunday they will self-quarantine themselves following Paul’s diagnosis. Both are expected to be away for 14 days.
Other senators have placed themselves in self-quarantine and have since re-emerged, including Lindsey Graham (R., S.C.), Ted Cruz (R., Texas, Cory Gardner (R., Colo.), and Rick Scott (R., Fla.).
— Rob Tornoe1 hour ago11:25 AM – March 23, 2020
Pa., N.J. offer mental health assistance during coronavirus lockdowns
As people across Pennsylvania enter the second week of home isolation to prevent the spread of the coronavirus, state health officials reminded residents on Monday that mental health help is available via text.
The number of confirmed coronavirus cases in Delaware rose to 64 on Monday morning, following Gov. John Carney’s order for residents to stay at home.
There were 56 cases Sunday. According to health officials, at least six people have been hospitalized, and three are critically ill.
Like Pennsylvania and New Jersey, Delaware announced the closure of nonessential businesses, which will go into effect Tuesday at 8 a.m.
Residents are permitted to leave their homes to go grocery shopping, pick up take-out food purchases, receive medical treatment or care for an immediate relative, and exercise. They can also leave to go to work, if their employer is listed as an essential business.
— Rob Tornoe
Temple, Villanova cancel on-campus commencements
Temple University and Villanova University announced Monday they are calling off their on-campus commencements.
Temple’s had been scheduled for May 7; Villanova’s for May 15.
“While we will not hold the traditional in-person ceremony … we are exploring alternatives to this long-standing celebration of your achievement,” Temple President Richard M. Englert and Provost JoAnne A. Epps said in an email to the campus Monday morning.
Temple also has canceled all on-campus events through May 31, and announced that classes in its first summer session would be held online.
TIM TAI / STAFF PHOTOGRAPHERA pedestrian is reflected while walking past the shuttered Barnes and Noble on Temple University’s campus in North Philadelphia on Tuesday, March 17, 2020. The university has transitioned its classes online due to the ongoing coronavirus pandemic, and nonessential retail businesses have been ordered to shut down.
In a campus email. Villanova president the Rev. Peter M. Donohue said, “I will confer your degrees via a live-streamed event.”
An in-person celebration will be held when it is safe, he said.
Classes for the rest of the spring semester will be conducted online, the president said. The university also issued a temporary hiring freeze.
— Susan Snyder 2 hours ago9:55 AM – March 23, 2020
N.J. top court orders release of low-level offenders to thwart spread of coronavirus
New Jersey’s Supreme Court has ordered individuals serving time for low-level offenses in county jails to be temporarily released to mitigate the spread of the coronavirus in correctional facilities.
The order takes effect Tuesday and could mean the release of up to 1,000 people, according to the ACLU of New Jersey, one of the organizations that requested New Jersey take this measure.
“Unprecedented times call for rethinking the normal way of doing things,” Amol Sinha, executive director of the ACLU of New Jersey said, “and in this case, it means releasing people who pose little risk to their communities for the sake of public health and the dignity of people who are incarcerated.”
Individuals are to be temporarily released from jail while New Jersey is under a state of emergency. Once the governor declares the emergency over, judges will decide whether to commute sentences of anyone that has been released. Those who have tested positive for the coronavirus will not be released. County prosecutors can file objections to keep specific people detained, if they believe it is necessary.
— Pranshu Verma
Surgeon general warns: ‘This week, it’s going to get bad’
U.S. Surgeon General Jerome Adams issued a dire warning for the country Monday as the number of coronavirus cases continues to rise.
“I want America to understand. This week, it’s going to get bad,” Adams said on NBC’s Today show. “We really need to come together as a nation.”
During a separate interview on Fox & Friends, Adams attempted to downplay the hype surrounding two antimalarial drugs President Trump has pointed to in recent days as a possible treatment for coronavirus. Medical experts — including Dr. Anthony Fauci, a member of Trump’s coronavirus task force — have warned the drugs are untested in the treatment of COVID-19.
EVAN VUCCI / APSurgeon General Jerome Adams speaks during press briefing with the coronavirus task force, at the White House, Thursday, March 19, 2020, in Washington. (AP Photo/Evan Vucci)
“Here’s the thing about those drugs — there’s ‘may’ and ‘actually does’. This may be promising … We need to verify through studies that they actually work,” Adams said. “It’s not practical to think we’re going to treat our way out of this problem with new drugs, or with ventilators, or with supplies … We need more people talking about staying at home.”
As of Monday morning, there have been over 35,000 cases of coronavirus across the United States, according to Johns Hopkins University. At least 471 have died.
— Rob Tornoe
Stocks fall despite Federal Reserve’s new emergency efforts
Stocks opened slightly lower Monday despite unprecedented moves announced by the Federal Reserve to keep markets functioning amid the coronavirus outbreak.
The Dow Jones Industrial Average opened down about 1.5%, or about 280 points. The Nasdaq opened down slightly, while the S&P 500 opened down about 1% (about 20 points).
The Federal Reserve announced several new emergency programs Monday morning aimed at helping the economic impact caused by the coronavirus outbreak.
Among the moves are a commitment to buy an unlimited about of government bonds and mortgage securities and a program to buy certain corporate bonds “for the first time in its history,” according to the Washington Post.
“It has become clear that our economy will face severe disruption,” leaders of the Federal Reserve said in a statement. “The Federal Reserve is committed to using its full range of tools to support households, businesses, and the U.S. economy overall in this challenging time.”
Investors are also awaiting news about a massive stimulus deal being worked out in Congress aimed at helping individuals and businesses impacted by the coronavirus outbreak. As of Monday morning, legislators and Treasury Secretary Steve Mnuchin were still working to reach an agreement on the details.
Stocks have dropped over 30% since setting a new record on Feb. 19. Last week, the Dow suffered its worst week since the 2008 financial crisis, dropping 17.3%.
— Rob Tornoe
Pa. top court tosses challenge to Wolf’s ban non-life-sustaining businesses
JESSICA GRIFFIN / STAFF PHOTOGRAPHERA line of people wait outside of the Philadelphia Gun and Archery Club, in South Philadelphia, March 18, 2020. This location appears to be a gun shop that sells firearms and ammunition and a training facility. As of Wednesday morning, nearly 6,500 cases of the coronavirus have been reported in the United States, and 114 people had died. Cities around the United States, including Philadelphia, are increasing social restrictions in an attempt to slow the virus’ spread.
A divided Pennsylvania Supreme Court dismissed gun rights advocates’ legal challenge to Gov. Tom Wolf’s statewide order closing all “non-life-sustaining” businesses, clearing the way for enforcement of the mandate to begin Monday.
In an order issued late Sunday, the justices denied a petition brought by a Bucks County gun buyer and a Lancaster County gun store owner, who argued that the coronavirus clampdown violated their Second Amendment right to bear arms.
Though, as a body, the appellate court offered no explanation for their decision in their two page order. Three of its justices dissented, saying they were “troubled by the uncertainty” set off by Wolf’s decision and suggested the administration consider a limited exception to gun sellers.
Though Gov. Wolf’s order has been in effect since Thursday, enforcement by the Pennsylvania State Police and the state Liquor Control Board and Department of Health and Agriculture was delayed until Monday morning to give businesses time to prepare and the administration to review thousands of waiver requests from companies and industry representatives around the state.
President Trump attends the coronavirus response daily briefing at the White House on March 20. (Jonathan Ernst/Reuters
U.S. intelligence agencies were issuing ominous, classified warnings in January and February about the global danger posed by the coronavirus while President Trump and lawmakers played down the threat and failed to take action that might have slowed the spread of the pathogen, according to U.S. officials familiar with spy agency reporting.
By Shane Harris, Greg Miller, Josh Dawsey and Ellen Nakashima, The Washington Post
The intelligence reports didn’t predict when the virus might land on U.S. shores or recommend particular steps that public health officials should take, issues outside the purview of the intelligence agencies. But they did track the spread of the virus in China, and later in other countries, and warned that Chinese officials appeared to be minimizing the severity of the outbreak.
Taken together, the reports and warnings painted an early picture of a virus that showed the characteristics of a globe-encircling pandemic that could require governments to take swift actions to contain it. But despite that constant flow of reporting, Trump continued publicly and privately to play down the threat the virus posed to Americans. Lawmakers, too, did not grapple with the virus in earnest until this month, as officials scrambled to keep citizens in their homes and hospitals braced for a surge in patients suffering from covid-19, the disease caused by the coronavirus.
Intelligence agencies “have been warning on this since January,” said a U.S. official who had access to intelligence reporting that was disseminated to members of Congress and their staffs as well as to officials in the Trump administration, and who, along with others, spoke on the condition of anonymity to describe sensitive information.Coronavirus cases rose as Trump said they were under controlAt least seven times over the past two months, President Trump said the number of coronavirus cases in the U.S. were falling or contained even as they rose. (Video: JM Rieger/Photo: Jabin Botsford/The Washington Post)
“Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it,” this official said. “The system was blinking red.”
Spokespeople for the CIA and the Office of the Director of National Intelligence declined to comment, and a White House spokesman rebutted criticism of Trump’s response.
“President Trump has taken historic, aggressive measures to protect the health, wealth and safety of the American people — and did so, while the media and Democrats chose to only focus on the stupid politics of a sham illegitimate impeachment,” Hogan Gidley said in a statement. “It’s more than disgusting, despicable and disgraceful for cowardly unnamed sources to attempt to rewrite history — it’s a clear threat to this great country.”
Public health experts have criticized China for being slow to respond to the coronavirus outbreak, which originated in Wuhan, and have said precious time was lost in the effort to slow the spread. At a White House briefing Friday, Health and Human Services Secretary Alex Azar said officials had been alerted to the initial reports of the virus by discussions that the director of the Centers for Disease Control and Prevention had with Chinese colleagues on Jan. 3.
The warnings from U.S. intelligence agencies increased in volume toward the end of January and into early February, said officials familiar with the reports. By then, a majority of the intelligence reporting included in daily briefing papers and digests from the Office of the Director of National Intelligence and the CIA was about covid-19, said officials who have read the reports.
The surge in warnings coincided with a move by Sen. Richard Burr (R-N.C.) to sell dozens of stocks worth between $628,033 and $1.72 million. As chairman of the Senate Intelligence Committee, Burr was privy to virtually all of the highly classified reporting on the coronavirus. Burr issued a statement Friday defending his sell-off, saying he sold based entirely on publicly available information, and he called for the Senate Ethics Committee to investigate.AD
A key task for analysts during disease outbreaks is to determine whether foreign officials are trying to minimize the effects of an outbreak or take steps to hide a public health crisis, according to current and former officials familiar with the process.
At the State Department, personnel had been nervously tracking early reports about the virus. One official noted that it was discussed at a meeting in the third week of January, around the time that cable traffic showed that U.S. diplomats in Wuhan were being brought home on chartered planes — a sign that the public health risk was significant. A colleague at the White House mentioned how concerned he was about the transmissibility of the virus.
“In January, there was obviously a lot of chatter,” the official said.
Inside the White House, Trump’s advisers struggled to get him to take the virus seriously, according to multiple officials with knowledge of meetings among those advisers and with the president.
Azar couldn’t get through to Trump to speak with him about the virus until Jan. 18, according to two senior administration officials. When he reached Trump by phone, the president interjected to ask about vaping and when flavored vaping products would be back on the market, the senior administration officials said.
On Jan. 27, White House aides huddled with then-acting chief of staff Mick Mulvaney in his office, trying to get senior officials to pay more attention to the virus, according to people briefed on the meeting. Joe Grogan, the head of the White House Domestic Policy Council, argued that the administration needed to take the virus seriously or it could cost the president his reelection, and that dealing with the virus was likely to dominate life in the United States for many months.
Mulvaney then began convening more regular meetings. In early briefings, however, officials said Trump was dismissive because he did not believe that the virus had spread widely throughout the United States.
By early February, Grogan and others worried that there weren’t enough tests to determine the rate of infection, according to people who spoke directly to Grogan. Other officials, including Matthew Pottinger, the president’s deputy national security adviser, began calling for a more forceful response, according to people briefed on White House meetings.
But Trump resisted and continued to assure Americans that the coronavirus would never run rampant as it had in other countries.
“I think it’s going to work out fine,” Trump said on Feb. 19. “I think when we get into April, in the warmer weather, that has a very negative effect on that and that type of a virus.”
“The Coronavirus is very much under control in the USA,” Trump tweeted five days later. “Stock Market starting to look very good to me!”
But earlier that month, a senior official in the Department of Health and Human Services delivered a starkly different message to the Senate Intelligence Committee, in a classified briefing that four U.S. officials said covered the coronavirus and its global health implications.
Robert Kadlec, the assistant secretary for preparedness and response — who was joined by intelligence officials, including from the CIA — told committee members that the virus posed a “serious” threat, one of those officials said.
Kadlec didn’t provide specific recommendations, but he said that to get ahead of the virus and blunt its effects, Americans would need to take actions that could disrupt their daily lives, the official said. “It was very alarming.”
Trump’s insistence on the contrary seemed to rest in his relationship with China’s President Xi Jingping, whom Trump believed was providing him with reliable information about how the virus was spreading in China, despite reports from intelligence agencies that Chinese officials were not being candid about the true scale of the crisis.
Some of Trump’s advisers told him that Beijing was not providing accurate numbers of people who were infected or who had died, according to administration officials. Rather than press China to be more forthcoming, Trump publicly praised its response.
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Manufacturers are producing as many as they can to care for Covid-19 patients with breathing problems. Now the federal government is asking for even more.
Ventilators vary widely in cost and size, but their purpose is the same: They force oxygen into the patient’s lungs, usually through intubation.PHOTOGRAPH: RONALD BONSS/GETTY IMAGE
Gregory Barber reports for Wired
ERIC GJERDE, CEO of Airon Corporation, a small ventilator maker in Gainesville, Florida, has been getting far more business than he’d like in recent weeks. An Italian company asked him for 2,000 machines. His distributor in California, working with state officials there, asked for 500 more. Normally, his company sells 50 “in a good month,” Gjerde says, and they only keep so many parts on hand. He told the Italians no, and he told the Californians he’d do his best. “America has to come first,” he says.
On Monday, the California distributor came back to him: Could he send another 200? “Of course they want them today, and you just can’t do that,” Gjerde says. “Making ventilators is not a trivial process.” But again he said he’d do what he could.
As the number of Covid-19 cases surges, state governments and hospitals are clamoring for more ventilators and facing a dearth of supplies. The machines are a critical component in treating the most severe cases of the disease, in which inflammation restricts the amount of oxygen a person’s lungs can take up on their own. Ventilators vary widely in cost and size, from portable units used at home and in ambulances to much larger machines found in intensive care units, but their purpose is the same: They force oxygen into the patient’s lungs, usually through intubation.
Some estimates suggest demand for ventilators may quickly overwhelm US hospitals’ supply, which includes about 160,000 machines, plus 12,000 more in federal reserves, according to a recent tally by Johns Hopkins researchers. Not all of those machines are suited to critical care and, of course, many of them are already in use by people with other respiratory conditions.
Whether the nation will face a shortage depends on whether social distancing measures can flatten the curve, reducing the number of people who need hospitalization at the same time, says Craig Coopersmith, director of critical care at Emory University School of Medicine. “Right now we’re OK, but there will be shortages if the pandemic becomes severe enough,” he says. For a preview, doctors need only look to the hardest-hit parts of Italy and China.
Days after telling governors to fend for themselves in obtaining critical supplies like ventilators, President Donald Trump on Wednesday announced he would invoke the Defense Production Act to ramp up the manufacture of critical supplies, including ventilators. Passed in 1950 at the start of the Korean War, the act allows the federal government to step in to ensure the steady flow of goods, including military weapons but also food and health supplies.
On Tuesday, Secretary of Defense Mark Esper also announced that his agency would distribute 2,000 ventilators from their own reserve to the Department of Health and Human Services, but noted that these machines are different from ones normally used in civilian settings and would require special training from defense personnel.
It’s unclear what the immediate effect of Trump’s announcement will be, although it will allow federal agencies to order needed supplies from manufacturers. The question is whether new machines can be produced quickly enough. “The problem I have is that people have been seeing this coming for a long time and governments and hospitals just have not stockpiled,” Gjerde says. “These can sit in a box and never be touched.” For now, he’s had to say no to international orders, despite having distributors in Taiwan and Italy beg him for more.
Retooling a complex supply chain to build more machines quickly will be difficult. Airon relies on suppliers across the Midwest to make the valves and tubing, while another supplier in Washington makes each machine’s casing. A few parts come from China. Gjerde’s looking into whether he can get the circuit boards he needs produced locally.
More top-down coordination could potentially help, says Chris Brooks, chief strategy officer of Ventec, a ventilator maker based near Seattle. The company, which typically ships 100 machines per month, has seen immediate demand for thousands of machines. “Our hope is that we don’t need as many ventilators as people are saying,” he says.
In the United Kingdom, the British government is pushing for large manufacturers to switch from making cars and airplane engines to ventilator equipment. But Gjerde says that even the best engineering teams that are not used to making medical machinery will find it hard to reorient quickly. “They don’t know the nature of the beast,” says Gjerde, who’s received an offer of aid from an auto parts manufacturer in Canada. For certain components, it might be feasible, he says, but “it’s just too dangerous to be thrown into the hands of people who don’t know what they’re doing.”
In the meantime, some have taken to creative hacks, like open-sourcing schematics for the design of ventilator parts for 3D printing. In Italy, the approach was used to quickly produce much-needed valve replacements, reportedly over the objections of a ventilator manufacturer that threatened a patent lawsuit. On Twitter, ER doctors have traded tips on how to split ventilator tubes between multiple people.
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Health officials in New York, California and other hard-hit parts of the country are restricting coronavirus testing to health care workers and the severely ill, saying the battle to contain the virus is lost and the country is moving into a new phase of the pandemic response.
As cases spike sharply in those places, they are bracing for an onslaught and directing scarce resources where they are needed most to save people’s lives. Instead of encouraging broad testing of the public, they’re focused on conserving masks, ventilators and intensive care beds — and on getting still-limited tests to health-care workers and the most vulnerable. The shift is further evidence that rising levels of infection and illness have begun to overwhelm the health care system.
A similar message was hammered Saturday by members of the White House coronavirus task force, who said it was urgent to conserve scarce supplies and offered guidelines about who should get tested. Top priority, they said, should go to those who are hospitalized, along with health-care workers, symptomatic residents of long-term care facilities and people over 65 — especially those with heart and lung disease, which place them at higher risk.
“Not every single person in the U.S. needs to get tested,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease.”
Health officials are now struggling with a complicated and shifting message. More people can get tested as drive-through sites open and more tests are finally available. Nevertheless, those with mild symptoms should stay home and isolate. And everyone should practice social distancing to preserve the health care system’s finite resources.
To convey those points clearly, many officials are speaking in increasingly blunt terms, saying that wide testing could jeopardize the lives of health care workers and the U.S. response by burning through precious supplies as a tidal wave of sick people descend on the system.AD
“In a universe where masks and gowns are starting to become scarce, every time we test someone who doesn’t need one, we’re taking that mask and gown away from someone in the intensive care unit,” said Demetre Daskalakis, deputy commissioner for the Division of Disease Control of the New York City Department of Health and Mental Hygiene.
The tactical and messaging shifts come after weeks of efforts to expand access to testing after the federal government’s botched rollout, which hampered states’ ability to know whether the virus was already circulating and to take steps to get ahead of it.
Millions more tests are now available. And the Food & Drug Administration on Friday approved the first coronavirus test that can deliver results in 45 minutes. The turnaround time is far faster than for current tests, which are typically sent to centralized labs and can take days to return results.AD
The FDA granted “emergency use authorization” to Cepheid, a California company that makes a rapid molecular test, for use in “patient care settings,” but the company and the FDA said initially it will be used in hospitals, emergency rooms and urgent care centers.
The test will “help alleviate the pressure” on health-care facilities by helping doctors find out quickly whether a patient has the disease and select the appropriate treatment, David Persing, Cepheid’s chief medical and technology officer, said in an interview.
Despite those developments, however, many health officials remain concerned that testing sites will be inundated and that the president’s previous assertions that anyone who wanted a test “could have one” will lead many with mild cases to squander finite resources.
“I’m just scared there’s going to be mass confusion when people find out there is a testing site, are worried about their covid status, and they’re going to mob the testing site,” said Michael Fraser, executive director of the association that represents state health directors. “It’s confusing to people to hear that testing is being made available in a much more convenient way, and they think, ‘Hey, this is great, let’s get tested.’ ”
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