In 1939, two years before the Japanese bombing of Pearl Harbor drew the United States into World War II, the U.S. military was an anemic force in which Army troops still used horses to pull around artillery. Then an emergency buildup ordered by President Franklin D. Roosevelt transformed U.S. automakers’ manufacturing plants into extraordinarily efficient producers of tanks, guns, airplane engines and more.
One Ford plant in Ypsilanti, Mich., was able to build an entire B-24 Liberator long-range bomber — with 1.55 million parts — in just more than an hour. As much as anything, FDR’s directive helped the U.S. decisively win a complex war against Japan, Germany and Italy on three continents and in five oceans in less than four years.
Given this history, any assertion by federal, state and local officials that America is crippled in its coronavirus response because of a lack of coronavirus tests, hand sanitizers, sanitary masks, hospital respirators, respirator valves and ventilators seems simply bizarre. Generally speaking, these are not complicated products to make.
In Germany, a small, private laboratory quickly developed a diagnostic test in early January and produced 40,000 kits for the World Health Organization — enough for about 4 million individual tests. But the U.S. Centers for Disease Control and the Food and Drug Administration insisted on coming up with a test of their own, which was botched. They only allowed big private firms such as Roche and Thermo Fisher to step in and help in the past few weeks. That should have been their first step. The decision means millions of tests will finally be available next month.
This abundant availability should also be true of generic alcohol-based hand sanitizers, which cost less than $1 per unit. A federal directive to Purell or some other producer to mass manufacture sanitizers around the clock on an emergency basis at a guaranteed 10% profit would quickly flood the market. The same is true for makers of sanitary masks, which cost about 10 cents each, and respirators, which cost about $1. It took an Italian tech firm all of three hours to figure out how to use 3D-printing technology to produce valves that connect intensive-care patients to breathing machines at a unit cost of $1.09.
Ventilators that pump oxygen into the lungs of COVID-19 patients are far more complicated. Typical machines cost $25,000. But with the Trump administration and Congress throwing billions of dollars around in an understandable attempt to limit the fallout from coronavirus, compelling manufacturers to build ventilators on a 24-7 basis is an obvious decision. A 2005 study estimated the U.S. would need about 680,000 more ventilators to deal with a respiratory-related pandemic. Why not immediately order the building of something like 250,000 at a cost of $6.25 billion? Or why not take up tech entrepreneur Elon Musk’s offer to have his factories crank out ventilators?
President Donald Trump said Friday he would invoke the Defense Production Act, which sets the stage for government demands on industry. It’s a hugely welcome sign that he will no longer be passive in this emergency. The belief that government can’t act nimbly is dangerous.
Which brings us to the final, most complicated part of this picture: the need to rapidly develop, produce and distribute vaccinations during health emergencies. There is a presumption that 12 months of painstaking lab and animal testing are needed before a vaccine that appears to work can be introduced for general use. As a result, a vaccine to treat the Zika fever epidemic that was found to be 92% effective — developed in seven months in 2015 by researcher David Weiner and Inovio Pharmaceuticals — was never given to the tens of thousands of Zika victims in South America and the Caribbean before the epidemic petered out in November 2016. This was seen as unsurprising and unimportant by the medical community because of its “first do no harm” ethos.
But if “social distancing” does not work to slow coronavirus infections, especially in impoverished, heavily populated nations, and the deaths keep adding up, shouldn’t there be a sliding scale of reverence toward convention? Especially if there seems to be little risk of a bad reaction in giving an infected or uninfected person a promising vaccination?
The answer is yes, of course. And guess what? It’s happening. Moderna, a Massachusetts biotech firm, began preparing for human testing of its possible COVID-19 vaccination a few weeks ago — doing so with the blessing of the National Institutes of Health and despite the squawking of medical ethicists.
Chris Reed is the deputy editor of the San Diego Union-Tribune editorial and opinion section.
