HJNO May/Jun 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAY / JUN 2021 11 have a problem, not NewOrleans. So, it isn’t just our strategic national stockpile, it is how we manage resources within our country. I think that there was a real failure on how to manage that inventory of private assets. One thing I’m doing is introducing a bill — the one that we introduced regard- ing management supply has already been introduced with a fellow named Dick Durbin — but we’re also going to introduce others to better integrate the private and public sec- tors so that if there are private assets, which can be deployed, we don’t have to wait for the public sector to ramp up supply when inevitably it’s too late; and then you end up with too many of whatever you’re trying to produce. I also think that we need to think bet- ter about how we integrate the private and the public tied in with that inventory management. Editor So, a private hospital would give up their ventilators? The government would ask them or force them to? Dr. Cassidy Oftentimes, a private hospital doesn’t own its ventilator machines. There is an equipment company, which supplies Editor As one of the few MDs in the U.S. Legislative Branch, you have a unique perspective on the COVID-19 pandemic. Play armchair quarterback for a moment. Speak to the preparedness of our coun- try — how you feel it was and is being han- dled — and, with the luxury of hindsight, what you would have done differently as a senator or the president or as Louisiana’s governor. Dr. Cassidy First, we had a strategic national stockpile, which was started under GeorgeW. Bush but under Presidents Obama and Trump has been allowed to become insufficiently funded and maintained. So, one thing we clearly should have done differently was how we managed our strategic national stockpile. Now, I’m introducing a piece of legislation in which we would have management of the strategic national stockpile so that it would be constantly updated and the resources rotated. For example, if you have a bunch of N95 masks, you wouldn’t keep them until they expire, throw them away and fill it back up again. You would rotate them out when they have about 10months left to go before their expiration date, and you’d refill them. You keep a constant supply cir- culating through to minimize wastage but to always maintain preparedness, so that lowers the expense of maintaining, much more toward zero than it otherwise would be, but it keeps it actually maintained — a novel concept. Secondly, related to that, we’ve got lots of resources in our nation. We were scram- bling for ventilators, but we knew the epi- demic was not hitting everybody at the same time. So, there were operating rooms in LosAngeles with perfectly fine ventilators that could have been transferred to New Orleans; and then when the New Orleans crisis went down, those same ventilators could have been transferred back to Los Angeles, and then some, because now they those machines. The hospital, if they’re locked down and they can’t do surgery (as was the case), they’re paying for machines they can’t use. It has now become a cost center for the hospital; they can’t do any- thing about it. For the equipment company, they’re getting paid, but it’s really not the highest, best use. So, you can’t have a situa- tion in which the federal government would say, “Look, equipment company, this hos- pital cannot use these ventilators because they’re locked down, we need them here.” We’re going to help the hospital out by taking this contract off their hands for the moment, we will shift them back as soon as we’re through, and you’ll end up moving assets around almost like you’re in a battle. And if your enemy is coming at you on one flank, you shift troops from one side to the other to meet the threat on that one flank. This was a public health of equivalent of a war. In that case, you need to have the abil- ity to ship assets around much like we shipped the doctors and nurses around. The VAhospital, for example, was taking doctors and nurses out of facilities, which had a low incidence of infection in the community, and was shifting them to cities, which have a higher prevalence of infection. We would do the same thing with equipment as we did with nurses and doctors. Editor What have we learned from this pandemic, which you may have already answered, but how do we prepare for the next unknown pandemic? Dr. Cassidy Again, going back to the legisla- tion we’re introducing, a part of it I’ve cov- ered. We need to have a better management of our strategic national stockpile with a first in, first out inventory management. It’s what is routinely done in every major orga- nization in the United States and the private sector. We need to have a better inventory of those assets, which we can shift from coast