In the News

SPRINGFIELD — As hospitals across the country face shortages of protective equipment for their workers, many have turned to extraordinary measures to procure it.

For Baystate Health officials, that process recently involved convincing the FBI they were purchasing the equipment legally; protecting the shipment from the Department of Homeland Security, which was trying to divert it; and driving the equipment back to Massachusetts in disguised trucks. But unlike previous attempts, the health system managed to successfully obtain the personal protective equipment, or PPE.

“Deals, some bizarre and convoluted, and many involving large sums of money, have dissolved at the last minute when we were outbid or outmuscled, sometimes by the federal government,” explained Andrew Artenstein, the chief physician executive at Baystate Health, in a recent article in The New England Journal of Medicine. “Then we got lucky, but getting the supplies was not easy.”

In an interview with the Gazette, Artenstein said that, normally, he does not do supply-chain work for Baystate. But he said the health system now has a group of nearly 30 people chasing down any and all leads on essential equipment.

In Artenstein’s recent article, he said that after several hours of vetting a particular lead, the supply-chain group grew confident that the broker could secure a large shipment of three-ply masks and KN95 respirators — the N95 masks made in China. They received samples and then acquired the needed money, which was five times more than they pay for such supplies in normal times.

Hours before departing, the vendor told the team to expect only a quarter of the original order. But the supplies were desperately needed, Artenstein wrote, so three members of the team and a “fit tester” flew to a “small airport near an industrial warehouse in the mid-Atlantic region” and Artenstein arrived by car.

“Two semi-trailer trucks, cleverly marked as food-service vehicles, met us at the warehouse,” he wrote. “When fully loaded, the trucks would take two distinct routes back to Massachusetts to minimize the chances that their contents would be detained or redirected.”

Artenstein said the group was “jubilant” to see the pallets of KN95’s and face masks, and they opened several boxes to vet the equipment, hoping the random sample would be representative of the whole shipment. But before they could wire the funds to the seller, he said, two FBI agents arrived and began asking him questions, such as whether the shipment was headed for resale or the black market.

“The agents checked my credentials, and I tried to convince them that the shipment of PPE was bound for hospitals,” Artenstein wrote. “After receiving my assurances and hearing about our health system’s urgent needs, the agents let the boxes of equipment be released and loaded into the trucks.”

Artenstein said he understood why the FBI was doing that work.

“I think their intentions were pure,” he said. “What they told us is that they were there to be sure that any supplies were going to hospitals and first responders and not elsewhere. And that’s good.”

However, what Artenstein still doesn’t understand is what happened next. In his article, he wrote that he was shocked to learn next that the Department of Homeland Security was still considering redirecting Baystate’s PPE. It took a call from the office of U.S. Rep Richard Neal, D-Springfield, to prevent DHS from seizing the equipment, he said.

“I remained nervous and worried on the long drive back, feelings that did not abate until midnight, when I received the call that the PPE shipment was secured at our warehouse,” Artenstein wrote.

Artenstein said he is not sure why DHS tried to seize the shipment.

Neal said Sunday that he took the call from Baystate President and CEO Mark Keroack on April 6. He said that the overlapping responsibilities of federal agencies may have caused the situation, and that those agencies were accommodating once his office connected with them.

“They feel as though they’re constrained by the rules in front of them,” he said of the staffers his office dealt with. “The snafu that we ran into, we were able to make it work, but I just hope that there are not other examples of this.”

When asked what Baystate’s experience says about the U.S. response to coronavirus, Neal said that there will have to be a period of reflection when the pandemic is done to ensure the country is better prepared in future. He said a big challenge is that the country has not faced a similar pandemic for 100 years.

“People come to accept the normal, thinking nothing will change,” he said.

For his part, Artenstein said the entire anecdote is indicative of a “disorganized response system” in the United States. He said that no one group or administration bears the full blame, but rather that state and federal administrations have let the country’s public health infrastructure deteriorate over a period of decades.

Responding to a public health crisis “requires a coordinated and planned response,” he said. “It needs to be taken seriously and planned appropriately.”

In his article, Artenstein said the experience might have made for an interesting cocktail-party tale were the stakes not so high.

“Did I foresee, as a health-system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organization would ever be faced with such a set of circumstances?” he wrote. “Of course not. Yet when encountering the severe constraints that attend this pandemic, we must leave no stone unturned to give our health care teams and our patients a fighting chance. This is the unfortunate reality we face in the time of Covid-19.”

As for PPE at Baystate, Artenstein said the health system thinks it is prepared to address the health needs of the community going forward. But he also said there remain many hurdles, from increasing testing for the virus to securing more PPE. He said Baystate is now running low on disposable gowns for health care workers, which he described as “absolutely essential.”

“To be honest with you, we’re just having trouble getting them,” he said. “I think everyone is.”