Maine has received zero of the 400 ventilators it requested from the federal stockpile, which is now all but empty. And it isn’t clear why.

The Maine Center for Disease Control and Prevention initially requested 300 ventilators from the Strategic National Stockpile, a federal cache of vital medical equipment held in a series of secret warehouses across the country. On March 30, Maine CDC director Nirav Shah announced the state had increased this request to 400 ventilators “in light of some of the planning exercises we are undertaking.”

With the stockpile now depleted, Maine and 37 other states have received no ventilators at all, apparently because they did not rise to the top of the heap in an assessment of which ones most needed some of the 9,500 that remained on March 30.

On April 1, the Trump administration directed that ventilators – machines that help seriously ill patients breathe – be treated as a “strategic national asset” only to be released to states that could answer what the Federal Emergency Management Agency described as a “tough series of questions” designed to determine if they had an “exigent need” to sustain lives “within 72 hours.”

Those questions, forwarded to the Press Herald by a White House spokesman, asked Maine and other states to report how many ventilators, ventilator alternatives, and ICU beds they currently had and how many were in use; what plans they had for establishing field hospitals; and how many anesthesia machines were in the state and whether they had been converted to serve as ventilators.

“These shipments are being sent with prioritization given to the areas of greatest need,” FEMA spokesperson Elizabeth Litzow said in a written statement also forwarded by the White House. “FEMA did not block shipments of ventilators to any state.”

Recognizing Maine would not receive 400 ventilators it requested, the state CDC plans to revise its request downward to 100, agency spokesman Robert Long told the Press Herald Tuesday. He said this was not due to a revision of worst-case planning scenarios but rather to the presence of 245 alternative ventilators. These are devices that the U.S. Food and Drug Administration approved for emergency use March 22, citing the critical shortage of proper ventilators. They include converted anesthesia machines, ambulance and home-use ventilators, and even CPAP machines usually used to treat sleep apnea.

As of Tuesday, the Maine CDC reported Maine hospitals had a total of 332 conventional ventilators, with 280 available. When the alternative devices are added to the tally, Maine remains 23 short of the projected worst-case peak need of 600.

Rep. Chellie Pingree, a Democrat who represents Maine’s 1st District, said the effort to get information about how the federal stockpile was being distributed was frustrating.

“We’ve heard stories: Do you have to be friend of the president? Are they confiscating equipment so they can hand it out to other states to score political points?” she told the Press Herald via telephone. “Obviously ventilators cause the most angst of anything. In these conference calls with the White House or with our committee chairs who have been in direct contact with the White House or the (U.S.) CDC, there’s just a complete lack of transparency.”

Sen. Angus King, an independent who caucuses with the Democrats, said the federal response to Maine’s medical requests has been inconsistent and, in terms of decision-making criteria, opaque.

“Fortunately, our supply of ventilators remains sufficient at this time – but the time to prepare is before crisis strikes, not once it begins,” he said in a written response. “I have been pressing hard with my Maine colleagues to make sure the Administration … provides clear answers on what steps are being taken to ensure Maine can access additional ventilators in the event of a heightened outbreak.”

A spokesman for Sen. Susan Collins, a Republican in a tough re-election fight, said she had supported Maine’s requests for personal protection equipment from the stockpile but had not received any requests from the state CDC or Maine hospitals for assistance in procuring ventilators.

“Just yesterday, Dr. Shah said there were nine COVID-19 patients using ventilators, and 441 ventilators are available in the state right now,” spokesman Christopher Knight said via email, inaccurately citing the ventilator count and excluding the 43 non-COVID-19 patients currently intubated in Maine hospitals. “Last Thursday, reporters asked Dr. Shah if he was going to send ventilators to other states.

“If Senator Collins does receive a request from the Maine CDC for additional ventilators, she will of course work to help address this issue as well,” Knight added. “She is concerned about recent outbreaks of the virus among vulnerable seniors in long-term care facilities.”

Rep. Jared Golden, a Democrat representing Maine’s 2nd District, said Maine had thus far avoided a severe spike thanks to public compliance with Gov. Janet Mills’ social distancing policies.

“Maine isn’t at an immediate risk for a severe ventilator shortage,” he said via email. “As Americans, we need to balance our states’ potential needs with the immediate challenges facing our fellow Americans in places like New York and Chicago, where hospitals are currently struggling with severe shortages of ventilators and other essential equipment.

“I recognize that the administration must confront these very realities in making their decisions about the distribution of the Strategic National Stockpile,” he added.

A Department of Health and Human Services tally of the distribution of the federal stockpile released April 8 by the U.S. House Committee on Oversight and Reform showed Maine, the District of Columbia, and 38 other states had not received a single ventilator as of the morning of April 6.

The distribution of ventilators included many hot spots. New York (including New York City) received 4,400; New Jersey got 1,100; Los Angles received 170; Pennsylvania and Washington State got 500 each; Michigan, 400; Illinois (including Chicago) got 450; Florida got 200, while Louisiana received 150. Four other states – Oregon, Georgia, Maryland, and Connecticut – got between 50 and 150 each.

But on April 8, President Trump announced on Twitter that Colorado would receive 100 ventilators specifically because Sen. Cory Gardner, a vulnerable Republican up for re-election, had requested them. The episode raised concerns the president was using ventilators as political tools.

“If a Republican senator calls the president up does that mean he just gets some?” Rep. Diana DeGette, a Democrat from the Denver area, told Bloomberg News. “And then the president tweets out ‘good job?’ That doesn’t seem to be according to any kind of a process. It just seems political to me.”

White House spokesman John Horstman did not respond to questions about the president’s apparent intervention in the FEMA process. FEMA itself did not respond to any of the Press Herald’s inquiries for this story.

“It’s just this constant state of chaos and confusion every day,” Pingree said of the allocation process. “There’s just a complete lack of transparency.”