News

Recommendations for the National Strategic Pandemic Stockpile

    Authors:
  • Christine Cassel
  • Chris Chyba
  • Susan Graham
  • Eric Lander
  • Ed Penhoet
  • William Press
  • Maxine Savitz
  • Harold Varmus
| May 20, 2020

Report by former members of President Obama's Committee of Advisors on Science and Technology to prepare for future pandemics

John P. Holdren, Co-Director of the Belfer Center's Science, Technology, and Public Policy Program and former science advisor to President Barack Obama, joined with other former members of President Obama's Council of Advisors on Science and Technology (PCAST) this week to release “Recommendations for the National Strategic Pandemic Stockpile." To distinguish their group from the original Obama PCAST, they refer to themselves as the OPCAST Subgroup.

Holdren convened the nine member Ad Hoc OPCAST COVID19 Subgroup in March with the aim of drawing on insights from studies relevant to pandemics that their former PCAST group produced between 2009 and 2016—and from research and observations since. The goal was "to develop recommendations on how to prepare for future waves of the COVID19 pandemic and other viral pandemics that will eventually follow."

The report - the first of several the Subgroup will produce - clarifies that the members of the group are serving as individuals, not as representatives of their institutions. They are working on their own time;  the effort has no sponsors and no budget.

In addition to Holdren, the OPCAST subgroup includes Dr. Christine Cassel (UC San Francisco), Dr. Chris Chyba (Princeton), Dr. Susan Graham (UC Berkeley), Dr. Eric Lander (MIT and Harvard), Dr. Ed Penhoet (UC Berkeley)), Dr. William Press (U of Texas Austin), Dr. Maxine Savitz (National Academy of Engineering), and Dr. Harold Varmus (Cornell Medical School).

Subsequent releases over the coming months will address issues such as contact tracing, serology and antibody tests, and data management.

Introduction

In 2002, the federal government established the Strategic National Stockpile (SNS), a pharmaceutical and vaccine stockpile, jointly managed by the Department of Homeland Security (DHS) and the Department of Health and Human Services (HHS), to provide for public health emergencies. The SNS extended earlier stockpile programs for use in case of chemical, biological, radiological or nuclear attack. In 2006, Congress funded the addition of protective equipment to the stockpile, adding 52 million surgical masks and 104 million N95 respirator masks. That legislation assigned to the HHS Assistant Secretary for Preparedness and Response (ASPR), responsibility for coordination of the stockpile for the Secretary of HHS. During the spring 2009 H1N1 pandemic, much of the mask stockpile was depleted .

In March 2013, Congress enacted the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013.  Section 403 of the Act 

“Reauthorizes the Strategic National Stockpile for FY2014-FY2018. Requires the Secretary of HHS to: (1) submit to the appropriate congressional committees, to the extent that the disclosure of such information does not compromise national security, the annual review of the contents of the Stockpile; and (2) review and revise the contents of the Stockpile to ensure that the potential depletion of countermeasures currently in the Stockpile is identified and appropriately addressed, including through necessary replenishment.”

On October 1, 2018, the full responsibility for the SNS was transferred from CDC to ASPR. The stockpile was not replenished, however. In March 2020, the Secretary of HHS reported that the stockpile held 30 million surgical masks and 12 million N95 masks.

During the period from 2006 until now, many studies have projected the needs, in the event of a pandemic, for surgical and high-intensity respirator masks, other personal protective equipment (PPE), durable equipment such as ventilators, and supplies used for testing, together with estimated quantities that should be stockpiled to help satisfy that need . In 2016, the National Academies of Science, Engineering, and Medicine (NASEM) held a workshop to study the SNS program and recommend improvements.

 The result of the failure to act on the recommendations of these studies and to appropriate and carry out the funding and actions authorized in Public Law 113-5 (as well as the failure to renew the authorization beyond 2018) has been that the United States was unprepared for the supply needs of the Spring 2020 COVID-19 pandemic. The extraordinary shortage of supplies in Spring 2020 has been well-documented in the press and has been exacerbated by supply-chain changes such as just-in-time manufacturing and globalization, and by the lack of a coordinated Federal/State plan to deploy existing supplies rapidly to locations of greatest need. There has been a persistent shortage of ventilators, testing kits, masks and other PPE, mitigated only in part by funding appropriations in late March and in April.

The fault is not with the Federal Government alone. According to Greg Burel, Director of SNS from March 2007 to December 2019, SNS planning assumed that state stockpiles would also be in place, as they were in the past. For the most part, however, those stockpiles were not replenished and maintained after the 2008 financial crisis.

For more information on this publication: Please contact Science, Technology, and Public Policy
For Academic Citation: Holdren, John, Christine Cassel, Chris Chyba, Susan Graham, Eric Lander, Ed Penhoet, William Press, Maxine Savitz and Harold Varmus. “Recommendations for the National Strategic Pandemic Stockpile.” News, , May 20, 2020.

The Authors

John P. Holdren

Eric Lander