While Trump minimizes the toll, government orders 100,000 new body bags
WASHINGTON — The federal government placed orders for well over 100,000 new body bags to hold victims of COVID-19 in April, according to internal administration documents obtained by NBC News, as well as public records.
The biggest set was earmarked for purchase the day after President Donald Trump projected that the U.S. death toll from the coronavirus might not exceed 50,000 or 60,000 people.
That batch is a still-pending $5.1 million purchase order placed by the Department of Homeland Security on April 21 with E.M. Oil Transport Inc. of Montebello, California, which advertises construction vehicles, building materials and electronics on its website. The "human remains pouches" have not been paid for or shipped to the Federal Emergency Management Agency yet, according to the company's marketing manager, Mike Pryor.
"I hope to God that they don't need my order and that they cancel it," Pryor said in a text message exchange with NBC News.
Body bag contracts bid by Homeland Security and the Veterans Affairs Department are just one illustration of how Trump's sunny confidence about the nation's readiness to reopen is in conflict with the views of officials in his own administration who are quietly preparing for a far worse outcome.
Around the same time it wrote the contract for the body bags, FEMA opened up bidding to provide about 200 rented refrigerated trailers for locations around the country. The request for proposals specifies a preference for 53-foot trailers, which, at 3,600 cubic feet, are the largest in their class.
Worried about several major risks ahead
The cache of internal documents obtained by NBC News includes an April 25 "pre-decisional draft" of the coronavirus task force's "incident outlook" for the response, a summary of the task force leaders' meeting the same day and various communications among officials at several agencies.
The documents show that task force members remain worried about several major risks ahead, including insufficient availability of coronavirus tests, the absence of a vaccine or proven treatments for the coronavirus, and the possibility of a "catastrophic resurgence" of COVID-19.
When asked in the past about the contrast between his assessments and those of senior officials on his task force, Trump has described his role as "cheerleader" for the country. "I want to give people in this country hope," he said in March.
The president has also said testing "is not going to be a problem at all." But officials from FEMA and the Department of Health and Human Services clearly disagree. They flagged concerns with the testing plan in the draft of the incident outlook report, which was circulated to task force members along with a summary of the meeting.
The list of testing problems includes: "Limited number of diagnostic supplies. Limited capacity of test facilities. Limited trained response personnel to administer the tests. Unknown epidemiological information regarding COVID-19. Access to testing sites by underserved areas and at risk populations. Effective vaccines and therapeutics will not be available in sufficient quantities to meet the need. PPE is required by [medical countermeasures] developers and manufacturers."
Task force officials raised those possibilities as they developed the "incident outlook" two days before Trump unveiled his "Reopening America Again" plan Monday. That strategy is designed to hand off more responsibility for the response to governors and local officials.
The documents show that the White House and its coronavirus task force are making a quick transition toward an advisory role in public health decisions made by states while maintaining the power to acquire goods and allocate them. Simultaneously, the administration is preparing for many more casualties.
The body bag order, confirmed by internal administration communications obtained by NBC News, is in addition to shipments of several thousand more body bags from vendors for the General Services Administration and the Defense Logistics Agency.
The VA, meanwhile, paid the supply distributor ISO Group $293,780 for an unknown number of body bags to be fully delivered Thursday. The contract states that the purchase is "in response to COVID-19." ISO notes on its website that the federal government has awarded eight contracts for that specific body bag in the past 90 days for a total of $12.1 million.
More than 61,000 people have already died of COVID-19 in the U.S.
The VA and ISO did not respond to NBC News' inquiries about the contracts. A senior White House official declined to comment on the body bags.
Sam Imbriale, a senior aide at the Department of Health and Human Services, told members of the federal response team over the weekend that all resource request forms used by state, local and private sector officials to seek federal supplies and other assistance must now be routed to the White House, according to a person who heard his remark to dozens of people on a phone conference.
NBC's request to HHS for an interview with Imbriale was routed to FEMA's media relations team, which did not respond, and the senior White House official did not reply to a question about the remark.
The senior White House official, speaking on condition of anonymity, said that Trump is taking into account the dangers associated with loosening stay-at-home restrictions and is following the advice of Coronavirus Response Coordinator Deborah Birx and other doctors on his task force in moving forward.
"At each of the three phases, they make recommendations for what needs to be done to safely begin reopening, while keeping in place mitigation efforts like social distancing," the official said in an email. "Dr. Birx, for example, has been in consultation with states, on behalf of the White House, to advise if they are ready to move toward reopening based on a number of factors, one of which is testing capacity."
Trump and his top advisers have long said that more widespread testing is the predicate for resuming commercial activities paused by efforts to prevent the spread of the disease.
"We want to reopen, and the testing is not going to be a problem at all," he declared Monday, adding later that "the fact that people aren't allowed to have their freedom causes a tremendous amount of problems, including death."
The White House official said the federal government is "ramping up" testing capacity rather than "slowing down" and noted a new deal with the Maine-based company Puritan to produce an additional 40 million testing swabs. The administration says 5 million tests have been administered so far — a number equal to about 1.5 percent of the national population — and that the goal for states to be ready to re-open is the ability to test 2 percent of their populations per month.
The push to kickstart an economy that is now hemorrhaging workers as it shrinks has drawn little public criticism from within the administration, even as many health experts say loosening stay-at-home rules could greatly increase the number of casualties from a pandemic that already has claimed almost 60,000 lives. But similar concerns were flagged in the preliminary version of the document supporting his strategy that was developed by subunits of the coronavirus task force consisting of employees of FEMA, the Defense Department, the HHS Department and other federal agencies.
Those interagency teams concluded that governors, mayors, community leaders and individual Americans may resist Trump's pressure precisely because they believe it will lead to more death.
Reversing social-distancing guidelines could have fatal consequences
"Late indicators and human decision making may delay mitigation to prevent catastrophic resurgence," the "incident outlook" report developed by FEMA and the HHS Department states in a subsection of the document entitled "risks/limiting factors" for the objective of "minimizing transmission & risks to public health."
The other reasons listed demonstrate federal officials' own fears that reversing stay-at-home rules and social-distancing guidelines could have fatal consequences.
"States may not be following the recommended 'gating' process to make community mitigation adjustments," the document says. "Individual mitigation measures (e.g. hand washing) are often easy to support, but stricter community mitigation measures (e.g. social distancing) can be disruptive making them difficult to sustain. Individuals travelling from high impact areas to low impact areas may have contracted COVID-19 but are asymptomatic. Mitigation fatigue. Community mitigation measures may not have the desired impact. Insufficient [state and local] staff to implement moderate mitigation measures."
The president is aware of these worries and shares concerns about the potential for a resurgence, the White House official said.
"Our guidelines are based on strong public health science and have been vetted through the interagency," the official said. "But we also understand the novel nature of this virus and that nothing is foolproof. We are encouraging extensive mitigation efforts in the public space to ensure health and safety."
Some of Trump's advisers have put more emphasis on health risks and less on immediate economic peril. Dr. Anthony Fauci, the head of the National Institute for Allergy and Infectious Diseases, said Tuesday that there could be "a bad fall" if states and cities re-open too early.
"If by that time we have put into place all of the countermeasures that you need to address this, we should do reasonably well," Fauci said in remarks to the Economic Club of Washington, D.C. "If we don't do that successfully, we could be in for a bad fall and a bad winter."
Among others, the April 25 meeting was attended by FEMA Director Pete Gaynor, Admirals Brett Giroir and John Polowczyk, who are the assistant secretary of Health and Human Services for health and the coronavirus' supply-chain task force lead, respectively, and staff from the White House's National Security Council. The NSC staff dialed in by videoconference, according to the summary of the session.
The preliminary incident outlook draft also laid out challenges to stabilizing the medical supply chain and healthcare systems — including the risk of disasters on top of the COVID-19 crisis — as Trump tries to reduce the federal role in the response and put more responsibility on state and local governments.
"Food/water or other large commodity mission resulting from an additional disaster declaration would reduce response capabilities for COVID-19," the outlook document states.
The resiliency of the U.S. health care system faces hurdles, too, according to the incident outlook draft.
"Additional disasters may further stress the healthcare system," the document says. "Lack of [personal protective equipment] will decrease effectiveness of proposed strategies. Essential pharmaceutical supply shortages. Infection rate and absenteeism of workforce. Non-pharmaceutical interventions may not have the desired impact."
The primary complication for communications during the period of transition to more localized control of the response, according to the incident outlook report, is "lack of trust in government messaging."