The government’s emergency stockpile of respirator masks, gloves and other medical supplies is running low and is nearly exhausted due to the coronavirus outbreak, leaving the Trump administration and the states to compete for personal protective equipment in a freewheeling global marketplace rife with profiteering and price-gouging, according to Department of Homeland Security officials involved in the frantic acquisition effort.

As coronavirus hot spots flare from coast to coast, the demand for safety equipment – also known as personal protective equipment (PPE) – is both immediate and widespread, with health officials, hospital executives and governors saying that their shortages are critical and that health-care workers are putting their lives at risk while trying to help the surging number of patients.

Two DHS officials said the stores kept in the Department of Health and Human Services’ Strategic National Stockpile are nearly gone.

During Wednesday’s White House briefing, President Donald Trump confirmed the stockpile is nearly depleted, telling reporters his administration has sent supplies “directly to hospitals.”

“The stockpile was designed to respond to handful of cities. It was never built or designed to fight a 50-state pandemic,” said a DHS official, who spoke on the condition of anonymity because the official was not authorized to speak publicly about the stockpile. “This is not only a U.S. government problem. The supply chain for PPE worldwide has broken down, and there is a lot of price gouging happening.”

President Trump said during Tuesday’s White House briefing that the administration has nearly 10,000 ventilators on reserve and that authorities are ready to deploy the lifesaving equipment rapidly to coronavirus hotspots in coming weeks. He also said that large amounts of PPE were being shipped directly from manufacturers to hospitals. But the DHS officials said the stockpile has not been able to handle the load.

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Hospitals and states face a real risk of running out of supplies, one of the officials said. “If you can’t protect the people taking care of us, it gets ugly.”

Several reports in recent days have documented a Wild-West-style online marketplace for bulk medical supplies dominated by intermediaries and hoarders who are selling N95 respirator masks and other gear at huge markups. Forbes reported that U.S. vendors have sold 280 million masks – mostly into the export market – and that U.S. states and local governments were outbid in the frenzy.

There are few signs the Trump administration is making efforts to stop the export shipments or seize the supplies for use in U.S. hospitals, despite statements from Attorney General William Barr last week that U.S. wholesalers hoarding masks and other supplies would get “a knock on your door.”

Governors have been pleading with federal authorities to ship more equipment and protective gear. Distribution of the supplies has happened unevenly, with some states saying they’ve received a fraction of the supplies they desperately need and some cities having received no assistance from their state governments.

Officials at the Federal Emergency Management Agency said the government had anticipated the Strategic National Stockpile would be exhausted, and the administration is moving swiftly to procure and distribute medical supplies.

“FEMA planning assumptions for COVID-19 pandemic response acknowledged that the Strategic National Stockpile (SNS) alone could not fulfill all requirements at the State and tribal level,” Janet Montesi, a FEMA spokesperson, said in a statement. “The federal government will exhaust all means to identify and attain medical and other supplies needed to combat the virus.”

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The government has more than $16 billion available to make the acquisitions, she said.

“We remain committed to helping ensure key medical supplies expeditiously arrive at the front lines for our health care workers,” Montesi said.

According to the White House, FEMA had shipped or delivered 11.6 million N95 respirator masks, 26 million surgical masks, 5.2 million face shields, 4.3 million surgical gowns, 22 million gloves, and 8,100 ventilators as of March 28.

A stockpile of 1.5 million expired N95 masks that U.S. Customs and Border Protection has in storage will be distributed to the Transportation Security Administration and U.S. Immigration and Customs Enforcement, CBP said in a statement. The CDC has issued guidelines for the safe use of masks with expiration dates that have passed, potentially leaving their elastic bands too loose to form a proper face seal.

U.S. Rep. Nanette Barragán, D-Calif., said this week she and other lawmakers were told some of the expired CBP masks would be given to hospitals.

“Officials confirmed that the masks would indeed go to health care workers and be prioritized by highest need such as NY and NJ. I will follow up to make sure this happens!” the lawmaker tweeted Sunday.

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A CBP official on Wednesday confirmed to The Washington Post that the masks would go to ICE agents and TSA officers instead, not to FEMA staff or medical personnel.

The government has long viewed the national stockpile supples as a holdover during an emergency so the government could buy time for manufacturers to boost output and for new supply chains to solidify, according to a senior administration official. Having the medical supplies sitting in a warehouse doesn’t serve any purpose, the official said, even though the administration has been holding back thousands of ventilators.

Asked about concerns that the government will not be able to keep pace with the demand for PPE supplies, the official said the government has planes coming in from Asia every day for the next few weeks ferrying new materials, noting that a planeload with 80 tons of PPE arrived from China on Sunday.

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