During the initial stages of the COVID-19 outbreak in the United States, numerous states, such as Ohio, were caught off guard and urgently sought out masks and other forms of protective equipment. Due to severe shortages, Ohio resorted to purchasing millions of medical gowns from a marketing and printing firm, resulting in a $20 million investment to produce personal protective equipment within the state.

After three years, with the pandemic losing its hold, Ohio and other states are attempting to address an abundance of protective equipment by getting rid of their stockpiles in large quantities.

Due to the expiration dates approaching and limited demand for access to the reserve, the state of Ohio sold 393,000 gowns for a mere $2,451 and disposed of an additional 7.2 million items, including expired masks, gloves, and other supplies. These expired resources, which had been purchased with approximately $29 million in federal funds, were no longer usable.

Across the nation, a similar evaluation is taking place. Objects are becoming older and states must determine how much funding to put towards preserving warehouses and supply reserves before a deadline to distribute federal COVID-19 funds arrives next year.

A recent investigation by the Associated Press revealed that several states, ranging from Alaska to Vermont, have disposed of portions of their supplies of personal protective equipment (PPE) due to expiration, excess stock, and a lack of interested recipients.

Over 18 million masks, 22 million gowns, and 500,000 gloves were discarded. This does not include data from states that did not provide exact numbers or used different units of measurement. Rhode Island reported recycling 829 tons of PPE, while Maryland disposed of supplies worth over $93 million.

Dr. Georges Benjamin, executive director of the American Public Health Association, expressed frustration over the lack of preparation and inefficient public health system that results in wasteful over-purchasing during emergencies. He emphasized the need for better management of stockpiles to prevent such situations.

The AP asked all 50 states for information on their stockpiles of PPE over the course of several months. Only half of the states responded.

The states stress that they provided significantly more equipment than they disposed of and made efforts to donate the remaining supplies. Last year, Washington state sent hundreds of thousands of items to the Marshall Islands. Pennsylvania claims to have offered personal protective equipment to 10,000 cities, healthcare facilities, and more during the pandemic. However, both states still had to discard a significant amount of expired items.

A few states discovered restricted ways to use something after its expiration, such as for training purposes.

Several states are retaining some or all of their remaining protective equipment. For example, Minnesota intends to replenish their stockpiles.

Some argue that due to the unpredictable nature of the pandemic and limited supply of personal protective equipment (PPE), there was no alternative but to obtain these items. Now, they must be disposed of, albeit reluctantly. Expiration dates are in place to ensure the effectiveness of the protection and the Federal Emergency Management Agency has deemed expired supplies to have no monetary value.

Louis Eubank, in charge of the South Carolina health department’s COVID-19 coordination office, expressed frustration when discussing the disposal of over 650,000 expired masks. He mentioned the difficulty in obtaining these masks initially and the disappointment in seeing them go to waste or not being used as intended.

Prior to the outbreak of the COVID-19 pandemic, distributors of healthcare products typically maintained a supply of 20 to 30 days. However, this supply was inadequate when the pandemic hit and there was a sudden surge in demand for N95 masks, gloves, and gowns. These items became extremely scarce, leading some healthcare workers to resort to using homemade masks and trash bags as makeshift gowns.

According to a report from the inspector general, the Strategic National Stockpile of the U.S government was ill-prepared to handle the COVID-19 crisis due to lack of funding and increased duties. As the stockpile’s resources depleted, states resorted to competing in international bidding wars and making unorthodox arrangements. In fact, Massachusetts even utilized the New England Patriots’ airplane to acquire masks from China.

The high demand for personal protective equipment (PPE) caused a rapid increase, followed by a sharp decline, for American manufacturers. According to the AP’s investigation in 2020, states spent more than $7 billion in a short period of time on PPE, ventilators, and other essential medical equipment in a market where sellers held the advantage. In the end, the federal government covered the cost for many of these supplies.

According to Ohio Department of Health representative Ken Gordon, it was impossible to determine at the time of purchase how long the shortage of supplies would continue or what amounts would be necessary.

During the pandemic, Ohio provided over 227 million items of protective gear. However, as the shortage of supplies and the health emergency improved, the need for gowns decreased.

According to Linda Rouse O’Neill from the Health Industry Distributors Association, all parties involved in the system, including states, hospitals, and manufacturers, now have surplus products.

Because there is currently an excess amount of goods, items that have been accumulated in storage are being sold for discounted prices, if they are selling at all. For example, Vermont was able to sell 105,000 boot covers for $82.50 and thousands of safety goggles for only 29 cents each.

The glut extends beyond states. Georgia’s Fulton County, which encompasses Atlanta, dispensed gloves, hand sanitizer and other supplies by the dozens of boxes at a public PPE giveaway in March.

The city of New York reported that they sold a large amount of “non-medical-grade” personal protective equipment that was either expiring or being replaced by newer and improved versions. In May, Health Commissioner Dr. Ashwin Vasan informed local government representatives that they would prioritize improving supply contracts for future emergencies instead of maintaining a fixed stockpile of goods.

The Department of Mental Health in Missouri initially intended to hold an auction for a surplus of masks, gowns, and other protective equipment purchased with funds from the federal government for coronavirus relief. However, they ultimately decided against it, citing a belief that federal regulations prohibited such a sale. Later on, the U.S. Treasury Department informed the AP that states are allowed to sell excess personal protective equipment.

Disruption in the supply chain caused certain governments to make multiple purchases, leading to excess goods upon delayed delivery.

A veterans’ home in New York, operated by the state, received a large number of PPE deliveries in early 2021. These deliveries were stored under tarps in a parking lot due to limited space. However, four months later, a warehouse was finally arranged. Unfortunately, between $560,000 and $1.6 million worth of supplies had been damaged and could not be used. The cost of incinerating these supplies was an additional $21,000, according to a report from the state’s inspector general’s office. Furthermore, an additional $779,000 worth of expired items had to be discarded.

Striking a balance between preparedness and surpluses is “a major dilemma” for governments, said Scott Amey of the Project on Government Oversight, a Washington, D.C.-based watchdog group. And while politicians vowed in 2020 never to be caught off guard again, “memories are short, budgets are tight,” Amey noted.

The budget in Wisconsin was reduced by a legislative committee by $17.2 million, which was originally intended for a warehouse to hold a continuous 60-day supply of PPE for a period of two years.

The Department of Health Services for the state has announced plans to “dismantle the warehouse” and is currently working on donating the remaining supplies. So far, Wisconsin has disposed of approximately 1.7 million masks and close to 1 million gowns.

According to a new law in Michigan, the state health department is obligated to maintain a reserve of medical supplies that can last for two months. As indicated on the department’s website, there are currently over 38 million items in stock.

However, Republican state Representative John Roth, one of the sponsors of the law, has expressed a change of opinion and believes it may be necessary to reevaluate the law. He suggests that limiting the supply to one month may result in less waste.

The Health Industry Distributors Association advises that distributors of products should have a 60-to-90-day stockpile to prepare for any sudden increases in demand. However, the organization believes it may not be necessary for every member of the system, including manufacturers and doctors’ offices, to maintain such a large reserve.

Several government officials agree.

Adriane Casalotti, from the National Association of County and City Health Officials, stated that it is not feasible for the majority of local health departments to maintain a significant supply of materials for potential emergencies. This is due to their limited budgets and space constraints.

Pennsylvania authorities are seeking to maintain a 15-day supply of stock after open discussions about their financial limitations in terms of both preservation and replenishment. Numerous batches of PPE have already reached their expiration date and have been marked for disposal.

Andy Pickett, the director of emergency preparedness and response at the Health Department, stated that having unlimited or significantly increased federal funding for public health preparedness would make the concept of a 60-day or 90-day stockpile a great idea.

The health department of Missouri has consistently stored a 90-day reserve of personal protective equipment, taking into account the peak months of the pandemic. They are also holding onto expired supplies, anticipating that the federal government will approve their use in case of an emergency, as they did for COVID-19. Missouri has insured this stockpile for $19 million.

Missouri health director Paula Nickelson stated that failing to make an investment, even if it is ultimately not utilized, could leave one unprepared to provide aid to the public in times of need.

The Department of Health in Minnesota received funding this year to maintain and replenish their PPE supply. They are currently determining the amount needed and working to reduce the size of their stockpile. According to emergency response official Deb Radi, the agency plans to discard a small number of gowns that are close to expiry. These were previously difficult to obtain, leading the state to purchase disposable raincoats instead.

Radi stated that although some individuals may criticize our current surplus of supplies, they would have been even more critical if we had not taken steps to obtain them when necessary.

She desires for the national government to investigate the process of setting expiration dates and the possibility of extending them.

Chris Emory, the head of New Mexico’s Bureau of Health Emergency Management, proposes offering incentives to encourage suppliers to increase their inventory. However, despite this suggestion, New Mexico is currently keeping a reserve of personal protective equipment (PPE), as they had previously utilized leftover masks from the H1N1 flu outbreak during the onset of the COVID-19 pandemic.

Unfortunately, Nevada is struggling to distribute its aging personal protective equipment (PPE) quickly enough. Jack Robb, the Director of the Department of Administration, expressed his disappointment that pallets of PPE are either already expired or close to expiration in a warehouse they have leased.

Nevada is making an effort to safely and efficiently dispose of expired supplies and avoid wasting money. However, according to him, a majority of these supplies will ultimately be discarded in a landfill. Some have already been disposed of in this manner.

However, Robb stated that authorities faced difficult choices in dealing with a disease responsible for approximately 7 million deaths globally, including individuals he was close with.

“I pray that we never witness anything like that again during our lifetime,” he expressed.