A 2015 report issued by a task force in New York found that the state would need something like 16,000 ventilators a week at the peak of a flu-like pandemic. Per one estimate, there are around 2,000 ventilators in the state currently available and not in use.

“We could increase production five-fold in a 90- to 120-day period,” says Chris Kiple, chief executive of Ventec Life Systems, a Bothell, Wash. firm that makes ventilators used in hospitals, homes and ambulances. He’d have to tool up production lines, train assemblers and testers and get parts. Accelerating the parts delivery might be the toughest task, he says.

The ventilator industry is getting a burst of desperate orders from China and Italy. The U.S. hasn’t seen that yet, although manufacturers are bracing for it. “The time for action by the government is now,” says Kiple. “[Covid] is most likely to get worse next fall.”…

If there is a risk of a surge in need, and if it takes three months to boost part deliveries, somebody ought to be placing orders right now. But a hospital might well hesitate, given the perhaps equal risk that the extra machines will never be used. Who would eat the cost? That explains why the German order came from the government.

Ventec is a small player in the field, the Forbes story notes, so maybe larger manufacturers have already received orders from state governments. The price tag would be steep for a state government, though: The average ventilator costs $25,000 or more, which means a rush order of 10,000 machines would cost New York $250 million and up — possibly more in order to cover the overtime on labor and rush orders on parts. Pence and his team have reportedly discussed ramping up supply, including identifying regulations that would need to be overcome in order to make that happen, but I haven’t seen any reports yet that the wheels are actually turning.

It’s not just ventilators either, of course:

Officials from the Department of Health and Human Services told medical professionals on a conference call Monday that there was not enough personal protective equipment in the Strategic National Stockpile to fulfill anticipated gaps in state and local supplies, according to a source who was on the call. The call was confirmed to CNN by a Department of Health and Human Services official…

Because of the growing shortages, some medical professionals have floated the idea of Trump invoking the Defense Production Act — an idea that several House Democrats support. The act, passed by Congress in 1950, allows the president to expedite production of critical materials, through various means, needed for national defense…

According to a source familiar with this letter, some lawmakers believe Trump could force private companies to accept government contracts to aid in the quick production of much-needed medical supplies.

Sloan Kettering in NYC, which already has five staffers infected with coronavirus, has a one-week supply of masks and a clientele full of people with compromised immune systems due to chemo treatments. We might end up with a command economy for awhile, at least as far as health care is concerned.

How much of the feds’ slow-footedness is due to incompetence at the agency level, how much is due to bureaucracy, and how much is due to poor management is a story that won’t fully be told until this nightmare has abated. Some of it is certainly agency incompetence: You know that the CDC failed badly in providing timely and effective testing for Americans and you know that the FDA was slack in reaching out to foreign labs who were manufacturing tests to make up the gap, but you need to read this to see how bad it was. There are management problems too, though: Trump prefers a … nontraditional staff structure, to phrase it politely, which makes it less clear which advisors are responsible for which tasks. (Does that help explain why they’re having trouble moving quickly on ventilators?) He also seems to trust Jared Kushner at least as much as his own experts even though Kushner’s instincts have reportedly been terrible at every stage of this. Allegedly he thought that the virus was being hyped by the media to hurt Trump at first; then he spearheaded last week’s terrible Oval Office address; then he took charge of the Google testing website initiative that turned out to be exaggerated in its reach.

This stuff adds up PR-wise. Not as much with Republican voters as with Democrats and independents, perhaps, but there’s an effect. Here’s the shift over the course of a month when people were asked if they’re confident in the feds’ ability to handle a coronavirus outbreak:

A poll taken by NPR found a similar decline among Dems and indies, with independents dropping from 69 percent last month who said they thought the feds were doing enough to stop the spread of coronavirus to 47 percent who say so now. Partly that’s a product of public ignorance, not federal incompetence: Any uptick in the number of cases nationally was destined to bleed some confidence among people that things are getting better, no matter how proactive the government was being. But a big reason why the public had such confidence that this would blow over in the first place is because Trump spent the better part of two months insisting that it would. Now we are where we are.

By the way, even if they bring thousands of new ventilators online soon, there’s still the minor problem of staffing people to administer the machines. The Forbes story describes crash-course training for various medical personnel, including potentially veterinarians, on how to operate the ventilators as hospitals are overwhelmed. Hoo boy.