(CN) — President Donald Trump recently has taken to calling the United States the “king of ventilators,” ready to service Covid-19 patients domestically and internationally, but federal records show the royal line of succession runs through Europe.
U.S. investments in ventilators came late, with the federal government doling out billions in contracts long after New York had been forced into a dangerous compromise of splitting two patients per machine.
And “America First” nationalist rhetoric aside, the largest contractors tapped for this work have owners or corporate parents in the Netherlands, Switzerland and the United Kingdom.
A Courthouse News investigation found that awards to the top-five ventilator contractors in response to the novel coronavirus pandemic topped $2.3 billion, more than $1.9 billion of which went to four companies with a foreign parent or owner.
All of those contracts had delivery dates scheduled well after the apex of Covid-19 infections in New York, the U.S. epicenter of the pandemic.
The data contradicts Trump’s bluster about U.S. dominance over the life-saving machines.
“Now, we’re the king of ventilators,” Trump boasted this past Saturday, when he first coined his regal analogy. “We have ventilators. We’re going to be helping other countries very soon. We’re going to be helping Mexico.”
A few days before that briefing, on April 15, the Department of Health and Human Services entered into roughly $551 million contract for ventilators with Swiss manufacturer Hamilton Medical.
New York coronavirus cases had already started to decline by that point, , weeks after Empire State hospitals had been driven to pioneer a risky technique of splitting ventilators between two patients.
Hamilton Medical’s guidelines warn against this use of the machines.
“This will most probably result in distending (and damaging) the healthier lungs of the ventilated patients, while the lower compliant lungs will collapse further,” the company wrote, an assessment shared by six medical associations.
Another warning came on March 26: “Attempting to ventilate multiple patients with COVID‐19, given the issues described here, could lead to poor outcomes and high mortality rates for all patients cohorted,” the Anesthesia Patient Safety Foundation and five other groups wrote.
All five of the largest contracts America awarded for ventilators since the novel coronavirus broke out post-dated these warnings, a database of these contracts shows.
The largest coronavirus-related ventilator contract was a roughly $646.7 million award on April 8 to Philips North America, a subsidiary of the Dutch company Royal Philips that had boasted of its international ventilator sales to China, southern Europe and the United States.
“In line with Philips’ mission, we are fully committed to helping as many healthcare providers as possible diagnose, treat and monitor the growing numbers of Covid-19 patients,” Royal Philips CEO Frans van Houten said in a statement, announcing that more machines were being built in Pennsylvania and California.
That release highlighted an April 8 emergency-use authorization by the Food and Drug Administration, aiming for production of 15,000 Philips Respironics E30 ventilators in Pennsylvania per week that month.
For two other models of hospital ventilator — Philips Trilogy and Philips Respironics V60 — the Dutch giant has partnered up with Jabil in St. Petersberg, Florida, and with Flex, which is legally domiciled in Singapore, but these machines are not expected to be made as quickly.
“The combined hospital ventilator output is projected to increase to 4,000 units per week by the third quarter of 2020,” Philips projected.
Hamilton Medical announced on April 14 that it had started ramping up production at its base in Switzerland earlier this year but would launch a new line for critical care ventilators in Reno, Nevada.
“The best approach is to create a new production line with a new supply chain — so that we could avoid diverting from existing production needed around the world or worsening the ongoing supply chain bottlenecks,” CEO Bob Hamilton said in the announcement, noting a partnership with General Motors.
Though Hamilton and GM started production in late March, the first line of ventilators is scheduled for the end of April.
Vyaire Medical, the recipient of the U.S. government’s third-largest ventilator contract at $407.9 million, is based in Mettawa, Illinois — and owned by the British private equity firm Apax Partners.
Set to produce 22,000 ventilators by the end of June under the contract, the company emphasized on April 16 that it’s been long prepared for the pandemic.
“Our team accelerated production and delivery of ventilators back in February,” CEO Gaurav Agarwal said in the statement.
The Massachusetts-based Zoll Medical Corp., part of Japan’s Asahi Kasei Group, received a $350.1 million award for ventilators on March 30, but it also took action before nabbing that U.S. government contract.
A week before the deal, Zoll announced a 25-fold increase in production that would aim to build 10,000 ventilators a month.
“We have received many unsolicited offers of help from not just medical companies, but industries including aerospace, automotive, and information technology,” CEO Jon Rennert announced on March 23, encouraging the federal government to follow suit. “We look forward to working with the U.S. government and private industry collaborators to meet this urgent need.”
Of the top-five recipients of U.S. government ventilator contracts, only one — Datex Ohmeda, a subsidiary of General Electric — does not have a foreign parent or owner.
The Department of Health and Human Service on April 13 announced the contract to build 2,410 GE Healthcare Carescape R860 ventilators in its Wisconsin facility by the end of June.
“GE Healthcare already has doubled its capacity of ventilator production of its CARESCAPE R860 and has plans to double it again by the end of June to help address the increased need,” a spokeswoman for the company said in an email. “Separately, our efforts with Ford to quickly scale the Airon-licensed Model A-E ventilator will provide an additional supply of critical medical equipment needed to arm clinicians in the fight against Covid-19.”
Other than the top-five contractors, the Department of Health and Human Services announced far smaller awards for ventilators to the San Diego, California-based ResMed ($31.9 million), the Batesville, Indiana-based Hill-Rom ($20 million), and Dublin, Ireland-headquartered Medtronic ($9.1 million).
The agency says the spending spree will produce 137,431 ventilators, the vast majority of which will not arrive until the end of 2020.
HHS Secretary Alex Azar touted Trump’s use since April 8 of the Korean War-era Defense Production Act.
“The thousands of ventilators delivered to the Strategic National Stockpile starting this month, continuing through the spring and summer, will mean we have more capacity to respond to the pandemic as it evolves,” Azar said in a statement. “HHS and FEMA deployment of ventilators from the stockpile have helped ensure that hospitals in states such as New York have not run out of ventilator capacity while working to save lives.”
The White House did not immediately respond to a request for comment.
The United States leads the world with 792,958 reported Covid-19 cases and 42,531 deaths.
Trump issued an order temporarily suspending U.S. immigration — purportedly in response to the coronavirus — late on Monday.
Critics called Trump’s policy a cynical gambit to play to his base on immigration on a thin public health pretext. Mexico has reported 8,772 cases and 712 fatalities.