E Pluribus Unum

E Pluribus Unum

A national crisis deserves a national response. This has already been demonstrated by actions from the Federal Reserve, Congress and the White House. Upwards of $4 trillion will be injected into the economy to assist in everything from small business loans, unemployment insurance and backstopping many elements of the financial system. This massive infusion took only three weeks to design and implement. It is close to the total amount that had been injected into the economy from 2008 to 2013. Despite a deeply divided republic, the nation and its elected officials acted quickly once they fully understood the gravity of the Coronavirus pandemic.

More must be done. It is now time to centralize the medical response in order to fully meet the needs of citizens who continue to suffer and die at an alarming rate. The United States has been invaded by an invisible enemy, who in a period of only one month, has completely changed our way of life and shuttered the global economy. A “free for all” has emerged with states competing with each other, the federal government and hospitals for limited resources. This approach will not accomplish the mission of efficiently delivering equipment to where it is needed most. The current system lacks a coherent grand strategy, which requires a coordinated national response.

This response must be spearheaded by a centralized National Command Authority (NCA), led by a General Officer. The NCA would assist in placing orders to manufacturers. Manufacturers should be linked with distribution chains to speed delivery. The NCA would dispatch appropriate transportation elements to these facilities. It may be more efficient to rely on regional coordination centers to assist in this distribution. As in a wartime situation, ground commanders still answer to higher authorities, but have flexibility to address situations which are in their area of operations. Most importantly, the NCA would have the ability to resolve competing interests, especially between states or regions. Additional assets could be deployed from one state to another to assist in deliveries. 

From now until early summer, the means of production are converting plants to produce new products. The initial output may be slow, but once ramped up, these facilities will rapidly meet our needs. As a nation, we need to think in terms of manufacturing billions, not millions of gloves, gowns, shields and masks. We may need a million respirators, perhaps more. We will need several hundred million testing kits. This increased volume makes the need for a coordinated delivery system even more essential. As we move into the fall, a second wave of infections may begin again. We need an abundance of supplies in hospitals and a good reserve in place. Quantity has a quality, all its own. We must also remember that as individuals return to work, converted automobile plants may return to making cars, not respirators. Plan for that inevitability. 

The NCA will assist the regional coordinators to prioritize deliveries. Segregate the response to routine, priority and urgent. Identify the manufacturing facilities in each state. Have these firms transmit daily product availability reports to regional centers that would dispatch transportation to these plants for pickup and delivery to local treatment facilities or aircraft. Once the aircraft have reached their destination, transportation would be waiting for delivery directly to hospitals or other facilities. Urgent deliveries can be placed on designated vehicles and delivered immediately to hospitals. Priority can go scheduled aircraft and next available transport. Routine shipments would be released at specific times of the day. Existing supply chains such as Amazon, UPS and others could be utilized if deemed more efficient. They can be delivered next day, if that service is needed. The intent is to maximize the use of the entire transportation assets in the United States in a coordinated and intelligent manner to accomplish rapid delivery to treatment facilities.

The reserve and National Guard transportation units that are not currently tasked, should be the first logistical responders. The regular army should not be diverted from its primary mission of defending the homeland. The airlines and rental truck agencies should be aligned with reserve and National Guard transport forces, ground, sea and air, to provide a maximum centralized response. Commercial trucking companies can also be utilized to assist. A coordinated response with regional centers to link arriving aircraft with dedicated transport assets would ensure immediate delivery. To more remote areas, helicopters would be utilized. These aircraft are already being tasked to assist in delivery of supplies.

Here is an example of this how this system would function. Massachusetts General Hospital has an urgent request for 10,000 masks. The NCA receives the request and relays it to its regional centers. The General Motors plant in Warren, Michigan, has masks available. Transportation assets are dispatched to the plant and deliver the masks to Detroit Metro Airport. The masks are loaded on to the next flight to Boston Logan Airport or on one of the standby aircraft and a special flight is made. A vehicle meets the aircraft on the tarmac in Boston and the masks are delivered.

By not using a centralized approach to address a national crisis, the United States now resembles the Confederacy during the Civil War. The South lacked the logistical coordination used by that of the North. Especially in the latter years of the war, southern armies were desperate for supplies, which were available in warehouses, but not released by the individual states. The North, on the other hand, brought all of its resources to bear against the confederates and overwhelmed their forces by concentrating men and material in a decisive manner. America’s best strategy against the virus must be implemented by a national logistical effort that is coordinated, efficient and logical.

American citizens are battle casualties in an ongoing conflict, where our health care professionals are the front line of defense, short of supplies. Once our industries ramp up to full production, the United States will need a coordinated distribution plan to speed products to the end user. There are plenty of assets available from the private sector and military that currently sit empty on tarmacs, motor pools and loading bays across the country. 

Get them rolling!

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Written by
David Breuhan