Thread by @JeremyKonyndyk

Today @realDonaldTrump claimed his administration was providing "historic support" to the states and was "very much involved in terms of getting the equipment they need."

I spent much of the week talking to frontline local officials and docs. Here's what I'm hearing:

"We're getting NOTHING from the feds. The mayor is trying to cultivate the VP's office but it hasn't delivered so far."

"The feds have shat the bed on this...we've given up trying to rely on them."

Hospitals are very close to running out of basic supplies and PPE. Within days of exhausting their supply of gloves.

Trying to request support from the Strategic National Stockpile but "we can't get shit."

In one city, 1/3 of hospitals are on the verge of exhausting reserves.

Officials in two different states told me today that they are so desperate for PPE that their state/local govts are calling around to family practitioners, dentists, anywhere that may have small reserves of viable PPE and asking that it be donated for hospitals.

One said "I'll probably spend much of next week driving around collecting PPE donations in my Subaru."

This is a senior official in a major US city.

The PPE shortages jam up everything else. Need PPE to triage and treat patients; to conduct testing; to prevent infections in high-risk facilities like assisted-living homes.

Huge, huge rate-limiter on all other aspects of the response.

"The White House has consistently over-promised and under-delivered."

On testing, no one is able to scale to the level they need.

Doc on the East Coast: "Most people I saw were symptomatic and were negative for non-COVID. Most were sent home" because they couldn't be tested for COVID.

State official: Still lack the kits and private lab capacity has yet to come sufficiently on line. Currently can't get the needed reagents.

Given the vacuum in federal leadership "we're all competing with each other." There isn't one coherent homeland approach, instead "there are 50 homelands" each looking after their own needs.

And not just competing with each other. One city tried to act on Trump's advice that cities/states should meet their own needs directly. Tried to order PPE from suppliers and lost out multiple times to bids from...the federal government.

This is a mess, and its about to get dramatically, dramatically worse. Case counts in most US cities aren't yet that high; the wave is only starting to hit.

And if states are finding it easier to get PPE from local dentists than from @HHSGov...I don't even know what to say.