By The Washington Post · Amy Brittain, Isaac Stanley-Becker, Nick Miroff · NATIONAL, HEALTH
"One hundred flights for Project Airbridge have been completed to date," McEnany said, delivering "nearly 1 billion pieces" of personal protective equipment to the front lines. The flights had traveled 720,000 miles, the display read, equal to "more than 3 trips to the moon!"
Since the debut of Project Airbridge in March, the Trump administration has promoted the initiative as part of a historic mobilization "moving heaven and earth" to source and deliver vast amounts of medical supplies from overseas to pandemic hot spots in the United States.
Widely credited to President Donald Trump's son-in-law and senior adviser Jared Kushner, the plan harked back to storied U.S. wartime efforts such as the Berlin Airlift. It called for the federal government to partner with a handful of medical supply companies, which could purchase emergency masks, gowns and gloves in Asia. The government would pay to fly the supplies to the United States - bypassing weeks of shipping delays - as long as the companies sold half of the goods in parts of the country hit hardest by the pandemic.
Almost six weeks after its launch, Project Airbridge has completed its 122nd flight, having cost taxpayers at least $91 million. But its impact on the pandemic is unclear and shrouded in secrecy: The White House, the Federal Emergency Management Agency and the companies involved have declined to disclose where supplies have been delivered.
Administration officials, meanwhile, have pointed to the project as a signature initiative of their pandemic response. Broad and sweeping statistics about supplies procured through the project have been an almost daily fixture of White House press briefings.
"Through Project Airbridge, we have succeeded in bringing planeloads of vital supplies into the United States from overseas," Trump said at a briefing on April 7. "These are massive planes, by the way. The big planes - they are very big, very powerful - and they are loaded to the gills with supplies."
But the White House has on several occasions overstated the amount of supplies the project has delivered, according to a Washington Post review that compared shipment totals provided by FEMA to statements made by White House officials through news briefings and on social media. FEMA records, for example, show that Project Airbridge on average has delivered about 2.2 million surgical masks a day over the program's span. Yet Vice President Mike Pence claimed in a news briefing in April that the program delivered 22 million masks daily.
Overall, Project Airbridge flights have distributed just 768,000 N95 masks - far fewer than the 85 million N95 masks procured through conventional federal relief efforts, according to the latest FEMA records.
The N95 masks, which offer greater virus protection than surgical masks because they can filter airborne particles and tiny droplets, have made up less than 0.1 percent of Project Airbridge items shipped, records show. Disposable gloves account for about 90 percent of the nearly 1 billion items that McEnany said had been flown in through the initiative.
At the heart of Project Airbridge is the deal the Trump administration struck with the six medical supply companies: Cardinal Health, Concordance, Henry Schein, McKesson, Medline and Owens & Minor.
In exchange for the subsidized flights - costing taxpayers $750,000 to $800,000 per trip - the companies agreed to sell half of their cargo to customers in geographic hot spots specified by the administration. But the companies decide where to sell the rest of the supplies flown into the country at taxpayers' expense.
"The fact is you're using taxpayer dollars to distribute private resources," said W. Craig Fugate, who led FEMA for eight years under President Barack Obama.
Asked about Fugate's comment, FEMA spokeswoman Janet Montesi said: "FEMA covers the cost to fly these supplies from overseas to the U.S., cutting the amount of time it takes to ship supplies from weeks to days. Once the supplies have landed in the U.S., the medical distributors are the ones who distribute these supplies, not the federal government."
The Trump administration has said Project Airbridge eased medical supply shortages in some of the areas hit hardest by covid-19. FEMA officials said pandemic hot spots designated by the Centers for Disease Control and Prevention have received half of all supplies, but they declined to provide details of those shipments.
To assess the program's impact, The Post interviewed 49 government and health-care officials, including those in the 10 states and 10 counties hit hardest by the pandemic.
Officials in three of the 10 counties said they believed they had not received any supplies through Project Airbridge. In seven counties, officials said they said they had no way to know.
"I haven't heard of it," Jeremy Simmons, an emergency manager in Lincoln County, Ark., said of Project Airbridge. In April, Lincoln was among the counties with the highest rate of infection per capita.
In five states - Connecticut, Illinois, Maryland, Michigan and New Jersey - officials confirmed deliveries but said they could not provide details about the supplies or the destinations of shipments.
Officials from New Jersey and Maryland said they were told by FEMA that they could not share information about what medical supplies had arrived through Project Airbridge.
"The FEMA guidance specifically says the information is not for release," Michael Ricci, director of communications for Maryland Gov. Larry Hogan,a Republican, said when asked to provide numbers for Airbridge deliveries.
FEMA's Montesi disputed the claims from state officials.
Rear Adm. John Polowczyk, who is responsible for managing Project Airbridge operations at FEMA, said that the speed of the effort has been its greatest asset and that Project Airbridge has delivered hundreds of millions of items of personal protective equipment.
"I view it as a success, as a short-term measure," he said in a recent interview.
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Early news accounts of Project Airbridge often ascribed the original idea to Kushner - "We formed an unprecedented public-private partnership," he told numerous media outlets at the end of March - and Ivanka Trump has posted praise on social media for her husband's role in the program.
But the framework for Project Airbridge originated hundreds of miles from the White House, within the Boston home of Valerie Karplus, an assistant professor at the Massachusetts Institute of Technology who specializes in science and technology policy and is a member of the Covid-19 Policy Alliance. The group analyzes data and offers policy recommendations related to the pandemic.
Karplus and others in the alliance had become convinced by mid-March that rapid air transport was the solution for the country's growing shortage of personal protective equipment, or PPE, she said in an interview.
On March 22, Karplus spent the day crunching the numbers - the weight of materials, the volume of cargo space and the number of flights needed to satisfy the needs of various infection scenarios in the United States. She said she enlisted the help of a friend, an aerospace engineer. Later that day, she put together her proposal, titled "A Medical Supply Airlift to Protect the U.S. from COVID-19."
The memo, reviewed by The Post, made no mention of a partnership with private suppliers. Rather, it focused on the strategy to procure goods from China, laid out the benefits of air cargo transport over sea travel and provided estimates of goods that could be rapidly flown to the United States.
The following day, March 23, Karplus emailed her memo to Polowczyk, who had just been assigned to FEMA to lead an effort to fix the supply-chain crisis.
Karplus and Polowczyk exchanged emails and spoke by phone over that week.
"Obtaining enormous volumes of PPE in a matter of weeks was something of a herculean task that they were asked to do late in the game," she said. "There's a lot that I actually don't know about the implementation. I did find that Admiral Polowczyk was really receptive to this idea."
Separately, others at MIT passed the memo along to Kushner, and his team soon joined the discussions, according to interviews with White House officials. Adam Boehler, a friend of Kushner's and former chief executive of Landmark Health who now leads the U.S. International Development Finance Corp., and Brad Smith, a Medicare official and the founder of Aspire Health, talked through scenarios with Polowczyk.
"What became really apparent was that it was going to be really hard to buy more stuff and make sure we're not getting screwed," said one White House official who was not authorized to comment publicly and spoke on the condition of anonymity. The administration feared being overcharged for emergency supplies, the official said, and ultimately decided to "fly it over and let [the companies] do what they want."
Karplus's memo included an offer from MIT experts who said they could help federal officials determine where PPE should be delivered.
"Upon arrival in U.S. hubs, the COVID-19 Policy Alliance will be able to advise on routing equipment to areas that need it most," Karplus wrote. But the White House officials who took charge of the effort were convinced that the private sector could move the supplies faster.
Within days, the pitch from MIT experts morphed into the Trump administration's Project Airbridge, a plan designed to take advantage of the buyer-seller relationships maintained by the largest health-industry suppliers in the United States.
"I came up with the concept for Airbridge," Polowczyk said, adding that he drew upon conversations with his colleagues and MIT economists.
White House officials involved said they chose the six companies because their distribution contracts covered about 90% of the country's health-care facilities.
"One of the reasons that we used the distributors is that we didn't want supplies going from abroad to sit in a federal warehouse and then sit in a state warehouse instead of going direct to the hospitals," Boehler said in an interview. "The important thing wasn't how to get supplies into the country but how to get them to end users in the quickest time possible."
The companies also had extensive relationships with manufacturers in Asia, including experience with orders for medical supplies that would ordinarily take a month or more to arrive via cargo ship.
Cardinal Health and McKesson - both embroiled in costly lawsuits related to the opioid epidemic - and the four other companies were now key partners for the White House.
The companies sent a letter to the Justice Department requesting an antitrust waiver and expedited clearance of their plans to work together. Separately, they signed project agreements with FEMA. The Post filed a Freedom of Information Act request for these documents, which is pending.
Officials with knowledge of the arrangement said that the companies agreed to charge "reasonable" prices for PPE delivered to hot spots and that the prices would be consistent with what customers were paying for supplies under their existing contracts with the companies.
Karplus said the White House approach may overlook buyers such as state governments and senior care facilities that may not have previously purchased large amounts of PPE from any of the six companies.
"The private sector is incentivized to focus on its existing, profitable relationships," Karplus said.
Two of the medical supply companies - Henry Schein and McKesson - provided statements to The Post about their work with Airbridge. The other four declined to comment.
"We feel it is important to be doing our part to help mitigate the spread of the coronavirus, and we will continue to work in partnership with FEMA as long as the crisis requires," Henry Schein said in a statement.
McKesson issued a statement that said the company has used its "expertise in managing complex logistics to deliver lifesaving medicines and medical supplies across the country."
On March 29, leaders from the six companies gathered around a conference table at the White House to discuss the launch of the initiative with Trump.
"Our first project - and we call it 'Airbridge,' " Trump said at the meeting, which was televised. "It's 'Airbridge.' That's the name."
The president praised Polowczyk, saying his work on Airbridge was "just fantastic."
Then, Trump turned to Cardinal Health CEO Mike Kaufmann and pointed to Polowczyk. "Is he doing well?" Trump asked Kaufman about the admiral.
"If he's not, let me know," Trump said, laughing. "We'll reduce his rank by one notch."
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On March 29, the day of the White House roundtable, the first Project Airbridge flight landed at John F. Kennedy International Airport in New York.
A commercial aircraft arrived with 60% of its cargo - a mix of masks, gowns and gloves - purchased directly by FEMA and earmarked for delivery in New York, New Jersey and Connecticut, according to an agency spokeswoman.
The flight, however, would be an anomaly in the overall Airbridge effort.
Every flight since has carried supplies purchased by the companies involved, according to FEMA and White House officials.
On April 3, several days into the new initiative, a FEMA regional administrator hosted a conference call with the Florida congressional delegation, including Rep. Ted Deutch, D-Fla. Deutch said he was confused during the call as the FEMA official suggested that just 20% of Airbridge-delivered goods would go to pandemic hot spots, while 80% would go elsewhere in the companies' supply chains.
Several days later, FEMA announced that 50 % of the supplies were going to hot spots. The mixed messages befuddled Deutch, who said he has sent FEMA Administrator Peter Gaynor requests for flight manifests, cost breakdowns and a list of recipients of goods.
"If you think about it, if there are 100 cargo planes, then right now what we know at a minimum is that 50 cargo planes full of much-needed, desperately needed PPE is coming to America and we have no idea where it's going," he said in mid-April of the 50-50 distribution split.
Jared Moskowitz, the director of Florida's Division of Emergency Management, said he has no way to confirm whether Project Airbridge supplies have been delivered to the state. He said it has been hard to plan his state's response without an explanation from FEMA about how the hot-spot deliveries are prioritized.
"What's confusing to us is the 50 % that goes to the vendors," Moskowitz said. "Do the feds tell them where they want it to go? Or is it the vendor that then gets to decide which order to fill? And how is that even decided at all? Is it based on how old the order was? Is it based on price? Is it based on need? There's no visibility on any of that."
Kevin Klein, director of the Colorado Division of Homeland Security and Emergency, also wanted answers about how supplies were being distributed when he read in news reports that FEMA would direct shipments to certain counties.
"No transparency. No communication with the states," Klein wrote on April 6 to a regional FEMA director in an email released through a public records request. "Kept us out there fighting for supplies. It may have been effective 6 weeks ago, but now? What is really going on?"
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In recent days, Pence has highlighted Project Airbridge's deliveries to his home state of Indiana, as well as to Minnesota and Wisconsin - likely to be key states in the November election - in promotional graphics posted to his Instagram and Twitter pages.
Pence claimed that more than 1.4 million N95 masks were delivered in the three states through Airbridge. But Airbridge has brought in fewer than 800,000 masks for the entire country, according to FEMA records. FEMA released total numbers of each type of supply delivered but declined to provide details on where they were distributed.
In a statement, the Joint Information Center in Indiana said this of the figures touted by the vice president: "We cannot verify these numbers."
After Post reporters asked Pence's office about the claims, the Instagram and Twitter posts related to Indiana and Minnesota were deleted.
"It was an incorrect graphic," said Pence press secretary Katie Miller. She said the numbers included other federal relief efforts. The original postings were replaced by new graphics that said "FEMA total deliveries."
In some cases, Project Airbridge received credit for supplies obtained through other means.
In Cook County, Illinois, local officials held a news conference on April 14 to celebrate the arrival of 240,000 N95 masks, some of which were stacked in boxes behind the speakers' lectern. Kevin Sligh, a deputy regional administrator for FEMA, took the microphone and credited Project Airbridge for swift action.
"Project Airbridge has ensured critical health-care supplies are getting to communities who need them the most, including here in Cook County," Sligh said, briefly describing Project Airbridge's "commercially procured" supply chain.
A Cook County spokeswoman later confirmed to The Post that the supplies were donated by the Defense Department.
Sligh later said he erred during the news conference.
"Initially we were under the impression that it was from Project Airbridge," he said in a phone interview. He said he learned in recent days that the Defense Department had donated the masks.
To locate deliveries of Airbridge supplies, Post reporters contacted governors' offices, state emergency management agencies and county officials across the country in areas with high rates of confirmed infections per capita.
In addition to the five states that confirmed Project Airbridge deliveries, New York, Louisiana and Massachusetts officials referred reporters to FEMA. Rhode Island did not respond to requests for information, and in Delaware an official said he was unsure.
"We really cannot say with certainty what, if anything, has been received with the support of this initiative," said Jeff Sands, a spokesman for the Delaware Emergency Management Agency.
In Tennessee, where an outbreak in a Bledsoe County prison made the area a top-10 hot spot nationally, a state official was unable to verify that any Project Airbridge supplies had arrived.
"I'm not saying that Tennessee and other states aren't getting shipments of PPE through Project Airbridge," said Dean Flener, a spokesman for the Tennessee Emergency Management Agency. "It's just that when we get PPE, we don't know if it's from Project Airbridge. They don't stamp, you know, 'Courtesy of Project Airbridge' on the boxes."
Reporters also sent inquiries to 25 of the largest health-care chains in the country, asking whether their facilities had purchased supplies flown through Airbridge. Most did not respond. The others said they were unaware of the initiative or simply unable to confirm how they had received their PPE.
"We are not aware of the project," said Angela Marie Dejene, a spokeswoman for Sanford Health, based in Sioux Falls, South Dakota, where an outbreak at a Smithfield Foods processing plant turned the area into a major hot spot.
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As the number of Airbridge flights rose into the dozens by mid-April, Trump said that the program had helped equip "medical warriors on the front lines."
"The Airbridge has been incredible," Trump said at a news briefing April 17.
Some Democrats in Congress, however, began to criticize the operation for its secrecy, as well its reliance during a national emergency on the six companies, which are allowed to sell half the supplies wherever they want.
"Outrageous," Sen. Chris Murphy, D-Conn., said of the arrangement in a recent interview, calling it "the worst of all worlds."
Sen. Tammy Baldwin, D-Wis., wrote to Trump to say that Project Airbridge has given too much control to the six companies, "with no transparency."
At the end of April, Sens. Elizabeth Warren, D-Mass., and Richard Blumenthal, D-Conn., sent letters to the six companies with questions about Project Airbridge, including requests for what they were charging for supplies transported by the project and a list of the states, municipalities, tribal governments, hospitals and others that received them.
"The American people need an explanation for how these supplies are obtained, priced, and distributed," the senators wrote. "Unfortunately, neither the administration nor your company has explained critical details, such as the content of any existing contracts or financial agreements."
The companies had yet to respond, a Warren staffer said Thursday.
As quickly as Project Airbridge took flight, the program is winding down. As of Thursday, FEMA reported only 23 more scheduled flights.
In an interview in late April, Polowczyk said the administration may transition to moving cargo by ships instead of planes. While the travel time is weeks longer, stacking containers on commercial ships allow for more-efficient transport of bulky items.
"I can see where Airbridge will transition to maybe Seabridge," the admiral said.