Prioritization. Just because it is a hospital that wants to get them does not mean that it was that specific hospital had a higher priority on PPE at that specific time.

Today an unfilled request for PPE from Mount Sinai has a higher priority than an unfilled request for PPE in Boston. Mount Sinai therefore would win against Boston. Boston would win against a small hospital in Erie, PA.

"The Federal Government is not a shipping clerk". The biggest complaint in all of this is that the Federal government is not handling the allocation of these scarce resources, instead forcing states to engage in bidding wars that only enrich suppliers and brokers.

The system is setup to allow for individual players to continue to engage in the commercial transactions however they want as long as the prioritized requests have been satisfied.

Requests are prioritized based on the "hotness" of the requests and a probability of the issuer of the request not being able to find a way to resolve it.

If Mount Sinai (NYC, red zone) needs 20k masks because they are projected to run out in two days ( burn rate 10k/day) and Abington Health (PA, outside Philadelphia, yellow zone) has 20k masks that are heading to it ( its burn rate is 200/day ), the feds will absolutely take it and redirect to Mount Sinai.

On the other hand if Mount Sinai is projected to run out in a week, feds won't touch it.

Oceania had always been at war with Eastasia.

You imply that there is some list of prioritization out there. President Trump has repeatedly maintained that the Federal Government is not in charge of organizing who has what, and that the States should be managing this.

Given this lack of control (or even central organizing), who exactly would be determining who has the priority that you are asserting?

The Admiral Polowczyk whom they brought to run the logistics on coronavirus task force said there's absolutely a prioritization list based on "hotness" of the zone. He said it himself to camera during the briefing number 21(Edit: not 21, it had to be earlier - it was within a few days of the NYC lock down. Maybe that Monday ).

They spent the first week implementing/adapting some DoD system that allowed them to track the pipeline of orders and goods matching the orders to the individual hospital level and if necessary redirect from one to another.

That would be great if it were being distributed by FEMA or whoever and there weren't obscure private brokers involved.