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