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- [00:00]
Isaac Saul
Instacart is on a mission to have you not leave the couch this basketball season because between the pre game rituals and the post game interviews, it can be difficult to find time for everything else. So let Instacart take care of your game day snacks or weekly restocks and get delivery in as fast as 30 minutes because we hear it's bad luck to be hungry on game day. So download the Instacart app today and enjoy zero dollar delivery fees on your first three orders. Service fees apply for three orders in 14 days.
- [00:29]
Will Kbach
Excludes restaurants okay business leaders, are you here to play or are you playing to win? If you're in it to win, meet your next MVP NetSuite by Oracle NetSuite is your full business management system in one convenience suite. With NetSuite, you're running your accounting, your finance, your HR, your e commerce and more, all from your online dashboard. Upgrade your playbook and make the switch to NetSuite, the number one cloud ERP. Get the CFO's guide to AI and machine learning at netsuite.com tech netsuite.com tech.
- [01:00]
John Lal
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- [01:35]
Isaac Saul
From executive producer Isaac Saul. This is Tangle.
- [01:49]
Ari Weitzman
Good morning, good afternoon and good evening and welcome to the Tangle Podcast, a place where you get views from across the political spectrum spectrum, some independent thinking and a little bit of our take. I'm your host Today Senior Editor Will Kbach, and in today's Friday edition, we're going to be winding back the clock to 2022 and taking a look at a story that has fallen out of the news cycle but remains particularly relevant to some of the major issues of today, and that is the infant formula shortage that took place for about six months in 2022 during the pandemic. We're going to look at what happened, the causes of the shortage, how we got out of it, and some of the lessons that we should take. And we're also going to talk a little bit about how the media's coverage of that incident influenced the way we think about the news and consume the news it's part of a series that we're considering making a reoccurring project at Tangle, so we'd love to hear what you think about this coverage style. We'll talk more about the framing of this piece as we get into it. So for now, let's get started. Foreign Sometimes consuming the news can feel like trying to carry all the bags from a big grocery run into the house in a single trip. You've got to balance uneven weights in uneven ways while trying to do a normal task like opening your front door. And as the news increasingly moves to digital platforms, it can sometimes feel like we're carrying that weight every hour of every day. Every once in a while, on our seemingly endless grocery run, we'll drop something. Case in point. Do you remember the baby formula shortage? In truth, we forgot about it too. Our news cycles are filled with stories that seem to disappear just as soon as they arrive. Stories that feel like they'll have a major impact on our country or planet, but then kind of fade away stories. Of course, that's not to say these stories are unimportant. While they may not have become historic events, year defining events, decade defining events, they still offer important lessons that we should take heed of in the present. At Tangle, we've recently been reflecting on our coverage from the past five years, identifying stories that we covered once or twice thought could potentially reshape our lives and then didn't. And we're asking what happened to that story? So today we're trying to figure out how one story in particular has panned out. The baby formula shortage, as we'll get into below, the story combined pandemic era challenges with existing supply chain issues and a little bit of bad luck, raising fears that millions of infants across the US Were facing a nutritional crisis. But did those concerns actually come to bear? And are the underlying issues of the shortage actually resolved? If you like this piece and the idea of revisiting other stories from recent years, write in, send us a note, let us know. And we'd also like to hear the topics that you'd be interested in having us cover in the future. Like I said at the beginning, we're considering making this a recurring series and we'd love to have you help shape it. Let's rewind to 2022. At the height of the formula shortage in May, news outlets framed the story as a major crisis with the potential to impact millions of families. Here are some headlines from that time period. The Atlantic described a, quote, full blown national crisis, as did the New York Times. The Wall Street Journal suggested the shortage could, quote, leave parents scrambling for months. NPR called it, quote, a major stressor for parents. Fox Business said the shortage was reaching a, quote, crisis level and sparking panic. The Associated Press wrote about parents hunting for baby formula. As the shortage spans the United States, CNN said the problem is getting worse. So how did we get here? In February 2022, the Food and Drug Administration the FDA issued a recall of powdered infant formula produced by Abbott Nutrition at its Sturgis, Michigan facility after reports of product contamination linked to Cronobacter sakazaki bacteria. Four infants became sick after consuming formula produced at the factory, and two died from their illnesses. Now, Abbott maintained that the illnesses and the deaths were not due to contaminated formula, citing bacteria samples collected from the infants that did not match those found in the company's factory. However, the FDA said its investigation did not absolve Abbott, noting that the bacterial samples from the factory did not need to be an exact genetic match with those drawn from the infants to indicate that it was the source of the infection. Now, Abbott is one of three major formula manufacturers in the United States, producing about 40% of all formula sold domestically, primarily under the brand name Similac, and the Sturgis plant is the largest of its facilities. Abbott shut down the plant in early 2022 after the FDA's recall order, grinding all production at that facility to a halt. The shutdown exacerbated existing baby formula shortages linked to the COVID 19 pandemic, during which hoarding, labor shortages and supply chain issues impacted availability. In April 2022, Target, Walmart, CVS and Walgreens began limiting how much infant and toddler formula customers could purchase per visit. Later that month, 40% of the top selling baby formula products were out of stock, and in May, the Washington Post reported that the out of stock rate for infant formula was over 50% in eight states and ranged from 30 to 40% in several others. Families who relied on the government's Special Supplemental Nutritional Program for Women, Infants and Children, also known as WIC, which supplies formula to roughly 40% of all American babies, faced additional challenges due to the program's restrictions on which brands of formula it supplements, though the government did waive some restrictions during the shortage. As the situation worsened, President Joe Biden invoked the Defense Production act to allow formula manufacturers priority access to materials used to make infant formula. Biden also directed several federal agencies to partner to transport formula shipments from foreign suppliers to the U.S. now, Abbott resumed operations at its Sturgis plant in June after reaching an agreement on safety standards with the fda, while flooding from severe storms temporarily delayed production shortly after the plant was reopened, it was fully operational by August. By October 2022, the crisis had somewhat subsided, with some 18% of powdered formula out of stock during the first week of the month, compared to 31% in July. While those stock rates were still higher than the historical averages, the acute nature of the shortage had largely abated by the end of the year. So below we're going to share a snapshot of the reactions from commentators and experts during the peak of the shortage, including some original interviews from those involved. We'll also dive into how the issue was resolved, the story that the News may not have followed up on at the time, and finally, we're going to unpack what lessons we can take from the story of the shortage. Foreign.
- [09:16]
Paige
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- [10:04]
Ari Weitzman
So.
- [10:05]
Paige
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- [10:23]
Isaac Saul
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- [11:00]
Ari Weitzman
First the reactions. So newsrooms and commentators across the political spectrum characterized the shortage as a major crisis for families and to varying degrees blamed the Biden administration for failing to act sooner to prevent the worst case scenario from transpiring. The Bloomberg editorial board blamed, quote, bad policy and red tape, end quote for the crisis, writing, quote, decades of bad policy have led to an unduly concentrated market. Excessive tariffs and other trade barriers have all but shut out imported infant formula, even if consumers were willing to pay higher prices. The red tape that the government imposes on foreign products and retailers wishing to distribute them can be prohibitive. End quote in the Guardian, Matt Stoller criticized the quote, monopolized distribution system end quote for formula, writing quote, policymakers should stop allowing exclusive contracts in return for rebates. That means restructuring baby formula buying policy, but it also means repealing the anti kickback exemption for GPOs and enforcing laws against exclusive contracts and price discrimination in the form of rebates more generally. End quote Others, like National Review's Jim Garrity, said the supply chain shortages caused by the pandemic created a unique environment for a protracted shortage. Manufacturers of perishable goods would always prefer that the demand for their products be steady or preferably growing at a manageable pace, but the pandemic disrupted American baby making as much as it disrupted every other American activity, garrity wrote. Lawmakers also decried the shortage, with Republicans blaming the Biden administration's policies for exacerbating the problem. In May 2022, Representative Jim Jordan, a Republican from Ohio, said, quote, bare shelves Biden and quote, was to blame, a message that was echoed by the House Republican Twitter account and several other House Republicans. Democrats called for emergency measures to boost production and increase access to formula, while noting that structural reforms to the industry were also needed. Quote, it is horrible that in this country we have a baby milk shortage. I think we have to respond to that and then revisit the way we're structuring these contracts, end quote. Rep. Jahana Hayes, a Democrat from Connecticut, said the House also voted to pass $28 million in emergency spending to help the FDA restock shelves and improve food safety measures. Groups supporting mothers and young children reported widespread panic among the populations they served. Lindsay Groth, the executive director of the Human Milk Banking association of North America, also known as Himbana, told us that, quote, when those empty shelves started to show up in various places, people were frantically looking for ways to feed the baby. There were a lot of desperate calls from families looking to us for help. Himbana operates a network of milk banks across the United States that provide donated breast milk to infants, and they reported that inquiries for donor milk rose 20% during the height of the formula shortage. Grof called that period the most acute shortage she's experienced since she joined himbana 8 years ago. QUOTE it really opened my eyes to the extent of the supply chain problems we had, she said. Finally, the American public expressed the belief that the shortage was a pressing national issue. A May 2022 Data for Progress poll found that 94% of likely voters had heard about the shortage and 84% were worried about parents not being able to find and purchase baby formula. These concerns were consistent across partisan lines. So now that we've talked a little bit about the background and the reactions to the shortage, let's look at what actually happened to resolve it and the lessons we can take from the story. So the proximate causes of the shortage were apparent from its early days. But in the years since Congress, the FDA and researchers have found that the roots of the crisis went much deeper. In 2023, the FDA contracted the National Academies of Sciences, Engineering and Medicine to report on challenges in supply, market competition and regulation of infrastructure infant formula. The ensuing report identified five primary vulnerabilities in the inadequate risk management planning, overly concentrated production, limited capacity for rapid supply recovery, ineffective government response to consumer needs, and insufficient support for breastfeeding services. The report then recommended five core actions to address these issues, with each one addressing an individual risk one implementing evidence based redundancy in risk management plans at all levels of production and supply 2 diversifying manufacturing facilities through incentives like tax credits 3 granting the FDA greater authority to expedite the importation of safe infant formula during emergencies 4 creating plans for interagency coordination and communication with industry leaders during disruptions and finally 5 increasing access to qualified breastfeeding support to reduce dependence on formula. Congress also investigated the shortage, convening a hearing on the topic for the House Oversight Subcommittee on Health Care and financial services. In May 2023, Dr. Susan Main, then director of the FDA's center for Food Safety and Applied Nutrition, testified that the agency's response was, quote, less than ideal, end quote, and acknowledged that it could have acted faster to address concerns about contamination at Abbott's facility. In particular, lawmakers drilled down on an inspector General's audit that found the FDA did not act on a whistleblower complaint about conditions at the Michigan plant for 15 months. Additionally, the agency took 102 days to inspect the factory after receiving a different whistleblower complaint in October 2021, and during that time, the two additional complaints were filed about infants who consumed formula from the plant and became sick, one of whom died. Maine called the lack of action on the complaints, quote, a failure of escalation, adding, quote, there was no process within the FDA to escalate this particular whistleblower complaint. The FDA receives a large number of whistleblower complaints, she said. She also said decision making and communication channels at the agency needed to be streamlined and improved. Then FDA Commissioner Robert Califf testified that the agency was pushing for relaxed guidelines for imports and ramped up domestic manufacturing to boost supply while Abbott's plant was shut down, though he also acknowledged that distribution remained a challenge in some areas, particularly rural communities. Foreign.
- [17:53]
Paige
We'Ll be right back after this quick break.
- [17:59]
Will Kbach
Okay, business leaders, are you here to play or are you playing to win? If you're in it to win, meet your next MVP NetSuite by Oracle NetSuite is your full business management system in one convenience suite. With NetSuite, you're running your accounting, your finance, your HR, your e commerce and more, all from your online dashboard. Upgrade your playbook and make the switch to NetSuite, the number one cloud ERP. Get the CFO's guide to AI and machine learning at netsuite.com tech netsuite.com tech.
- [18:29]
Isaac Saul
We all belong outside. We're drawn to nature. Whether it's the recorded sounds of the ocean we doze off to or the succulents that adorn our homes, nature makes all of our lives, well, better. Despite all this, we often go about our busy lives for removed from it, but the outdoors is closer than we realize. With alltrails, you can discover trails nearby and explore confidently with offline maps and on trail navigation. Download the free app today.
- [19:06]
Ari Weitzman
So how about the lasting impact of this shortage? Well, upfront, it's worth reiterating that neither the FDA nor the CDC found conclusive evidence linking Cronobacter bacteria to formula consumed by the infants who became sick. Instead, Abbott says the bacteria was present in areas of the plant where products would not have come in contact with it. Still, as outlined in the FDA's response to Abbott, the lack of direct evidence did not absolve the company, as the agencies lacked sufficient testing processes to establish a causal link. We spoke with former FDA Commissioner Robert Califf, who actually assumed office on the same day of the Abbott recall, and he explained the difficulty of finding the source of contamination in a production facility like the one at Abbott's Michigan plant. He said, quote, what you need to truly prove a causal link is the same bacteria in the formula and in the bloodstream of the person who got sick, in this case the infants. Sometimes you're not able to do that because there's not a match. Sometimes you're not able to do it because you couldn't get a sample. I would doubt it if people inside the FDA said they were sure that there was a link. They just couldn't get the proof. There's been a revolution in the function of the FDA and CDC and their ability to genome sequence bacteria, but you still can't prove that causal link without the right samples. Caleb stressed that the FDA and Abbott worked as quickly as they could to address the safety risks in the Michigan facility and restart operations. But quote, there's only a certain speed that you can go Although the formula shortage subsided after a few months, contamination risks at formula production plants have persisted since the pandemic. In March, a judge in Missouri ordered a new trial over allegations that Abbott and Mead Johnson failed to provide proper warnings about the risks of their specialized baby formulas for premature infants, which purportedly caused a severe intestinal disease in a young boy. A state court had previously found the companies not responsible, but the judge determined their lawyers had engaged in misconduct during the original trial and this case is one of roughly 1,000 similar lawsuits currently moving through the courts around the country. Now, in terms of tangible impacts, we know the shortage put considerable stress on families. In 2024, researchers at the University of California, Davis studied the impact of the shortage on parents who were forced to substitute their preferred brand of formula when it became unavailable. Using a cohort of 178 parents with infants under six years old during the shortage, the study found that 81% switched formula brands or types. Among these, 60% reported adverse effects in their infants, including spit up, fussiness, gas constipation and diarrhea. Additionally, 30% of parents said they switched formulas three to five times during the shortage, visited more than four stores in a 24 hour period to find baby formula, and traveled more than 20 miles in a 24 hour period to find formula. The formula industry was also unprepared for a supply chain disruption of the scale that the pandemic brought. Rudy Leuchner, an associate professor in the Department of Supply Chain Management at Reuters, told us that US Formula producers typically keep enough materials on hand for six weeks of supply at any given time. But restarting production and getting formula.
- [22:32]
Paige
Hey.
- [22:32]
John Lal
Everybody, this is John, executive producer for Tangle. We hope you enjoyed this preview of our latest Friday edition. If you are not currently a newsletter subscriber or a premium podcast subscriber, and you are enjoying this content and would like to finish it. You can go to readtangle.com and sign up for a newsletter subscription or you can sign up for a podcast subscription or a bundled subscription which gets you both the podcast and the newsletter and unlocks the rest of this episode as well as ad free daily podcasts, more Friday editions, Sunday editions, bonus content, interviews, and so much more. Most importantly, we just want to say thank you so much for your support. We're working hard to bring you much more content and more offerings, so stay tuned. Isaac and Ari will be here for the Sunday podcast and I will join you for the daily podcast on Monday. For the rest of the crew, this is John Law signing off. Have a fantastic weekend y' all. Peace.
- [23:35]
Paige
Thank you for listening to this Tangle Media Production Our Executive Editor and founder is me, Isaac Saul and our Executive Producer is John Lal. Today's episode was edited and engineered by John Lal. Our editorial staff is led by Managing Editor Ari Weitzman with Senior Editor Will Kbach and Associate Editors Hunter Casperson, Audrey Moorhead, Bailey Saul, Lindsay Knuth and Kendall White. Music for the podcast was produced by Diet75 and John Law and to learn more about Tangle and to sign up for a membership, please visit our website@readtangle.com.
- [24:21]
Ari Weitzman
Foreign.
- [24:32]
Linda
This is Paige, the co host of Giggly Squad. I use Uber Eats for everything and I feel like people forget that you can truly order anything, especially living in New York City. It's why I love it. You can get Chinese food at any time of night, but it's not just for food. I order from CVS all the time. I'm always ordering ordering from the grocery store. If a friend stops over I have to order champagne. I also have this thing that whenever I travel, if I'm ever in a hotel room, I never feel like I'm missing something because I'll just Uber eats it. The amount of times I've had to uber eats hair items like hairspray, deodorant, you name it, I've ordered it. On Ubereats. You can get grocery alcohol everyday essentials in addition to restaurants and food you love. So so in other words, get almost anything with Uber Eats. Order now for alcohol you must be legal drinking age. Please enjoy responsibly. Product availability varies by region. See app for details. We had a 1,200% increase in sales using TikTok ads. My name is Linda and I'm a co founder of Love and Pebble. We created Beauty Pops, a frozen facial that melts into nourishing skincare. I started this business with my husband and and we do everything from packing, orders, marketing. Before it was just me creating videos, but now I have over 2000 affiliates that are working with us. If we can do it with TikTok ads, you can too.
- [25:57]
Ari Weitzman
Want to grow your business fast?
- [25:59]
John Lal
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