COLUMBUS, Ohio (AP) — An Associated Press review of more than 20 states has found that before the coronavirus outbreak most had only a modest supply of N95 masks, gowns, gloves and other medical equipment. In many cases, those supplies were well past their expiration dates — left over from the H1N1 influenza outbreak a decade ago.

Here’s a look at the history of Ohio’s stockpile:

A TERRORIST ACT

Ohio first began stockpiling after 9/11, storing the very few items it accumulated at National Guard hangars around the state, said Ohio Department of Health spokeswoman Melanie Amato.

Amid heightened awareness, Ohio created its own Bureau of Public Health Emergency Preparedness within the Health Department in 2005. State preparedness was initially funded through a $34.9 million federal bioterrorism grant, budget documents show.

STOCKPILE GROWS

The H1N1 pandemic of 2008-2009 left Ohio with a surplus of personal protective equipment and the antiviral Tamiflu, Amato said. The Health Department began at that point to lease and manage its own warehouse, where assets could be stored and later deployed in the event of public health emergencies.

During a public water crisis in Toledo in 2014, the state Environmental Protection Agency purchased water for the stockpile, she said. In 2016, during the Zika outbreak, the Health Department added a large supply of bug spray that could be dispatched to hard-hit communities.

Many of those supplies were exhausted or expired.

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STOCKPILE FLOWS

Beth Bickford, executive director of the Association of Ohio Health Commissioners, said, with the exception of the annual flu vaccine, county health departments get their emergency supplies through the state. It’s a process generally set in motion by a governor’s emergency order, she said.

“At the local level, there isn’t a cache maintained on a regular basis,” she said. “We aren’t in the usual business of buying and putting things away that we aren’t going to use right away.”

John Palmer, a spokesman for the Ohio Hospital Association, said hospitals typically keep only about a two-week supply of personal protective equipment and other supplies on hand. Vendors who typically could address high demand are now swamped.

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RESOURCES SPREAD THIN

Pots of money Ohio created to fund emergency preparedness tend to wane when the latest crisis is over.

The Health Department is authorized under a governor’s directive to purchase supplies for the stockpile, Amato said, but the state also has been in talks with the federal government for years to ensure Ohio was prepared for any outbreak, Amato said.

“This is not new,” she said. “However, the scale of this incident across the United States is. We are having ongoing conversations with the federal government, FEMA, HHS and other outside vendors to add to our stockpile to help fight this pandemic.”