The N95 mask shortage America can't seem to fix
washingtonpost.com
washingtonpost.com
https://www.npr.org/sections/goatsandsoda/2020/03/16/8149292...
The administration had a chance to buy machines that could do it but chose not to. Hindsight is 20/20.
> Except that in 2009, while Fuller was in his first job out of college, the H1N1 flu epidemic depleted 85 million N95s from the national stockpile — and the supply was never replenished. In 2013, 2014, 2016 and 2017, public health officials published alarming reports warning of a “massive gap” in what remained. Even more concerning, they said, the vast majority of N95s and the materials needed to manufacture them were now being made in Asia.
The previous administration didn’t care either and chose to not replenish stockpiles over a decade ago.
No one cares until it’s their problem.
I mean, someone cared because we used to have a stockpile. What's wrong with the government today compared to decades ago?
https://www.prnewswire.com/news-releases/halyard-health-awar...
> "All government agencies agree that a shortage of respirators will occur during a pandemic. So, we have a real opportunity to demonstrate our expertise and help make a difference in an area of critical need by performing research on the ability to develop an on-demand, high-speed machine that will make use of stockpiled raw materials to produce respirators."
Perhaps you misinterpreted the term respirator to not mean mask?
Until the next pandemic. We can spend hundreds of billions on national defense, but N95 mask machines for protection in a pandemic is where we draw the line?
It's September. We (the informed public) knew that the pandemic was likely going to be a major problem at this time in February, which is 7 months ago. The government probably knew a month before that.
We've already had a lot more than 6 months. And I really suspect it could be done faster in an emergency situation where you can pay all the workers overtime.
You have to assume that every country on the planet, not just the US, has the same problem you're ascribing to the US. That they could just order new production capacity into existence, but they are choosing not to.
Or we could allocate money to PPE and instead spend it on defense:
"Pentagon used taxpayer money meant for masks and swabs to make jet engine parts and body armor"
https://www.washingtonpost.com/business/2020/09/22/covid-fun...
This is just like the bailout money. No meaningful way to control how it's spent, that's why AIG all got golden parachutes. It's a body of dumb people making decisions in haste at best, or entirely corrupt (my vote).
I'd say by pragmatic measures, we're more likely to use our guns than to come across a pandemic like what we're seeing today.
And yeah, we had pandemic scares: H1N1 (aka: Spanish Flu part 2), The 1960s flu, Ebola. But none of them them really were an issue to this degree.
Perhaps we use the guns more because we have them available.
I think my general point is that our N95 mask production is enough, so long as we save masks and replenish the stockpile. Given the hundred years of pandemics, this COVID19 one is the worst since the 1918 flu by pretty much all measures. Its your canonical black-swan event.
> Perhaps we use the guns more because we have them available.
Did we run out of masks during H1N1, Avian Flu, Ebola, SARS, or any other pandemic before COVID19 ?
Its been years since those examples, so maybe I don't remember exactly. H1N1 was a big deal, but it wasn't "hospitals ran out of equipment" big deal from my memory.
> the H1N1 flu epidemic depleted 85 million N95s from the national stockpile — and the supply was never replenished. In 2013, 2014, 2016 and 2017, public health officials published alarming reports warning of a “massive gap” in what remained.
COVID-19 is not a black swan.
> “The Black Swan” was meant to explain why, in a networked world, we need to change business practices and social norms—not, as he recently told me, to provide “a cliché for any bad thing that surprises us.” Besides, the pandemic was wholly predictable—he, like Bill Gates, Laurie Garrett, and others, had predicted it—a white swan if ever there was one. “We issued our warning that, effectively, you should kill it in the egg,” Taleb told Bloomberg. Governments “did not want to spend pennies in January; now they are going to spend trillions.”
https://www.newyorker.com/news/daily-comment/the-pandemic-is...
The mask shortage isn't even a black swan, it was both predictable and predicted.
> The trade group for manufacturers of personal protective equipment in mid-2009 urged “immediate action” to restock N95 masks. The International Safety Equipment Association warned of “significant shortages” if another pandemic caused demand for masks to surge.
> A nonprofit representing public health agencies, the Association of State and Territorial Health Officials (ASTHO), echoed industry’s appeal in a 2010 report funded by the federal government, recommending the repository of masks be “replenished for future events.”
https://www.washingtonpost.com/investigations/face-masks-in-...
Yes.
Every single year when the wildfires torch California N95 masks become unobtainable for a couple of weeks. Having a larger supply and/or back stock available would make a difference. It's clear that planning is needed, but production also needs to increase to allow for stockpiling.
You also talk about a "black-swan event" for something that was foreseeable and somewhat predictable. Just like flooding and earthquakes, pandemics come in cycles and we were due for one any time. It also means it'll happen again, so maybe we should be ready.
That hasn't affected the National N95 stockpile until this year.
Maybe California should build their own N95 stockpile, at least if these fires keep happening more regularly.
There's 60 year old AKs in use in Iraq and Afghanistan, though
Allowing mask manufacturers to charge the market price for their masks, though, might have made it worthwhile to build out the necessary capacity (I am pretty sure that it would have, but I could be wrong, so I will hedge my bets). But then, grandstanding politicians would have claimed it was 'price-gouging' (which simply cannot exist) and might even have tried to send the mask-makers to jail. Who would take that risk?
Even if we did, there would be tons of complaints about speculators turning a profit on people's health.
EDIT: If you disagree, tell me why. "Capitalists" and "communists" both are getting downvoted in this thread for what I assume are ideological reasons and it's annoying me.
There simply isn't enough information to make good enough decisions centrally. There is waste associated with decentralisation, too (each of those middlemen gets his cut!), but it turns out that there is less waste and more wealth with a free market than with a centralised one.
1) The central planning authority sees you and allocates you some
2) Anyone with some $ sees you and allocates you some
The study of economics tells us that #2 will tend to more successfully allocate the resources where they are needed. The confidence level is near that of how biologists talk about evolution.
#2 does suffer from "but rich people will protect themselves first." Of course, just as with #1 politically connected people will protect themselves first, and their wealthy benefactors.
The inner party, as it were.
https://www.nytimes.com/2020/04/01/opinion/covid-face-mask-s...
Faced with a similar shortage of masks early in the year, the Korean government bought up the overwhelming majority of it's domestic mask production, and directed pharmacies to distribute them to the public at a fixed price according to a rationing system. As a result, every Korean has access to two N95-equivalent masks a week and the vast majority of Koreans wear them in public.
In Libertopia^wAmerica, the free market solution has trickled down unrated fabric masks to the general public and trickled up N95 masks according to the whims of Trumpworld.
In part due to universal masking with high-quality PPE, the South Korean death toll is 7 per million. In Galt's Gulch^w^wAmerica, the death toll is 597 per million.[0]
Government can work for the majority of people. The American free market does not.
[0] https://www.statista.com/statistics/1104709/coronavirus-deat...
https://www.ibtimes.com/us-accused-modern-piracy-redirecting...
Keeping prices low restricts availability now and in the foreseeable future.
They're not going to respond to a short-term increase in prices--in any market, not just pandemic-related PPE--by increasing long-term production capacity. They know that demand will eventually drop before they can pay off their capacity investments.
Indeed, in the absence of price controls, cutting production in the face of increased short-term demand can increase profits by raising prices.
There's a reason the oil industry routinely shuts down refineries, pipelines, and other infrastructure for 'scheduled maintenance' during long weekends, after all.
The issue that you have is that there is a decently large capital cost to building new production, and once the pandemic is over, the budget hawks are going to swoop in and cut purchasing of masks down to below pre-pandemic levels because there's now a massive unused pile of the stuff, why do we need any more? So the guaranteed-purchase contracts are abrogated, and the manufacturers are saddled with a lot of debt and no prospective income.
(This isn't a theoretical thought exercise, it actually happened during the H1N1 flu crisis).
All modern production has bottlenecks. For items that governments consider important, they find ways to manage bottlenecks.
The issue with US N95 availability is that no one in authority considers the problem important enough to be worth fixing.
https://www.washingtonpost.com/national/coronavirus-mayors-m...
The government takes on the risk that it might not be needed.
Of course seeing as how it's a paper mask with a near indefinite shelf-life given proper storage and the US should be maintaining a proper stockpile anyway, that's not much risk.
They tried to do something like this with Kodak, but the crooks at Kodak screwed it up.
The mask producer needs a second production line, but the land they need isn't for sale? Boom, now it is.
The mask producer can't meet parking minimums for their new line, or haven't completed an environmental impact assessment? Start building, we'll take care of it.
The mask producer needs a load of elastic, but their elastic supplier is busy making sunglasses holders for a car maker? No problem, go ahead and jump the queue.
Mask factory workers can't get to work, because the busses aren't running, because it's not economic to run them? They are now.
Needless to say, with modern international supply chains this might be less useful than it has been in the past - no way to jump a queue using the DPA if your supplier isn't under its jurisdiction.
I always figured the bottleneck would be actual mask assembly -- ultrasonic welding and the like.
Basically no willingness to commit to buying enough volume for it to make sense for production to ramp up.
Slap a massive tariff on any medical equipment from China and you'll get local producers that can meet the demand. Without it who is willing to chance bankruptcy for a short term "possible" boost in sales.
Just Devil's Advocate, but what's to stop those companies from outsourcing their manufacturing to Indonesia or South Korea instead? And if you tariff those two, what's to stop them from outsourcing to Malaysia or Brazil? And on and on.
On items like PPE, where you can sell large amounts of those anywhere in the world, manufacturers will always game to match cost of manufacture to market price. So if it's known that Indonesia and Kenya are definitely going to be buying crazy amounts of your product if the price per unit matches their economic reality, someone's always going to try to meet that demand. Millions and millions of pennies is still a lot of money. Plus you can sell the same PPE you manufactured at low cost into the EU and US.
It's just too profitable.
I suppose you could slap a tariff on PPE from anywhere other than the US? That would probably work.
Making planes is hard. We made one bomber an hour at Rouge River by the end of the war.
Government certainly can change this reality (perhaps via the defense production act) by agreeing to buy masks off the line for a time after the immediate demand has been met. Or whatever.
None of this stuff - for example, defense contractors being managed by the government and permitted to make a reasonable but not excessive profit during wartime, or the early and middle stages of the cold war - is even especially complicated. It's an ideological prohibition against the government managing a company's profits in a specific area, and of course globalization of the relevant corporations, that prevents us from doing it. I'm not sure about the globalization part - I expect 3M and other conglomerates would be happy to work things out if they were dealing with people in the federal government who were even approaching sane, trustworthy and intelligent.
Instead they encountered this:
https://www.nytimes.com/2020/05/05/us/jared-kushner-fema-cor...
Plus the machines already existed. They weren't making tanks in textile mills....they were making them in car plants.
Of course, but it seems the vaccines had priority, to the point of ignoring masks:
https://eu.usatoday.com/story/news/health/2020/08/08/feds-sp...
August 8, 2020: "Federal spending on COVID-19 vaccine candidates tops $9 billion, spread among 7 companies"
To compare, the OP article writes:
"Why is the world’s richest country still struggling to meet the demand for an item that once cost around $1 apiece?"
The sad aspect is, if it turns out that even vaccinated people can spread the virus (as in: "they can still become infected and only get less sick"), and that is estimated as very probable by the experts at the moment, the existence of other vaccinated people will not protect the high risk groups -- the so-called "herd" will never protect them, only the vaccine, and only if it works for them. Which they won't know in advance:
The experts also don't expect too high protection of the vaccine, as it is known that vulnerable are only some percentages protected by the similar vaccines (sometimes even less than 50%). So the masks can turn out to remain more important than we hope at the moment: then, the estimated protection if both the infected and the vulnerable wear a good mask could be higher in many circumstances than a vaccine. That was the sound basis for this claim:
https://www.cnbc.com/2020/09/16/cdc-director-says-face-masks...
In Redfield's own words:
“If I don’t get an immune response, the vaccine is not going to protect me,” he said. “This face mask will.”
We've demonstrated this repeatedly with military spending and NASA contracts. It doesn't always go well but if made sufficiently lucrative and performance-based (think wartime footing), with appropriate oversight, it certainly can get results.
We just don't have leadership at the moment, it seems, that has the intellectual capacity to consider these levers and pull them.
Yes, they're available, but at that price, noone buys them (they improvise or buy washable).
When does the USA plan to replenish its stockpile of 100M masks?
I would assume that demand will remain high until our stockpiles are replenished, which will be months (maybe years) after COVID19.
If this fact isn't clear, then our leaders should make it clear by passing a law ensuring the purchasing of N95 masks until the 100M stockpile is replenished.
Perhaps they've not got the US certification and therefore US hospitals can't legally use them? Doesn't stop anyone buying some for their family though.
In World War II, we retooled our entire economy to embark on years-long total war against fascism. Yet somehow now we can't re-tool less than 0.1% of our total industrial capacity to make PPE? That's beyond us now? Really?
> The machinery to make this is extremely complicated and takes 6 months or more to build, by which time there may be no demand. No amount of invoking the defense production act would change this reality.
We're more than 6 months into the pandemic at this point and no sign of reaching the end. Under a different administration, the Defense Production Act would have been invoked immediately at the outset, onshore manufacturing capability of PPE would have been dramatically ramped up, and it would now already be paying dividends (more than 6 months later!) in the form of significantly increased onshore production of N95 masks and other PPE.
So yes, invoking the DPA absolutely would have changed the reality. The problem is that we didn't do it, not that doing it wouldn't have worked (it would have).
But WW2 was an existential risk, if we didn't pull together the war will come over here and our country will be destroyed.
I live in New York, I can say for NYC took this seriously (eventually) and it still looks like someone Thanos-snapped half the economic activity in the city.
Now imagine if the city had kept on its initial path by not taking the virus seriously and leaving hospitals so full they couldn't even handle the dead bodies anymore?
Want to produce a rifle (in the 1940s)? Milling machines and operators. That's a factory order, done. Ammo? Couple four stage presses and some armorers, not even hard to train civilians instead.
Want to produce N95 masks? Ok, well there's a custom built machine that produces the correct kind of fabric, there are only two builders in the world, and the machine has a meaningfully high failure rate... and requires special shipping, assembly, maintenance and so on...
Wait, that’s not right.
That’s also ignoring scale. Getting a few machinists for rifles is pretty easy; getting all the machinists for total war is not. Comparative to the scale of government action and organization in WW2, manufacturing and distributing PPE is nothing.
The particular fabric machine for N95 masks is very specialized, and building those machines has a failure rate - you may be producing fabric only sufficient for a N90 or N85 application - a lot of "dust" or "atv" masks are exactly that.
The machines are physically large enough and with specialized enough parts you can't build one out of a machine shop.
It'd be like demanding we mass produce Titan IVs tomorrow. America has built a Titan IV before, we've built a few - surely we could just crank out one a day right?
This is not complicated, we just lack the will as a society to fix this.
Hence things like the Allied bombing of the German ball-bearing factory to wreck the aircraft engine supply chain.
I have a small lathe and mill sitting in my office right now. With those, I have everything technically necessary to build a Garand. Don't get me wrong - it would take a long time, and I would have to make substantial improvements to my tooling - I'd need to build a button rifling machine, for instance - but I have everything necessary to bootstrap production of M1 Garands in my office.
No amount of time or hacking would let me produce the fabric necessary for disposable N95 masks. I'm quite confident of this - I worked on the issue for quite a while, as I was unemployed at the beginning of this pandemic. The best solution I found was making filter cartridges for existing reusable respirators from HEPA furnace filters and 3D printed parts.
Can you name any? That would literally be world changing right now.
As far as my research has revealed it is literally only melt-blown fabric that can meet N95 standards and the vast, vast majority of melt-blown fabric does not (we use tons of the stuff in sofas and mattresses but that stuff isn't anywhere near N95).
And no, your dust sensor will not meet lab requirements for N95 testing unless it had a very large price tag.
The US effort for WW2 consumed damn near the entire manufacturing capability of the United States, required that civilians ration almost all consumer goods to make the war possible, created record breaking debt, and involved the mass training of heretofore economically excluded demographic groups in order to keep it going. Individual sub components of that war effort might have been “simple”, but at scale they are not simple at all. Comparatively the effort it would take to spin up half a dozen factories to produce PPE doesn’t come anywhere close to the mass efforts this country has sustained within living memory.
Correct - reasonably, I could produce one in about six months of work with subsequent ones coming faster after having built up the tooling and knowledge. My point is that there are millions of people like me and that the tools required to do that are common.
More to the point I could produce a working, reasonably polished firearm in a couple of weeks or less if I were doing so full time and were not restricted by US federal law. If I were basing my design off of something like a Sten submachinegun, now we're talking days at most and rapidly ramping up production speed after that.
There are no alternate designs for N95 masks that will meet the needs of healthcare workers. There are no alternate materials that are "good enough" for expedient use. This is not a product that can be reasonably manufactured in a distributed fashion.
Yes, making an M1 Garand is simpler than making PPE. But the process of training tens of thousands of machinists, many of whom had never had an industrial job before in their lives, in order to make millions of firearms in a short order is a huge undertaking that literally changed the entire fabric of American society. And that is only one tiny sub portion of a gargantuan effort that saw entire industrial centers dismantled in order to feed the war effort. As another example, the Swiss are only “famous” for watches because American watch factories were dismantled in order to make bomber components, giving the neutral Swiss an opportunity to take over from what had historically been an American lead industry.
The level of societal change that WW2 created was so massive that there are literally country bars in Chicago to serve the former residents of Appalachian states who were moved around due to the war and decided to not return to their original states; just the industrial aspect of that war deeply changed who we were as a society, and affected everything.
Compared to the gargantuan effort required to do all of that, creating a few factories required to make PPE on shore is nothing. All that needs to be done is rebuild a few factories to recreate a product that until 2000 or so was almost entirely made in the US. Yes, it’s more complicated than making a small number of firearms, but in the scope of resources that America has poured into other problems, recreating a factory or two doesn’t even register on the scale.
Also, whatever happened to American optimism? This is not a hard problem to solve. We invented the damn N95 mask in the first place, why is everyone so down on our ability to redo something that we did without even thinking about 20 years ago. This is not a problem of capability, this is a problem of public will.
I don't disagree at all with what you're saying about the scale and nature of wartime production. I get it, and we're totally on the same page there.
> creating a few factories required to make PPE on shore is nothing
Creating the factories is straightforward, as is hiring and training the workers. Expensive, sure, but that's not the problem. The problem is that there is a single material used in N95 masks for which we have limited sources and for which expanding the manufacturing capacity is very slow.
From https://www.cbsnews.com/news/n95-mask-shortage-melt-blown-fi...
> Even established companies are having trouble boosting production because they can't simply buy more machines, according to Dave Rousse, president of INDA, the Association of the Nonwoven Fabrics Industry.
> "There are only five or six companies across the globe that make these machines, and they're not inexpensive. These are sizable machines, a lot of technology, a lot of air handling, a lot of electronics, a lot of precision moving parts," Rousse said. "Normally it's nine to 12 months before you could get a machine delivery."
My understanding is that even if you can obtain the tooling, they're very difficult to keep operating - there are lots of variables to tweak and every batch has to be independently tested to verify that they meet the filtration standards. If they don't, that material ends up being used as "dust masks" and such. I would expect that means that training machine operators would be both time-consuming and expensive as well.
The bottom line of my point here is that the problem we're facing isn't one of resource allocation or of commitment to a goal - it's the tooling required to scale production significantly is slow to produce, and we don't know how to make it faster. The problem that needs to be solved isn't mask design, it's improving the production and testing equipment necessary to make the filtration media.
There is no market fundamentalism exhibited when it comes to other bailouts, only when it comes to trying to harm the least powerful in society.
The problem is that while having a can't do rather than a can do attitude is "only" causing the unnecessary deaths of hundreds of thousands of Americans right now, it is going to kill way more than that with our long-term ongoing failure to address climate change. That is where the costs of having a can't do attitude are going to be the most visible.
Its a big gap in my experience of economics/politics/management about how things were done back then to do this. Was it people doing the "right thing", or were companies paid to do it, or was it government controlled factories.
Its a bit like the British empire - ie we need to invade Malaysia to get rubber, or Arabia for oil. How were things done in the old days? In today's globalized commercial world I (or most other managers) dont really know.
The pandemic was a looming threat in January, but we'll give a one month pass due to bureaucratic slowness. If machine production had been started in February, we'd currently have two months of full scale mask production. Right in time for flu season.
Your "can't" is playing two parts here trying desperately to imply "unable" for dramatic effect but actually means "unwilling" which I think is super misleading.
Like of course we could have, but politicians were more afraid of headlines like "The government invoked DPA and spent billions to produce masks, now they're sitting in warehouses" and "N95 mask producers cash huge government checks to produce masks no one needs."
The actual politicians charged with making decisions have been (I think naively) optimistic about the pandemic and if that isn't us going back to our British roots of going to the pub and waiting for it all to blow over I don't know what is.
Yes, because of a set of beliefs about market fundamentalism. The masks aren't as important as maintaining the existing product structure of society and proving that government intervention in healthcare can't work; if it shows signs of working, those paid to sabotage it will make sure it doesn't.
Besides, denialism is widespread. There were all sorts of conflicting pieces of information about the effectiveness of masks and various other quick-fix cures. The informational infrastructure is broken in fatal ways.
It became impossible for the US to ignore Japan once the ships started sinking at Pearl Harbor. The striking thing about today is that the huge casualties haven't turned into a Pearl Harbor or 9/11 event, despite outnumbering both of those put together by orders of magnitude.
Likewise, Bush already wanted to go to war with Iraq, but 9/11 shifted public opinion to make it possible.
Surely 200,000 people dying is just as big of an event (or bigger) as Pearl Harbour or 9/11, it's just that the government are refusing to acknowledge it as such because it is not what they want and doesn't serve their purpose.
When the dear leader in the Forbidden City tells companies to shift production it will happen. When a president or prime minister wants to do anything he has to go through channels- including an army of lawyers.
https://www.digitalhealth.net/2020/06/nhs-contact-tracing-ap...
Plus we haven't even bothered to adopt Apple's version. When you try to turn that on it says it's not been enabled by your local health authority.
There are signs we are reaching the end of this pandemic. We've made a lot of progress. We are protecting nursing homes better. In most states death rates at the lowest they've been. NYC has shown that immunity is causing the virus to slow down. Hospitals have better treatments available to them. A vaccine is likely to be available by the end of the year and the systems are in place for fast administering to needed populations. Schools are back in session with minimal issues.
Your WW2 comparison would be tedious to even discuss. But in short, the economy did not switch overnight. And retooling and expanding is always easier than creating new production from nothing. Creating n95 masks isn't just an issue of "retooling".
We do not know if invoking DPA would have changed anything and this unsupported smug certainty is what ruins actuals discussion on this. You do not have any compelling reasons for HOW the DPA would have changed things.
This is a somewhat ahistorical. The Defense Production Act of 1950 is what everyone is talking about. Withe respect to WWII, production increased every month of the war until the end, and the ramp up began in a limited fashion a year or two before the US entered the war.
The thing people miss is that a lot of what was produced by converted companies in the first year of the war was junk. The guns jammed, the planes fell out of the sky, and so on. Typewriter companies just don't know how to make rifles, and it took a lot of trial and error for them to figure it out. Literally they had to get back field reports on what broke and then try to reproduce and fix it, then put that fix into production. No amount of the government will it to be could make typewriter machinists immediately good at making rifles, even though those worker probably knew men who would depend on those same rifles.
Now consider that the weaving machines for n95 masks are probably several orders of magnitude more complicated than the lathes used to make rifles or the tools used to make a 1945 aircraft.
You're also forgetting that the first thing we tried to ramp up with a government nudge was ventilators, and numerous companies tried. Most of them failed however, and that experience isn't forgotten by other companies. Then it turned out that no one was paying attention to data from China and Italy that suggested that ventilators may actually be causing WORSE outcomes, but when doctors noticed the demand plummeted. Those manufacturers were now left holding the bag. Who want's to sign on for that?
Then, consider the PPE ramp up. A lot of companies participated, but cash strapped hospitals weren't buying because the moratorium on elective surgeries killed their cash flow, which no one had previously expected at a policy level. Sure the government could have stepped in, but again no one saw that coming before hand so extra funding for PPE for hospitals didn't get included in the Covid relief bill.
Now, after 2 big misfires the political will is spent.
They also don't want to get stuck with a factory floor full of mask machines after the pandemic is over.
Here's an insightful prognostication by the late, great Chalmers Johnson around 2005: https://youtu.be/Q2CCs-x9q9U
> In World War II, we retooled our entire economy to embark on years-long total war against fascism. Yet somehow now we can't re-tool less than 0.1% of our total industrial capacity to make PPE? That's beyond us now? Really?
The really stunning thing here is that ~400,000 US troops died over a 4 year period in WWII. We've lost >200,000 US citizens in ~8 months due to COVID-19. I think American incompetence barely starts to cover this clusterf.
Past generations put men on the moon with less compute power than an iphone. Manhattan project, WW2, space program, interstate highway system, etc. This country has done great things (operative word being done).
Our generation doesn't want to produce its own health care products because it may not be cost effective. What a lack of ambition.
Imagine if we had ramped up N95 production in March.
The entire point of the DPA is to encourage and finance manufacturing of items that are strategically important but not massively profitable, partially by funding the investments required to make the initial machinery.
Production isn't the issue either - if you wave enough money in front of the private sector, they will do anything.
Prez simply makes a statement - every person will have N95 masks available to them - and we're going to do whatever we need to do to make that happen. It's better politically to guarantee everyone a $1200 check. This pandemic reveals the weaknesses in our systems.
The best case timeline for mass vaccinations looks like late 2021 at the earliest, which is considerably longer than six months from today, much less six months from when the pandemic started.
Further, government funding would entirely change the economics of ramping up mask production. If government was paying the bills, it wouldn't matter to manufacturers if demand disappeared before new production capability had paid for itself, because government was paying the bill.
Isn't this the point of the DPA? The government promises private industry that they will buy a certain amount of product to make it worth industry's while to increase production as though the crisis (and thus demand) were going to last more than 6 months? And I get that the machinery takes 6 months to assemble, but that's because everything was designed for a world where the demand for masks didn't rise or fall so dramatically; however, if we could build an atomic bomb in short order, surely we could figure out how to expedite the construction of fancy cotton candy machines in 2020?
I'm surprised no one in the comments so far has challenged that these machines actually take 6 months to build.
There would literally be hundreds of suppliers of the components of these machines around the world - and the process of making the masks and fabric is not rocket science: https://www.thomasnet.com/articles/plant-facility-equipment/...
Yup, and lots of folks here are missing that point or don't appreciate it enough. While I've never dealt with N95 masks or anything medical, there's a few things that immediately pop into my mind.
1. What's the certification process to get "N95"? From the body armor world (I was in it for just a little while years ago, things may have changed in the last 5+ years), getting NIJ certified is not completely simple. It's a time consuming process to get and keep standards (testing and manufacturing) to keep a ballistic grade. 1-3 months for new testing when the labs aren't swamped with armor to test (first timers in the field get "extra" testing). Since a N95 mask is life safety, I assume there's a process of submitting to 3rd party labs for quality, gov inspection of your manufacturing process and the batch testing against with 3rd party labs. How long does it take and how much does it cost? Just because you're finally up and running 6 months later, doesn't mean you're done. It would suck to do all that, then have the current leaders just steam roll your little operation's ass to crippling debt and layoffs.
2. What are the material requirements and how's that supply chain looking? If "everyone" is making N95 masks, how hard is it to even get the qualified materials needed? It would suck to pay all the money for equipment, training, personnel and the lab testing fees, then find out you can't even get enough stock of the materials. Then just to enter a completely flooded field. Older players get first dibs from distributors due to prior relationships both in time and yearly purchase amounts.
That's the two things off the top of my head. I'm pretty sure there's more, bigger issues I'm ignorant of.
Now, do I believe that there should be an "strategic supply of smaller manufacturers" that are prepped pre-crisis to fulfill such needs? Absol-fucking-lutely. But that's to be setup pre-crisis. Not during. Covid is a wake up call on the manufacturing needs of the USA. Any argument that globalization will save the USA in crisis is now dead and out the window. This applies to every other country too. Covid showed that every country has to think their own country first before they can help others. Situations like these makes things way more complicated and difficult on an already complex, fragile system. Just In Time Inventory only works if everything is "good and stable". While I love LEAN and understand the economic advantage of JIT, you still have to plan for big fuck ups, whether you like it or not. Reality doesn't seem to care what we all like.
Covid so far has been a love-tap of problem. If this was worse than a 0.5% yearly infection rate and worse than a 2% death rate, there would have been some serious, long term problems that we don't even want to imagine.
There doesn't seem to be any shortage of KN95 masks. There are dozens of boxes of them at my local Lowe's.
So, why is the nurse in this story wearing an N95 for weeks, instead of wearing the plentiful KN95 mask?
Am I missing something?
The article makes some vague reference to problems which forced health organizations to abandon KN95s, but this is the first I'm hearing of it and there's not enough information to look up what they're talking about.
I had an air purifier running indoors which kept my indoor air to around the equivalent of AQI 10 or better most of the time. (I say equivalent because my particulate matter sensor gives ug/m^3 and counts/cm^3, not AQI, so I had to estimate AQI).
If I took the mask off outside, the difference between outside AQI 200+ and indoor AQI 10 was immediately apparent.
For everyone who is not in some job with a high risk of prolonged COVID exposure, I'd recommend going ahead and getting a KN95 even if it uses ear loops and so won't be as protective as an N95. It will still be a lot better than surgical-style masks or most homemade masks.
Use the cheaper surgical-style masks if most other people around you are also wearing masks. That's the case here for 99% of the people I see in the grocery store. But I'm not confident that people will keep that up for as long as the science says we need to--we Americans have a habit of ending things too soon. If mask wearing falls off before it should, I've got my box of KN95s to switch to.
That's the real issue and one that I am sad to say far too many HN posters are working on and against daily...
Advertising and content engagement. These two things and their unfettered pursuits have destroyed America. When the only thing that matters is the pursuit of money, based on false metrics and false promises, we die. And yes, we're watching America die.
What do they have to do with it?
Sources:
https://www.foxnews.com/media/rush-limbaugh-democrats-mask-w...
https://www.newsbreak.com/california/salinas/news/1550365330...
Price gouging statutes added an unnecessary distraction to market signals, as they confused consumers and governors and wasted public resources trying to enforce. It is impossible to enforce them because legislatures didn't give power to curb market signals indefinitely and States have zero tools to handle states of emergencies in reaction to a disaster that is larger than their state, continues growing in scope, and that never ends. To allow the market signals to work for increasing production, states could have subsidized over a certain $ price, shielding consumers but allowing market to still function. The ideal result being that other companies took the risk of creating more product until the market was flooded with the masks.
The global procurement game was and still is a joke.
An N95 will filter out some/most of those microscopic droplets before you inhale them.
TL;DR - your cloth mask mostly helps protect other people, while an N95 mask helps protect you.
When we get a lot more science out of this COVID event in like ... a few years, it will be really interesting.
That said, at least where I live in a very blue state, people are quite good--I haven't seen any exceptions--about wearing masks indoors and (mostly) covering mouth and nose.
But all that talk early on about not touching face and mask etc.? Pretty much everyone pops a mask on their face as they go to enter a building and take it off as they leave. I'm skeptical most people would use N95 masks even if they were available for free.
What's needed is additional certification labs and US-based quality control for imported N95/KN95 masks. It is very cheap to set up a new lab - all you need to test a mask is a ~$1000 sub-micron particle counter. Just keep buying samples of masks from various manufacturers and make sure they are not slipping on quality.
3M and Powecom now offer one-time-use authenticity code for masks they ship (see https://safeguard.3m.com) and other manufacturers will likely follow soon. This means that you don't have to worry about the middlemen doing importing and distribution swapping the product for counterfeit - all you need is a quality reputation score for manufacturers themselves, making the problem much easier.
This is of course should've all been done by the CDC and US Customs already but they are dropping the ball and doing only a limited amount testing. Maybe universities can step up and use their labs for testing?
--- Additional PSA for people reading this thread: you can buy reputable-looking KN95 masks from Office Depot(!) right now. It's an ear-loop design which is not ideal, but you could fix the rubberbands yourself easily.
─ ECRI testing of imported FFRs has revealed that 60-70% provide only sub-95% filtration performance. ■ This trend aligns with what NIOSH has found through their own testing; as of September 2, 2020, 53% of the 358 FFR models tested did not meet N95 filtration requirements
https://assets.ecri.org/PDF/COVID-19-Resource-Center/COVID-N...
I think it largely confirms the point of my post though - we need independent certification labs in the US to make imported PPE usable. It is unclear what % of reported quality failures in that report were due to counterfeits. Now that the manufacturers have authenticity codes on their product we can hold manufacturers directly accountable for filtering performance.
I agree, but we've seen that be corrupted by profit-seeking
They blew through their supply in no time at the start of the pandemic.
Now, they get a single mask and wear it until it is obviously no good.
Yes, it may be hard for all of them to get PPE at all times but I would not feel guilty about your purchase and I would not donate them.
In fact, I can imagine an EMT/Firefighter/nurse on the other end being the one selling extras they have.
Talking about India, it’s soon set to cross the U.S. in total number of cases, now that the strict lockdowns have been lifted (and the economy battered by the lockdowns).
The situation with N95 masks was dire even in April, and there have been investigative reports on the “mask mafia” [1] who hoard these masks, engage in price gouging and also sell a lot of counterfeit (almost useless) masks using names like 3M.
We always knew that people will profit from any situation, but “disaster capitalism” is quite prominent in the handling of COVID-19. I can’t wait to see what happens when the vaccines arrive (there are already rumors of a looking disposable syringe shortage, which would affect people who routinely need these) and how many people are going to be injected with fake stuff and reused syringes and what not.
[1]: https://www.indiatoday.in/india/story/mask-mafia-caught-prof...
There doesn't seem to be any shortage of KN95 masks. There are dozens of boxes of them at my local Lowe's.
So, why is the nurse in this story wearing an N95 for weeks, instead of wearing the plentiful KN95 mask?
Am I missing something?
there are articles abound when you google "kn95" of up to 70% being not up to snuff
Experts at NIH CDC and universities have changed their dictates, dropped the ball and finally fallen in line on separate political sides of such issues. I guess Man is, after all, the "political animal" first and foremost.
The material to make N95 is the time consuming part, I think Houston can do it but not sure if any company created the production line. Without those raw material, there will always be N95 shortage, building it in USA is not cost-effective in the past.
However, when you compare wearing rates vs either reported or estimated infection rates three weeks later, there is no correlation at all.
It seems all the general public gets out of wearing masks is warm fuzzies and virtue signaling and implementation of authoritarianism.
Another novelty is fake news sites like http://covid19.healthdata.org/ have consistently for more than half a year displayed projections of the death rate where doing nothing will go exponential next month, wearing masks will flatline in two months, and the history now going back six months regardless of public behavior in lockdown or freedom, don't wear masks and save them for first responders or everyone should wear masks 24x7 ideally, its a boring flat line around twice the death rate from automobiles.
Clearly someone is operating the 21st century equivalent of the:
https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study
The only question is who is funding it, and why?