This is insane. 5x markup and federal seizure of privately procured masks that will then get given to private companies to give to hospitals. Instead, the government could institute price controls and distribute directly to those in need or allow all private purchases to go through while controlling part of the market. Absolutely crazy. Not to mention having to hope your governor praises the federal government to get their masks back.
You could not have invented a worse scheme for this, but somehow they have, AND they’re using federal manpower (in N95s, naturally) to intercept these shipments.
And that's in the present. What's more frustrating too is that if we're still debating about the present, there will certainly not be any accountability for the lack of preparedness from all levels of government in the past to prepare for health crisis.
where even the random person checking your temperature at subway entrances and toll stations are armed to the teeth in PPEs in China. And that's coming from a country that wasn't even able to genetically map SARS themselves <20 years ago.
This is the point I've tried to convey to my peers in the West over, and over, and over for years.
I hope this would finally be a rude awakening moment for countries in the West. The decay of essential social institutes in the West has reached the point when issues begin to snowball uncontrollably.
I don't like many points of that guy called Neil Fergusson makes, but he is 100% on the spot pointing that the West is loosing the "institutional IQ" after 20 to 30 years of "ultrapopulism" in government.
Just look at the level of organisation being exhibited now, and how emergency response was handled few decades ago. Quarantines were not so unheard of in the West even for things like bad flu outbreaks in the 20th century, but, nowadays, some countries can't quarantine even a single city.
The US is not the entirety of the west and its political, social, academic, journalistic, health, regulatory, and administrative systems are not identical to those of the rest of the west.
The breakdown of trust and the resulting inefficiency that exist in US systems aren't happening everywhere.
They are to some extent. The US has some... unique problems[1] in this area, sure. But general bureaucratic decay is everywhere. France and Germany are seeing the same PPE shortages, the same hospital equipment snafus, and pretty much no one in the world outside the Korean peninsula has figured out how to do enough testing to contain this thing.
Again, it's true that the US has fallen farther (consider the federal coordination of industry in WWII and compare to the disaster today). But no one is doing "well" here.
[1] I despise that I have to euphemize that here on HN, but those seem to be the rules the community enforces.
Exactly. The playbook is cynical and vile, but very effective. You first starve the government, then when government inevitably fails at its job, you point to that failure as a reason to starve it even further, on the basis that the private sector can obviously handle things better.
What I've noticed is the political system seems to increasing lack coherence. Unable to decide on a course of action and wield power accordingly. Totally unable to resist pressure put upon them by powerful domestic and especial foreign actors.
And this feeling that actions that were once unremarkable now seem impossible.
> I don't like many points of that guy called Neil Fergusson makes, but he is 100% on the spot pointing that the West is loosing the "institutional IQ" after 20 to 30 years of "ultrapopulism" in government.
By the way Neil Ferguson is a mathematical biologist at Imperial College, London who was instrumental in getting the UK government to change directions.
Niall Ferguson (also from the UK though currently at Harvard) is a historian. He is an excellent and insightful observer (especially his earlier work) but like you I often find he ends up drawing the wrong conclusions.
I think the West's democratic model of loosely fitting parts (yes, even in a country like France) permits greater resilience against various threats....but permits is not the same as guarantees!
The article mentions the DHS which was created in November 2002 in response to 9/11 and is the youngest U.S. cabinet department [0].
The other thread of the creeping problems in the West - that it is growth of government rather than decay of government - has some evidence to show here.
Institutional IQ isn't the issue. The DHS was never clever and the FBI has been a corrupt mess for a long time. See also J. Edgar Hoover and imagine him as a current president.
DHS is one thing, but make no mistake most government agencies outside DoD have seen resources cut and leadership with explicit tasks to water down, remove, and erode the performance of duties. See: DoE, the EPA (where leaders wanted the agency shut down) and number of “acting” leaders right now as a percentage. This is explicit and has happened rapidly since 2017.
Zero new cases, according to https://www.ft.com/coronavirus-latest.
That's leading, together with Taiwan. From the news I gathered that your prime minister has mandated early and effective lock-down.
Are there other noteworthy measures taken by your government that explain the success?
Institutional IQ or leadership or anything else like that does you no good when your country no longer has the manufacturing infrastructure to make PPE anymore and the countries which can would rather use it to protect their own citizens, and it's mostly the anti-populists which seem to be doubling down on denying that simple fact.
It actually does. For example, for things that cannot be produced locally in sufficient quantities (such as oil prior to the fracking boom), the US did maintain a strategic reserve. Even to this day, it still has a strategic oil reserve.
Lack of institutional IQ/leadership manifests in myriad of ways, such as the dismantling of California's emergency medical supply reserve in 2011 [0], defunding of organizations that address the current risks [1], and so on.
Addressing potential systemic risks through domestic production is only one potential way that leadership can handle them. Creating reserves and funding preparedness are some of the other ways to handle such risks.
The trouble with stockpiling PPE is that it's bulky, it expires in storage, and you need an awful lot of it to handle a crisis of this size. For anything beyond a short-lived, localized crisis, building out the production capacity to actually be able to make PPE in sufficient quantities seems a lot more feasible than a massive billion-item stockpile. The strategic oil reserve has the advantage that it can just pumping oil into well-selected holes in the ground.
Maintaining emergency stockpiles is the only solution to these episodes of commodity shortages, whether they're caused by increased demand or interrupted supply.
During normal times, the US may use several million masks per week. During epidemics, we may need more than 2 billion masks per week (1 per citizen per day).
We can't financially maintain 1000x production capacity for every potential emergency item. Businesses get screwed when they try to provide surplus capacity for our nation that it doesn't need the other 99% of the time: https://www.dallasnews.com/news/watchdog/2020/04/03/if-you-i... Even if we could it would be cost wasteful vs. stockpiles.
People talk about bringing all the production home, but that may be like getting rid of all your off-site backups and doing all backups onsite. It concentrates risk. What if there's a fire/pandemic/regional event that makes it so you need the emergency supplies, but also knocks out your plants that produce those emergency supplies? At least with some plants here, some plants there...if one country gets sick before the other, the currently-not-sick country can provide some supplies to the now-sick country, and vice versa when the pandemic ends in that place and moves to the other.
We probably need at least a 90 day supply of this stuff for the next pandemic. For n95 masks, I guess that's potentially 350 million * 90 days = 31 billion N95 masks. If they expire in 5 years, then we only need to manufacture 500 million per month to keep them up-to-date, and can pay maintainers to keep the supply rotating. We don't have to throw out soon-to-expire masks, we can sell them from the back of the stockpile at a small discount to end-users who need them regularly, like normal hospital or industrial use.
> building out the production capacity to actually be able to make PPE in sufficient quantities
as you put it, would require us to be able to make 10 billion masks per month (350 million * 30days), instead of just half a billion per month. Thats way more expensive. And those plants would sit idle for decades - who knows if they'd even turn on again? A rotating stockpile can be sold to hospitals for regular use, so we could constantly validate that the goods are good.
There are a few practical issues with this massive stockpile idea. Firstly, this pandemic looks like it might go on for about a year rather than 90 days, which puts the stockpile size required to have one mask a day for everyone to more like 130 billion masks. With a five-year lifespan, that means producing about 2 billion a month, only a fifth the rate at which you'd have to produce them with no stockpile at all - except you have to do that all the time, whether there's a pandemic or not, and store, rotate, and dispose of all them. Secondly, you can't just dispose of the expiring masks by selling them to people who'd need them normally, because the pandemic-level demand is so much higher than normal demand that just refreshing the stockpile produces way more masks than we'd normally need. 3M's normal global production of these masks is apparently around 50 million a month, meaning that even your 90-day stockpile would involve continuously producing and disposing of about ten times the normal, non-pandemic demand.
Also, if countries bring their production home with some surge capacity, then this actually gives really great redundancy compared to the status quo because all the countries which do this end up with production capacity that can be used to sell supplies to other countries in the case of some regional crisis there. It's much better than centralizing it in the lowest-cost country as often happens now.
I figure that a 90-day (or so?) supply would buy us the time needed to build additional production facilities to bring us up to the necessary continuous supply.
Taiwan had a huge stockpile, and that let them increase their production from 100,000 N95 masks per day to 20 million per day while drawing down the stockpile. Asia has had success building these factories in ~14 days from pouring cement to startup, USA might need a bit more time of course.
The way forward is sturdier masks that last "forever", with removable filters that can be sterilized in boiling water, exposure to the UVC in sunlight, drenching in household bleach or thorough washing with water and detergent.
This is exactly the way the Czech Republic is going, with several companies now churning out such masks and the government being the bigger buyer. Stockpiling billions of expiration-sensitive disposable masks is more expensive, compared to pre-distributing one reusable mask to every citizen.
>This is insane. 5x markup and federal seizure of privately procured masks that will then get given to private companies to give to hospitals. Instead, the government could institute price controls and distribute directly to those in need or allow all private purchases to go through while controlling part of the market. Absolutely crazy. Not to mention having to hope your governor praises the federal government to get their masks back.
This is pretty much how it went here in Czech Republic - initially outright ban on sale on the PPE needed by medical personnel, that was only removed very recently. And the state (army & fire fighters to be precise) handling all the distribution of PPE. Mainly to hospitals, care homes and also to local municipality offices where local general practitioners could pick them up.
First state distributed the PPE from the (unfortunately rather small) existing emergency stockpile, later from a central warehouse located next to a suitable airport close to the middle of the country where most of the "aerial bridge" cargo aircraft with PPE ordered from China land.
Not everything is rosy though. Ministries buying 40m eur worth medical equipment from some company that had no revenues last year or year before that. One ministry paying double the price for the same thing as the other. And that's not even mentioning how many companies from prime minister's holding are benefitting disproportionately - subsidies, testing, hand sanitizer....
Firefighters played a crucial part in the distribution concept I came up with two weeks ago. Nice to see something like that being implemented!
Do you have any details of how the logistics are run, especially the last mile? Really curious, because I never heard back from German authorities so far.
I'm not sure there is much coverage of that in English - from the local news, it looks like this:
- stuff gets ordered via Czech economic mission in China, communication goes by Chinese speaking Czech experts remotely, coordinating even the planes being loaded and other details
- plane lands in Pardubice/Prague/Ostrava airport
- supplies go to government stockpile in Opočník, designated as the centrail distribution point (from PRague and Ostrava I guess it might go directly to the destination sometimes, as that could be quicker that getting to Opočník & then back)
- army and firefigter transport it from the central stockpile to hispitals/care homes/minicipal offices/to army/firefighters/police who need it
Whats even more nuts is that N95's have taken this level of importance in healthcare at all instead of reusable P100 masks. I read a post on medium the other day about a hospital in Texas that does that and it was being treated as some kind of amazing discovery as if this was some unknown miracle device.
> Whats even more nuts is that N95's have taken this level of importance in healthcare at all instead of reusable P100 masks.
The obvious drawback to using reusable respirators to manage a pandemic disease is that they're another item to become contaminated and spread infection.
Sure, but disinfecting a mask like that is a known protocol. I mean I'd rather wipe down a mask daily than worry about baking my disposable N95 in an oven because there aren't enough. P100's are also more effective at filtering 100% vs 95% filtration.
Those are great but you still have to replace the filters quite often, right? Doesn’t solve the problem as the P100 filters are also sold out, and were in shortages back in January from what I saw.
No, Unless you are using it in a very dirty environment the filters should last 30 days or more. I've had one I use occasionally for wood working for several years and am still using the original filters.
I've found that the P100s tend to make me feel lightheaded pretty quickly. I tried to wear one on a very smoky drive from LA to SF during the fire season last year, but had to take it off after ~45 minutes because I felt my ability to concentrate on the road was being weakened too much. That would definitely be an issue for healthcare workers. I haven't experienced anything similar with an N95.
You might not have been wearing it right. You might also want to get your lungs checked with a spirometry machine a standard test that is done to make sure peoples lungs are healthy before letting the wear a respirator.
I run 3-5 miles most days, so I don’t think it was a lungs issue. I was wearing it very tightly—maybe I made a mistake, but I’m pretty sure it was on right.
The elastomeric masks allow any filter to be used in them. I have N95 pads in mine. Once a week I swap in "OV" (Organic Vapor) cartridges before I go change the cat litter, the activated carbon in the OV cartridges filter out harmful gases like H2S or even Chlorine gas.
Part of the point, is that the flat, simple, small, replaceable pads for the elastomeric masks use less "melt-blown fabric" than the curved, complex, large N95 face masks. Right now lack of the melt-blown-fabric is preventing us from making enough masks. So being able to make more masks from the same fabric would help a lot.
However, the filters do need to be swapped out from time to time. I don't think there's clear guidance on that yet, but there needs to be science backing up any kind of replacement cycle. Once per year would be atrocious, I feel. And of course the rubber itself should be constantly/consistently disinfected as you move between environments or take it off/put it back on.
Industry has been using these masks for years. The masks and filters come with documentation from the manufacture on filter replacement intervals depending on the use case and exact filter medium.
I do largely agree with this, but this is slightly outside of the typical use case for these masks. I'm not an industrial hygienist or other true PPE specialist, but I am a chemical engineer who has decent experience with a wide variety of PPE and it's been difficult for me to determine when I should replace my 6006 cartridges or 5P716 filter pads for home use (cleaning cat litter, preventing coronavirus).
This other brochure essentially implies the OV cartridges last up to 6 months, but those don't filter particulates. It does say however, that N95 masks become more effective as they get "dirtier", at the expense of being able to breathe easily. In this case, a tight seal would be extremely paramount, because eventually it would clog enough that you'd be breathing "around" the mask instead of through it. http://multimedia.3m.com/mws/media/447121O/filter-change-out...
They do have a web tool for calculating service life but it assumes you have at least one chemical contaminant, so the tool simply fails to calculate anything at all for hospital or home use.
The filters meant for chemical contaminants usually have some kind of active absorber ingredient that get used up which is why the replacement intervals are more defined. With particulate (which includes viruses) the only thing you have to worry about is the filter getting clogged or the filter breaking down due to old age but that isn't going to happen with indoor use unless you are talking years. That's why the filter replacement guidelines seems less specific.
And even if you were, was the smoke so severe that the cartridge may have quickly collected so much particulate matter that it was rendered less capable of allowing a high flow of air at a low pressure difference?
Yes, search on Montana Mask. The 3D files are available and you could print them at home. Part of the mask is the filter holder which you can stuff with N1900 or greater furnace filters, vacuum cleaner HEPA bags or whatever.
Edit- sorry, it's not quite like the P100, the filter holder is a rectangle in the center of the mask as opposed to the mask in the article that has two filter holders.
I saw an article saying the 5x markup is because of the air freight, which costs more.
Normally, the masks and other gear, are shipped via boat, and it takes over 30 days to transport it. But this is an emergency, so that lag in transport would have killed even more people and health care workers. Hence, the need to deliver it by air.
The problem is that the air freight companies are now resource constrained, that they are charging 3 to 4 times more than normal. These are the people that are causing the price gouging.
Then, to make matters worse, some European countries went on a media blitz to complain about shoddy Chinese made products. They bought non-medical masks, and were expecting it to be medical grade products!
So they complained about it on Twitter, which forced the China central government to crack down on manufacturers, and only allow “medical grade” certified masks to be shipped. This placed an even larger burden on the supply chain. (However, other masks not stamped with a “medical” label on it, were allowed to normally ship, as a consumer-grade item. So buy it at your own risk.)
So, this resulted in news that some expensive air freight flights, were only returning half-full. The other half was still sitting in the warehouse, awaiting customs export inspection approval, from the new Quality Control regulation.
Then, to make matters even worse, all countries all over the world, are now competing for the same products from China. And the Americans are buying the product outright, and in cash, and paying double or triple, what European countries are paying.
This all adds to the cost per product, which ends up justifying the 5x increase.
The freight costs makes sense and that's a great counterpoint. Thanks!
That said, the government has the ability to cap mask costs per unit and then only charge for shipping or, you know, bring a bunch of C5s and do the freight themselves to get the cargo hours. Or charter planes to help with airline bailouts or...
Instead of hammering the hospitals we have all sorts of options to help here. The fact that the only thing that occurred was HARMFUL to the process says a lot. It must feel pretty weird to be told "you're on your own" and then also have that same crew confiscate your mask shipments. That's what the mafia would do. Would be a shame if something happened to your PPE...
> which forced the China central government to crack down on manufacturers, and only allow “medical grade” certified masks to be shipped.
There is way more to it than that. That was a very convenient pretext for China to legitimise its unofficial exports ban. It reduced the number of exporters to single digits per provice, and even few ones with appropriate licenses are now being turn arond at customs without explanations.
China's official Red Cross, however, seems to have zero problem exporting just anything off the shelf.
Even supplies for which there simply can't be a medical certification are stalling at customs. I know a person who works in medical clothing industry, and they ran into that with... hospital bedsheets.
As of now, the lion share of PPE coming from China is effectively being smuggled out.
> China's official Red Cross, however, seems to have zero problem exporting just anything off the shelf.
> Even supplies for which there simply can't be a medical certification are stalling at customs.
I don't think there is way more ongoing. That's just how things work in China and CCP's distinct way of being incompetent. CCP is known for its intolerance of critics, especially when covered by international news firm. They try their best to avoid it, not considering anything else. When someone in country create buzz, they censor it, sometimes arrest the author. When someone they can't arrest does it, they suppress what they can to "avoid the problem". This is politic and weighted more than anything else. A lot of party members still don't recognize free market and a strong private side as being important, especially Xi. After all they are communist.
In this case, the problem was seen as "some shady businessmen exporting unreliable masks for their own profit and got caught, it harms our 'global image'". So they took them down, switched to assuming everything coming from private side are garbage unless you can prove otherwise.
OTOH, government-ran Red Cross have zero problems because they are "trusted and endorsed".
> In this case, the problem was seen as "some shady businessmen exporting unreliable masks for their own profit and got caught, it harms our 'global image'". So they took them down.
No, no, no, no. The point I make is very different. Don't think of them as that dumb.
While, yes, a giant amount of PPE is now being exported in contravention of the ban, the very few well connected companies are making 8 digit sums per day thanks to it.
Also, the Chinese red cross is now very happy with PPE makers having no way to sell their stuff to the West, because now they can buy piles of it on the cheap for export through their "special channel."
The same thing has happened during the ASF outbreak last year. Pork prices soared N-fold, state media were all screaming murder, the national pork reserve was unsealed, but... at the same time, pork importation was quietly banned using overzealous sanitary inspections, culls of otherwise healthy pigs were ordered, and somebody made billions.
it's not cheap even domestically, N95 china retail price is 20RMB right now (not like 3M, domestic brands). Compare to US price ~$6-7 most of that difference is shipping. The price inflation goes all the way to the source production equipment and raw materials, it's every step.
I haven't seen N95 prices that cheap here in weeks. Anything I see is mostly around 30RMB right now (like a 3Q with NIOSH certification). KN95s are still lower.
We've talked with multiple vendors who simply can't get non-woven material stock at all and are having to turn away orders.
It reminds me of Operation Barbarossa. Many reconnaissance pilots rang the alarm about the huge buildup of German forces near the Soviet border (in Poland). They weren't only ignored, but threatened. That continued even early into the German attack. German soldiers swam across the river to warn the Soviets. They were shot as enemy agents.
You don't prevent a fire by taking the piles out of the smoke detector.
If you build a culture where reporting problems is dangerous, you'll only hear good news that can be shared and catastrophic news that can't be ignored.
I know the Chinese government has been pushing the narrative that it was those European countries fault for buying the wrong product, but it's just not true. Everyone is perfectly OK with using non-medical industrial filtration masks under the circumstances. The reason that European countries have had to recall a bunch of Chinese masks is that they didn't meet the filtration standard they claimed to be made to, full stop. They let through substantially more particles than the standard allowed when tested. They also failed fit testing, which would make them unusable anyway.
These masks failed quality tests, but they were made by private manufacturers in China, that had no relation to the China government.
However, because they are stamped, “Made in China”, then they tarnished China’s international image.
And the European countries really didn’t help themselves here, when they did their media blitz, and claimed that the China-made masks were defective. Thereby insinuating that every single mask that is shipped out of China, is under the control and responsibility of the central China government.
Then, the entire Twitterverse lit up in laughter as: “Ha ha! See, we told you so! China only makes piece-of-shit crap! Now, they are selling us crappy medical products too!”
No it doesn't support that narrative. The claim in the comment I'm replying to is that the masks made by those private manufacturers weren't defective at all, and that the European purchasers went on an unfair "media blitz to complain about shoddy Chinese made products" when actually it was their fault for ordering the wrong kind of masks. That claim is completely and utterly false. The kind of mask they'd ordered would've worked perfectly well for their purpose if it was actually as described rather than a shoddy imitation that was, to quote the Dutch media reports, "some sort of FFP0.8 at best" instead of the roughly FFP2 it should've been.
Price ceilings cause shortages. Every time. Let’s not use Venezuelan-style economic illiteracy as a model for how to incentivize the flow of critical supplies to those who need it most during a crisis.
It's not hard to argue in favour of temporary emergency price controls using Econ 101. The field already makes a big distinction between the short-term and long-term, defining the later by the time required for new investments in production. That distinction is the crux of the shortage, so it seems it's with the bounds of what an introductory microeconomics course could handle.
No, this isn’t really true. Look at all the people hoarding toilet paper because the price is below market equilibrium. If the price were higher, there would be less hoarding, and more people could wipe themselves.
Not this BS again. For the nth time, the model of supply and demand you are familiar with depends on perfect competition, which involves transparency, substitutability, and frictionless entry and exit. When those conditions don't exist your idealized economic model will not operate efficiently and may not clear at all.
this is in every economics textbook and students are cautioned about differences between idealized models and real markets, but economic ideologues never seem to read that part.
I wonder how anyone can write a comment like this and think that our economic model is not completely broken for anything other than making one group richer.
This is only true if you can’t make more. If you can high prices are a powerful incentive for entrepreneurs to make more. When something is needed really badly for public health reasons the government should either be paying top dollar for delivery as close as possible to right now or paying up front for later delivery at a premium to normal prices. That way the manufacturers of what you want don’t pass on the extra sales for fear of going bankrupt.
They can't - and that's simply because there's not enough of them and nothing can circumvent that fact quickly. Let's not pretend you can solve a public health crisis with monetary policy.
Venezuela's problems come from international banking controls combined with hyperinflation and mandates to not increase prices. When you have a currency losing its value every week and the government mandating 10 cent gas with no way to transact with the outside world and escape your currency, things are going to get very distorted.
Venezuela has much bigger problems than price caps, it is not indicative of systemic ramifications either way here.
I also help with buying PPE currently and it's not 5x markup by the seller only. Everything got more expensive. Input material, machines, shipping. This results in the final price being 5x (or more). It's not the greed of one sales person (mostly).
Most factories I work with are NOT looking to take advantage of the situation. It actually hurts them because they can't accept new orders when they don't know the future cost of raw material next week.
> Instead, the government could institute price controls and distribute directly to those in need or allow all private purchases to go throug
Every country in the world is hunting for N95s right now. For the US to institute price controls just means the supply will shift to another country that doesn’t.
If the top 10 bidders are all Americans (which is plausible, given America's wealth and inflated healthcare costs), the U.S. government could use price controls to drive the price down from the 2nd highest to the 10th highest bid without losing supply to other countries. There's still the possibility that driving prices down would push manufacturers out of the business (or more likely, fail to pull in manufacturers who otherwise would have started producing PPE).
The 5x markup is basically in line with the increase in material cost and increase in risk of importing. The melt blown fabric prices have been increasing dramatically since January when China ramped up production.
I'm not sure what you're complaining about then. This is exactly what those federal agents attempted to do (and chose not to do). Are you saying it'd be preferable if these masks were seized by the Feds and sent to e.g. New York?
>> institute price controls
That's a very good way to ensure those masks go to other buyers. I'm just not sure that's what you were aiming for.
When I read this kind of thing I am happy we live in a society that allows the free discussion of information. It is no exaggeration to say this kind of honest description of events by a senior health official could have lead to imprisonment or worse in many historical and some modern contexts.
Given how many people are currently unemployed - how is it that we can fail to ramp up our own ability to produce this needed equipment? There is no shortage of labor. Forget about the failures to prepare in January, February and March - what are we doing right now to prepare for the next 6 months?
I'm looking around for a leader who has that vision. Governors are blaming the federal government. The federal government is blaming China and the WHO. Who is organizing the effort to fill the gaps?
>Given how many people are currently unemployed - how is it that we can fail to ramp up our own ability to produce this needed equipment? There is no shortage of labor.
Labor isn't the limiting factor. You need machines, raw materials, supply chains.
There are some surprisingly resourceful groups doing local manufacturing in incredibly inefficient, seemingly-unscalable ways and actually producing masks and eye-shields by the thousands.
This is just in the Portland area. I assume there are similar efforts around the country and around the world.
Ideally this stuff should be made in factories rather than hundreds of bespoke 3d printers operated by volunteers, but if the need and motivation is there, a lot can be accomplished. Maybe it's not enough, but it's a lot more than nothing. And the longer this goes on, the more efficient the organization and manufacturing gets.
Normally the regular supply chain would handle all this, but if the supply chain is broken by hoarding behavior or the wrong kinds of active government intervention, the alternative is to bypass the usual market and use whatever local workforce volunteers or can be hired to make what's needed directly for the institutions in need.
N95 masks don't require 3D printers, they require melt-blown fabric. My girlfriend and I are chemical engineers, and took a look at the process that turns bulk, cheap, and widely available plastic (PE, PP, PC, etc) into melt blown fabric. She noted that it looked pretty nasty to her, and she wouldn't want to be involved with the startup for a new plant, and we regularly work with pretty nasty chemicals in large quantities. I was less hesitant, thinking it doesn't look that awful but I tend to be far less risk-averse. With proper safety precautions I think I'd be fine with it, but both of us feel that companies are extremely likely to fail at fully protecting the workers near the equipment from hazards. Here's an example of the machinery required: https://www.youtube.com/watch?v=897yTI6wXWY
You need a lot of capital for a melt-blown fabric facility, and some specialized engineers. China and Taiwan managed to build new facilities of huge size very quickly - it can be done, but apparently much harder for the large American conglomerates to get off the ground as quickly. https://www.wfuv.org/content/covid-19-has-caused-shortage-fa...
If you can get >$10 million together, and a very dedicated and specialized team of engineers, plant operators, machinists, and businesspeople - you might be able to finish your factory before 3M's Rhode Island and Arizona plants, if you start right now. But you won't do it in a distributed way with a bunch of people with 3D printers.
However, it seems there's evidence that non N95 masks have some efficacy. Just regular old cotton clothing cloth. You could start an MLM/Amway/Mary-Kay/Avon/Vemma/Younique style thing to get out-of-work people to make these at home and sell them to friends and family.
Sinopec decided on Feb 24 to built a melt-blown fabric plant https://www.youtube.com/watch?v=p9lchhBE7cE. It was operating on March 6. It took them 10-12 days to build, from scratch, a facility to produce 1.2 million N95 masks per day. One of my links above shows another facility built in 11+ days making 200,000 N95 masks per day.
At the start of the outbreak, Taiwan could product 100,000 N95 masks per day, but have built over 60 production lines, and now make enough melt blown fabric to product over 20 million N95 masks per day. Notably, Taiwan had a HUGE stockpile of masks, so even though making 100,000 masks per day wasn't enough for their population, they had enough in storage to last them while they built up their capacity. Now they make enough to send tons of masks the the USA every week.
USA (3M) decided to build melt-blown fabric facilities around March 23: https://www.powderbulksolids.com/news/Honeywell-Expands-N95-... and to a much smaller capacity. And none of the new lines in the USA are up and running yet. "Before the onset of the COVID-19 pandemic, 3M was manufacturing about 50 million masks per month" ... "In its continuing effort to help meet demand, 3M says it is working to double its global N95 mask production numbers once again to 200 million units monthly." But they think that will take another YEAR to accomplish. Only 35 million N95 masks are currently made in the USA, by 3M or others. https://www.nasdaq.com/articles/n95-mask-production-wont-mee...
Ideally, each citizen would have a new N95 mask for every day. We'll get to 1 mask per citizen per month, sometime around a year from now.
I think you are underestimating the productive potential of 4 million people. Machines can be built, raw materials can be gathered and supply chains can be organized. The alternative is to sit at home doing nothing until the equipment we need comes from China, which is more-or-less what our current leaders are recommending.
That is of course true, but doing all those things takes a lot of time. Building machines that make the raw materials for N95 masks takes weeks for the companies that already know how to do it. I imagine it is a much slower process if you first need to train people.
The old cliche is the best time to plant a tree was 20 years ago, the second best time is now.
We marvel sometimes at how quickly China raises cities from the dust seemingly out of nowhere in short time frames. In this very thread are reports of Chinese companies building entire factories to manufacture N95 masks in weeks, including brand new factories for the difficult melt-blown fabric material.
The US doesn't lack the ability, it lacks the will and the vision. The alternative sentiment to what I'm saying is "It's too hard, it will take too long and China can do it better so let's all wait it out at home doing nothing until they catch up enough to get us what we need". Why do people believe this? Where are the leaders saying anything else?
Hol' up, are you saying that there's a reason besides economics that the government might introduce protectionist trade measures to keep some critical manufacturing domestic for use during an emergency when you cannot trust your supply chains which come from hostile -- or even friendly -- nations?
It's funny because this was a U.S. conservative talking point going back as long as I can remember (for me that's the mid/late 90s). There's even an episode of The Office (U.S.) where this point of view is lampooned (Oscar to Michael: "Wouldn't you say that the services sector is much more relevant than manufacturing?"). Never thought I'd see it expressed openly on HN, and with upvotes!
The governor I watched talk about this (NY) said something completely different: he said if you know how to make PPE, call me. If need funding to spin up manufacturing, I'll get it for you. And so on. This was a week or two ago.
It wouldn't even be hard, many businesses would love to help, they just need to be labeled essential (so their people can show up) and given reasonable plans to make something given their resources.
In short what the world needs is plans on how to make n95 mask making machines. There are plenty of manufacturers who can take those plans and build the machines in a few weeks (I'm guessing on time line but it seems reasonable) from there we can make as many masks as we have raw materials for.
Where are you seeing reports on piles of NWF in China? I'd be very interested in this. Seems the masks/filters are pretty easy to make once you have the NWF
I believe that you are wrong. We can make the machines in a few weeks. It wouldn't be efficient, but we can do it. Take thousands of machinests, give them plans, divide them up, and build. Note that overlap means that you get multiple copies of the parts.
Of course the traditional way to build these machines is more efficient.
> There are plenty of manufacturers who can take those plans and build the machines in a few weeks (I'm guessing on time line but it seems reasonable) from there we can make as many masks as we have raw materials for.
If it was reasonable, why hasn’t it happened? Seems like it’s either not possible, or not worth it at whatever price points the masks would sell at, which is basically the same thing.
The material required to make N95 masks is in short supply because it is tricky to make. It takes a very long time to set up new machines to make this material. I recall reading 6 months.
NPR wrote a good piece about this, if my memory serves me right. I apologise for the lack of sources.
Is it worth it? If because of an inefficient process I need to charge $1000 for a mask to break even should I bother at all, or just let the more efficient producers do it for a few cents. (remember break even costs not profit)
the key is raw material, e.g the heart of a mask is Polypropylene, the machine to produce masks is available to purchase actually, but you can't find those raw materials in the US
> Given how many people are currently unemployed - how is it that we can fail to ramp up our own ability to produce this needed equipment? There is no shortage of labor.
> COVID-19 Has Caused A Shortage Of Face Masks. But They're Surprisingly Hard To Make
> ...
> Both the masks made for medical personnel and for consumer purchase require a once-obscure material called melt-blown fabric. It's an extremely fine mesh of synthetic polymer fibers that forms the critical inner filtration layer of a mask, allowing the wearer to breath while reducing the inflow of possible infectious particles...
> And there's now a global shortage of melt-blown fabric due to the increased demand for masks — and the difficulty in producing this material.
I think one of the hallmarks of great leadership is to inspire people to see beyond barriers. Melt-blown fabric is not likely to be the only or even the biggest hurdle.
Maybe it will take months/years to go from zero to production quantity/quality no matter how hard we try or how well we organize. And maybe by the time that production capacity is active the market will be flooded by PPE from China (let's hope). Yet I would still rather be over-prepared and with people actively productive compared to behind the ball with people sat at home.
Maybe I'm just tired of the government telling us to be patient while we continue to hear reports like this. I want someone to tell us how to be proactive.
Hospitals are looking themselves how to fill the gap while supply of PPE comes back. Here's a an example of a tutorial for masks made using readily available tools: https://enmed.tamu.edu/diymasks/
There are many other tutorials online from various sources which use different machines (sewing machine, 3d printers, etc), so people can improvise based on what they have.
The PDF shows detailed price breakdown for materials of ~$5/mask and estimates 10 minutes per mask, since of course it's diy, there's a lot of warning labels, but it's better than nothing. If people can produce ~40 masks per day using basic tools, this can scale based on the availability of raw materials and tools.
Who is left, between the federal and state governments, except private companies? Some of them are doing things to acquire or manufacture PPE but it's a piecemeal effort. Apple and Tesla come to mind as companies not traditionally in the medical space who are trying to help.
The only way this will work on a nationwide scale is if the federal government coordinates it. Leaving it to the states is problematic because some states won't try to do it, and some can't afford to do it without federal money even if they wanted to. That's only going to get worse as unemployment claims use up all the money the states have left.
> The only way this will work on a nationwide scale is if the federal government coordinates it.
Your comment made me think of a wild and impractical idea. Airbnb, Uber, Lyft, Etsy and others unlocked a gig economy in specific industries. Is there any possibility to do the same with PPE?
Excellent point. What is 3M for example — an American company — doing? Are they attempting to ramp up production in the US or have they determined that it’s not feasible because PPE prices are are not permitted to rise because of anti gouging laws?
The problem isn't anti-gouging laws, it's that medical customers aren't willing to commit to long-term contracts to justify the investment to increase production.
> ...during an outbreak like this, everybody wants to be [an American mask/respirator maker's] customer. But as soon as an outbreak subsides, his customers dump him and run back to China. The reason? His masks may cost a dime each, but a made-in-China mask might go for two cents.
> “Last time he geared up and went three shifts a day working his tail off,” the mayor recalled. “As soon as the issue died, he didn’t have any sales. He had to pay unemployment for all these people, and he had to gear down.”
Also, why would you think anti-gouging laws would be the problem? The only thing raising prices would do is send PPE towards people with money who may or may not have actual need. No one sensible is going to ramp up extra capacity or create stockpiles of perishable goods with the idea that they'd be able to gouge during infrequent, unpredictable crises. The only people that price gouging helps are the parasitic middlemen who make a profit engaging in it, and the fools with money to burn who can't demonstrate priority need.
Gouging helps those who have the foresight to stock up long before. If I knew I could see large amounts of 2 cent masks for $10 every few years I could stock up, and throw away expired masks. Every few years my profit more than makes up for the losses every other year.
Of course it is unlikely someone would take the risk, but gouging laws make it impossible.
I already said gauging helps parasitic middlemen who are just out to make a profit for themselves. It just doesn't do anything to actually help society in a crisis.
For every $10 of masks some wannabe gouger was motivated to buy and store in their closest for years, a professional gouger will buy $10,000 worth the day the crisis starts and help hasten the arrival of empty shelves and shortages. Then he'll turn around and ask those who truly need them for $100,000. If he can't sell all his inventory at his markup, he'll just dump the remainder after it's no longer needed for the crisis at the regular market price.
What the "gouger" is doing is correcting a market inefficiency by performing arbitrage through time. In order to turn any sort of profit, they must have more accurate information than the rest of the market. The guy who chooses to buy $10,000 bucks of masks on day 1 of a crisis is sending a message to the market - "I believe that masks are currently undervalued." If they are right, it might indeed hasten the day you can no longer buy the masks at their original, undervalued price. It might also spike demand earlier than it would have spiked, which sends a signal to ramp up production. That is a market correction they are helping to realize. And the result is it prolongs the time you can buy any masks at all, at any price. 1 person snapping up 10,000 masks with intent to sell is better than 100 people snapping up 100 masks each that they intend to stick in their closet "just in case", while people that really need them find empty shelves.
Nothing is exempt from market forces. Masks are more valuable now than they used to be, that's just a fact. If you try and hide that fact, you will prolong the shortage and cause more harm than good. If you don't like the idea of the government having to pay more to procure this essential commodity in this time of sudden shortage, the people you should be annoyed with are the ones who depleted the national PPE stockpile in time of plenty, when it existed for this very reason. Don't shoot the messenger.
I don't see it that way at all. Grocery stores are now rationing which is fair to all consumers. If one rich person is able to buy up an entire store and then resell it, all it's done is made the food more expensive for the people, and funneled wealth towards an already wealthy person. I don't think we should advantage those types of people. Market forces seem to always benefit just a few. In all of history market forces have not resulted in an equitable situation for everyone.
I would like to recommend "Basic Economics" by Thomas Sowell. It provides an excellent understanding of economics in language that is accessible to everyone and uses historical examples to demonstrate all of the concepts. I think if you understood markets and pricing better, you would have a different opinion. Your grocery store example would not turn out the way you're describing.
The "mainstream views" section suggests that market economies are believed to be closer to efficient than other known alternatives. The mainstream only recommends macroeconomic type interventions to counteract the economic cycle. Macroeconomic interventions are monetary policy, not price fixing, confiscation, etc.
In a survey of economists, only 8% supported legislation against price gouging. 51% were against. The economists opposing the proposal argued that such legislation would lead to a misallocation of resources and lead to lower supply and greater scarcity of the resources, or argued that the proposal in question was vague.
The advantages show the Soviet Union industrializing... while starving to death because the central planners did not have infinite knowledge, which the central planning idea requires.
It doesn't matter where you go, everywhere you will see markets are better at allocating resources. Politicians implement bad policy because voters demand action. Trump can use the Defense Production Act to command masks be confiscated and sent to a hospital, and he will act like he's a savior, and economically ignorant people will believe it because action looks better than inaction. But he's not doing that because all the economists have said that's the best way to get masks where they need to be. In the end, he's killing people with these kinds of actions, not saving them.
> In a survey of economists, only 8% supported legislation against price gouging. 51% were against. The economists opposing the proposal argued that such legislation would lead to a misallocation of resources and lead to lower supply and greater scarcity of the resources, or argued that the proposal in question was vague.
I wouldn't put too much stock in that survey. It was about a specific Connecticut law, it only included 40 economists, many chose not to answer, and many of the others took issue with some vagueness in the wording. Furthermore, I wouldn't blindly follow "economists" on any policy matter. Sure, their ideas have some merit, but their discipline has its biases, too.
> The advantages show the Soviet Union industrializing... while starving to death because the central planners did not have infinite knowledge, which the central planning idea requires.
Oh, please. Anti-price gauging legislation is not central planning. It's pretty weak to trot out the Soviet Union to refute anything but the purest capitalism.
> It doesn't matter where you go, everywhere you will see markets are better at allocating resources.
The first army to learn to allocate supplies to the front lines on free market principles will be unstoppable! /s
Can you provide ANY literature suggesting mainstream economists, on average, support price fixing, confiscation, or purchase limits as a means to allocate resources effectively in a crisis?
>The first army to learn to allocate supplies to the front lines on free market principles will be unstoppable! /s
The military primarily gets work done by allowing private contractors to bid on projects. In order to get troops near the front lines, most military personnel take commercial airline flights to get there because it's more efficient. Military operations are wildly inefficient, but they still use markets wherever possible because it gets things done as efficiently as possible.
> I DDG searched "do economists support anti price gouging laws". Here's the top results. Every one of them disagrees with you.
If you think that, you must not have even read the links you gave me. The first one takes a turn halfway through with "but, as with so much of economics, there is disagreement," and has an economist outline a lot of the problems with price gouging that the other economists are missing.
> Can you provide ANY literature suggesting mainstream economists, on average, support price fixing, confiscation, or purchase limits as a means to allocate resources effectively in a crisis?
Frankly, I don't really care if "mainstream economists, on average" support anti-price gouging legislation or not. Like I alluded to before, they have their biases. For instance, they spend their careers focused on certain problems and not others. That doesn't mean those other problems are unimportant and can be ignored. Good policy will ignore economists in some cases, when factors economists de-prioritize need to be prioritized.
Your qualification of "mainstream" is also kinda interesting. I don't consider economics to be any kind of settled science. It's almost certain that there are serious problems caused by following "mainstream economics" due to its flaws, omissions, and biases. Its ideas should be given due weight, but they're not the gospel truth. That's especially clear on the question of price gouging, because even in the survey you cited there were economists that strongly supported efforts to curb it.
>>> It doesn't matter where you go, everywhere you will see markets are better at allocating resources.
>> The first army to learn to allocate supplies to the front lines on free market principles will be unstoppable! /s
> The military primarily gets work done by allowing private contractors to bid on projects.
That's clearly not what I was talking about. If, as you say, "markets are better at allocating resources" everywhere, don't you think a front line army unit should get supplies allocated to it based on market principles (e.g. the unit bids against other units in a market to get more ammunition)?
> What the "gouger" is doing is correcting a market inefficiency by performing arbitrage through time. In order to turn any sort of profit, they must have more accurate information than the rest of the market.
No, that's only true if you believe the simplistic myth that a price-driven market is always the best and fairest way to allocate scarce resources, in all circumstances. That myth is false, but it's a seductive myth because the market works very well in many situations.
Price gougers operate only in crises, inserting themselves as middlemen to extract a profit on emergency essentials. They can't do anything to increase supply, because there's no time for that. They don't direct resources to where they're most needed, rather they direct them wherever the most profit is. They perform no social good, and are actually a form of market failure.
> It might also spike demand earlier than it would have spiked, which sends a signal to ramp up production.
That's a fairy tale. The manufacturers aren't solely reliant on price to learn about demand, and they have clearer and more direct ways to communicate with their customers in situations like this. Do you think Purell and 3M needed guys like this [1] to tell them demand for their products was spiking due to an incipient pandemic? No. 3M was literally ramping up in late January [2], before the COVID-19 was even a blip on the price-gouger's radar.
> 1 person snapping up 10,000 masks with intent to sell is better than 100 people snapping up 100 masks each that they intend to stick in their closet "just in case", while people that really need them find empty shelves.
Firstly, there are better ways to manage the surge demand, which the actual businesses involved are implementing: prioritizing sales to customers based on need and implementing retail purchase quotas to prevent people (usually gougers) from buying everything up and creating artificial scarcity.
Secondly, it's likely that the 100 people in your example who bought from the gouger just put the masks in their closest anyway. Gougers take supply out of the normal channels and inflate prices so much that the people who bought from them are worried people with more money than sense, rather than those with real need like nurses and hospitals.
Thirdly, at the maximally inflated prices gougers often sell for, they may end up functionally becoming hoarders themselves and still make a profit. If a gouger buys 1000 masks at $1/per, sells 100 at $10/per, 200 at $5/per, 300 at $2.50/per, and unloads the rest at the original $1/per after it's all over, he's more than doubled his money while wasting half his inventory. He's not looking to speed resources to where they're needed, but milk every cent out of them that he can. The supplies do no more good in a profiteer's garage than in a prepper's closet.
[2] How 3M Plans to Make More Than a Billion Masks By End of Year (https://www.bloomberg.com/news/features/2020-03-25/3m-double...): "Andrew Rehder, manager of 3M Co.’s respirator mask factory in Aberdeen, S.D., got the call from headquarters on Tuesday, Jan. 21....Rehder told them that a new virus was spreading rapidly in China and that 3M was expecting demand for protective gear to jump....Now, Rehder told his charges, Aberdeen would shift to “surge capacity.” Idle machinery installed for precisely this purpose would be activated, and many of the plant’s 650 employees would immediately start working overtime."
That's more of a problem for surgical face masks, where customers seem to be more cost sensitive. A reasonable chunk of N95 masks are made locally in the US and other countries and 3M apparently has a certain amount of surge capacity ready in case of emergencies like SARS, the trouble is that the current demand is so far beyond what's been needed before that they literally can't be made fast enough.
According to anecdata from a friend of mine at 3M, they are running manufacturing 24 hours / day and are expanding. Apparently one of the problems was that when China was infected, 3M depleted a lot of their existing mask stock selling to the Chinese. When the virus came to the US, existing stocks were already somewhat depleted.
The issue is a lot of the factories that make these products are in China. The US has foresight to ensure military supply lines aren't dependent on China, but that foresight didnt extend to medical equipment. There simply isnt the capacity enough masks in the US.
I'm actively on the hunt for PPE on behalf of hospitals and I can tell you the mark up comes from several places:
- First, manufacturers have marked up prices. What used to cost 5c from a Chinese manufacturer now costs 30c or more.
- Aside from supply being keen on the shortage, demanders are also willing to push prices even higher. I have even had people /outbid/ my place in line for product.
- Airfreight costs $14.50 a kilo. It's typically around $2-3 a kilo.
- Financing is hard. In many cases, no one wants to pay up front at all or make deposits because of all the scams and counterfeit products. Suppliers similarly want money up front, often 100%. The transaction itself becomes a more risky proposition. I can't find anyone willing to finance part of a 30 day transaction for 5% returns.
The Federal seizures have made everything even more risky. Price controls will not fix this. A manufacturer in China has enough demand from the rest of the world to charge. (I was out bid from someone from France.)
This is quite interesting to read. Most of the media coverage in France has been very hostile against the US with little evidence to back it. We've seen claims of Americans waiting on the tarmac to buy our masks and redirect planes, cash in hand ready to be given. And in major newspapers [1, 2].
It doesn't help that the US tried to make some shady deals with a German company for exclusive access to the vaccine, and allegedly rerouted PPE paid for and headed to Germany.
i've been sourcing kn95's from family friends who are higher ups at the handful of CDC NIOSH NPPTL certified manufacturers. they are reporting that their raw material costs have skyrocketed from what use to cost them 20k per ton to 400k per ton (RMB).
another problem is due to the limited number of actual manufacturers that got the CDC/CE certifications long ago, they have established brands (ie: Maskin) that now, has knockoffs/counterfeits of which is sowing mistrust even for the certified manufacturers.
lastly, especially in America... we keep biting the hand that is feeding us in the sense that we are dependent on China's ability to mass produce KN95 masks but inevitably, when there are counterfeits as people cash in on the craze, "China" as a whole gets a bad rep.
this week, China issued an entire ban on mask exports. if you had problems getting masks already, it's about to get almost impossible to get them as there are plenty of other countries that would gladly receive shipments.
even so, i'm flabbergasted at the price the US government is reportedly reselling masks to states for between $5.50-7.50 per KN95/N95 mask... my current cost to the states is around $3.50/mask (after accounting for lost shipments) and i'm not getting any sort of big volume.
We should give US doctors lots of PPE for no cost.
Then a few months later, mail the hospitals bills for every person involved in making those masks. Also separate bills for the "specialists" who packed them into cardboard boxes. Then a month later we should send them another bill explaining that we decided the original mask shipment actually wasn't covered under their donation plan.
If they have trouble paying we should let them know we have payment plans available.
Yeah it is rather ironic all this talk about price gouging in a state of emergency when hospitals do it all the time, especially for emergencies where the person has no choice.
Oh masks cost 5x as much now? What a tragedy, they are charging 1-3 orders of magnitude markup on everything, all the time. But now people want to talk about “ethics”?
I hope when this is all over that is sparks a serious conversation about the healthcare mafia. A lot more needs to change before throwing tens of trillions of dollars at them for Medicare for all.
While I can only speak for Europe, more particularly for Germany, I learned quite a lot about masks in the last couple if weeks when I tried to leverage my logistics contacts to get masks and stuff from China.
IMHO we see what a complete brake down of an established supply chain looks like. As end users in Germany are unable to source directly from Chinese suppliers, and these suppliers are unable to import, the high demand, combined with production shutdowns, resulted in a near global stock out.
While this is bad enough, the multi-tiered distribution chain (producer, importer, wholeseller, local distributor) is by definition not capable or fast enough to recover in any reasonable amount of time. And that is under ideal conditions, and not during a global shortage and run on the product in question.
One would be tempted to assume some central entity would be able to step in. But in Germany, that fell to the armed forces and other government entities. And those have not the slightest clue about international trade. So the insisted on suppliers to import. Remember why the supply chain is the way it is? So the only thing working is donations, because there logistics pros are running things.
It is not a question of availability of masks nor transportation capacity or lead times, just price.
Now it seems the import part is solved. I give the government 2 weeks tops to realize distribution is not that easy neither. Just having masks in some warehouse is only the first step of supplying the front line people.
Sounds duly familiar to what I read about Wuhan back in late January and February. Only donations work. Had massive trouble distributing things. Fortunately at least you don't have to deal with another distraction named "government redirected your donation shipment to Red Cross (ran by government in China) and they sat on their stockpile doing nothing or malicious".
It's absolutely insane that PPE isn't something that's being procured on a national level. Why are hospitals and clinicians having to deal individually? If there were a monopsony buyer (i.e. the Feds), suppliers could be bullied into providing reasonable terms.
Well, I suppose the real answer is: Because that's not how healthcare works in America...
Anyhow, in Canada, the federal government has created its own global supply chain to produce and distribute PPE as needed within the country, hiring two international firms to store and verify equipment sourced from China. Meanwhile, national air carriers are re-fitting their unused jets to carry PPE and the feds are happily paying them to fly them.
"The ministry of procurement has signed a deal with two international firms to temporarily store and verify equipment in China – awaiting Canadian jetliners to safely retrieve the materials and return home.
Bollore Logistics – of France-based Bollore Group, a multi-national transport and logistics firm – is providing storage and transportation services within China, as well as preliminary testing capabilities."
This is the sort of war-time posture that every country needs to take. It's sad to see the lack of federal government leadership in the US leading to hospital staff becoming PPE supply chain experts. What a horrible waste of their talents.
Would you even trust the current administration to not interfere and distribute with partisanship in mind? On the remote chance they chose anyone competent to manage it.
I sure as hell don't, we have our head of state literally saying governors need to be nice to him to get their states federal help and stirring up in-person quarantine protests against governors from the opposite party. Unfortunately in this vacuum of leadership states are all we have. I am glad the north east and west coast seem to be starting to coordinate on a larger level.
I'm going to repeat your question: why isn't ppe being procured on a national level, and instead why is dhs seizing supplies, and why is not a war supplies act being declared when the national government is clearly needing them and not able to procure them.
The coronavirus task force has talked somewhat candidly about why the centralized monopsony buyer has been a problem. Because everyone is lying. A hospital might really need 100k masks, but they ask for 500k because they're afraid there won't be any more in the future. NYC demanded 40k ventilators, but it turns out they needed I think less than 10k. Multiply this by every hospital in every municipality across the country. There's no way a hand full of bureaucrats in Washington could make sense of that in reasonable time. I understand why pricing feels cruel, but it's a better system at more efficiently allocating resources. Anyone with some money can allocate some masks to a place with need that's in their line of sight. This provides much better coverage than the central planning models of: price controls, purchase limits, and confiscation/redistribution.
Same reason we do not have (health) records in the same place in a common format that would allows us to intelligently coordinate moving what supplies we do have around in a proactive fashion.
We already have the ability to measure COVID status because diagnostic labs are required to report the presence of certain things to CDC in real time upon positive test result. COVID-19 is almost certainly one. Further, countries like Britain tried what you are describing and the process was a total shit show ultimately leading to failure.
What makes flawless real-time communication hard is that you're talking about integrating thousands and thousands of groups of various sizes, with various technical capabilities and budgets, with various requirements, and with various legacy systems in place. You have multiple stakeholders who all want something different out of the project. You have very real security, availability, privacy, and fraud concerns. Oh and did I mention the government would really rather not pay for it?
Just creating a practical UUID for every citizen in the US is unprecedented, let alone associating all existing historical data for one person from all over the country / world with that handle, parsing that data into a standard format, and creating a system where that record could be updated in real time in a secure manner. Unsurprisingly, it's a monumental undertaking.
I was certain by this point in the crisis we'd be seeing video akin to WWII/"Rosie the Riveter" stuff of PPE flowing out of factories around the country.
Is the U.S.A. simply not capable of this level of production any longer? What the heck is going on? It's sobering.
It seems to be happening at the individual state level, but without smarter coordination between states there's a lot being left on the table.
WWII had the benefit of an extent Works Progress Administration [1] that had lot of power to swing jobs between and among states. It also had a lot of little powers that added up, like the Federal Arts Project (FAP) that pulled together the artists to create such works of art as "Rosie the Riveter" to motivate.
Maybe little things like a Federal Dank Memes Project could help in a time like this, maybe not. The "Rosie the Riveter" equivalent memes are out there, in some states, scattered and crowd sourced to social media. That more states don't even realize what their neighbors are up to in mobilizing PPE is itself a failure in coordination at the Federal level.
As we get through this we're probably going to need to talk a lot about renewing the New Deal.
I work at Nike and we've already retooled our major local factory to making PPE but it's all going to local hospitals at this point I believe so there hasn't been any big national news about it. I feel like this is probably happening elsewhere as well.
Taiwan increased their production of N95 masks from 100,000/day earlier this year to over 20 million/day now.
Asia can build N95 plants, starting with concrete foundations, in <14 days and 3M hasn't managed to start up any new production lines in existing facilities since announcing them nearly a month ago.
I'd like to imagine this is primarily a leadership issue. I'd like to think that if money was given to the right highly motivated people that it wouldn't matter than "we don't have melt blown fabric machines" because we could design and manufacture them from scratch in our machine shops.
Sometimes though, I do worry about a potential domestic shortage of skilled machinists and manufacturers. And of our ability to allocate either public or private capital to the right entities during national emergencies. I'd imagine $10 million could go pretty far right now, but I haven't heard of any millionaires trying to work outside of the capitalist systems by building something philanthropically. I also haven't seen anyone try to crowdsource money for some plants here.
It took a while for the US to get the war production really going during the war. Logistics and production was a mess in 1942 and it wasn’t really until 1944 that they were pumping out dozens of carriers and hundreds of liberty ships a year.
We seem to have spent an amazing percentage of that energy on spooling up ventilator manufacturing instead. Most of that capacity will be ready once the crisis is well beyond its peak.
I also do not understand why we weren't able to scale basic PPE quickly.
Because retooling is expensive and time consuming. And there is no guarantee how long this level of demand will sustain. And no guarantees on cheap chinese goods flooding the market and taking all your customers in a few months.
This is an incredibly easy problem to solve, relative to the current crisis: it only requires the federal government allocate enough money.
There is some price per mask at which the N95 respirator manufacturers that currently exist in the US would be willing to hire more people, buy more supplies, etc and start running 24/7. The only reason they aren't already is because nobody has agreed to pay for it.
From what I've heard, the US federal government agreed contracts fairly early on in the crisis where they'd buy up any excess US production of N95 masks that goes unsold in order to guarantee a market for exactly this reason.
We subsidize American agriculture because its important. We should do the same for other industries. I'm not sorry public services and concepts like this fly in the face of economic ideology that profit motive is the end-all be-all.
> And no guarantees on cheap chinese goods flooding the market and taking all your customers in a few months.
You might could fix that with strong tariffs. There was a guy recently, can’t remember his name, who was very much in favor of domestic manufacturing and tariffs against China. Seemed to catch a lot of flak for those policies! Wish I could remember who that was...
Bingo. It's amazing, this could have been the shining moment for his platform. Give domestic mask manufacturers immediate long-term federal contracts and a promise of significant tariffs when the dust settles. Instead he denied the problem even existed, encouraged people to get infected, and delayed our response by six weeks.
Does anyone know why these shortages haven't been sorted out? I don't work in manufacturing but aren't these things relatively simple to manufacture? We have factories and employees that are sitting idle, why can't they be repurposed to manufacture these en masse? It would resolve our supply issues while providing employment. Am I missing something?
Well it is happening [0,1,2], just not at the scale I would expect when you consider the fact that a large portion of our economy is at a standstill. You would think it would be all hands on deck when there are trillions of dollars on the line. And like the GP pointed out, we've achieved things that are magnitudes more difficult when it comes to quickly repurposing our industry when the situation calls for it.
You need the right machines. In the factory. A cnc lathe is no use. The large collection of jigs for whatever they made before don't help.
They can get the right machines and jigs but that means making them which takes time. They you need the right materials, you aluminum supply chain isn't helpful (unless they retool to make your raw materials...)
What I fail to understand - where was the emergency planning? A global pandemic is surely one thing that is a) foreseeable and b) possible to plan for. PPE could have been stockpiled, essential industry identified, testing infrastructure established, quarantine protocols put in place. We even had a dry run with SARS!
I'm sure there are (or were) civil defence / continuity of government plans in case of nuclear war, this must have been number 2 on the list of possible national emergencies?
Serious question: If the FBI and DHS are seizing PPE, where is it going? Why can't this hospital be a beneficiary of seized PPE, rather than an (almost) victim?
Yeah, they should have spent a month or two vetting every single company out of tens of thousands involved in the effort. This armchair quarterbacking is tiresome.
Come on. There's a middle ground. Of course the government can't be expected to vet every company in absolute depth right now, but it can very easily check a few criteria:
- does this company have any experience making the product in question?
- what size workforce does this company have to deploy once they receive funds?
This is basic stuff. Very basic stuff. And the government is failing at it.
To be distributer of FDA regulated medical gear you need a FDA license, they could have easily verified that. They couldn't even legally take possession of the masks for distribution.
I wrote up instructions on how to buy KN95 Masks from China for $1.67 delivered. Please share it to anybody in need of KN95 masks. If you need samples of the masks, I can send them to you for free, just shoot me a message.
The price premium comes from shipping and the cost of time.
MOST suppliers and even stateside vendors are trying to use Fedex, UPS, DHL. Many profiteers/altruists have already seen the possibilities here, and it is crowded but has irreconcilable limitations. You need your own cargo planes, shutting out most of the market. Plenty of other pitfalls too. With the risk involved, the "public health" ethical debate around pricing now falls flat, there is fortune involved in overcoming these hurdles.
People IN THE US want supplies IN THE US, not 10-15 days later with threat of seizure by CCP, by Customs in China, by Customs in US, by Federal Government and questionable product validity. So there is still actual, irreconcilable scarcity, because even the fastest trendiest entreprenuers just really cannot tell and operate on assurances, whereas the people that can have a limited supply that is bought instantly in a constant bidding war.
If this sort of seizure is being conducted under the Defense Production Act Section I, there should be greater transparency of what PPE materials are currently subjection to allocation control. Otherwise, we might as well have the National Guard protect shipments from seizure within the states.
Fixing our PPE supply chain was/is a solvable problem that our governments have utterly failed to address properly. It is shameful that our federal and state governments haven't better organized and incentivized solutions to fix this. I understand that it's hard. I understand that they're working hard to address this problem. But it's unacceptable that we haven't just gotten this done -- that we've instead put the burden on our medical workers to solve this life-or-death problem. As if they didn't already have enough to worry about.
I feel much closer to this issue than I expected to be. Because I worked for weeks with a volunteer group called helpfulengineering.org to help figure out how to make face shields through local partnerships. I was helping organize efforts for the city of Chicago. Our group made dozens of 3D printed face shields, then hundreds. Each face shield was given to a medical worker who sent back stories about how desperately important each one was to them.
In an effort to scale up faster, we got price quotes from local manufacturers who could manufacture NIH vetted face shields in bulk using injection molding or die cutting. These local manufacturers were very eager to help and work with us. We were prepared to get our own investment to kick-start the manufacturing as long as we had some confidence that we could get the products to market and not lose tens of thousands of dollars. We were prepared to sell them AT COST - not even for a profit. Next step: we just needed help to connect these manufacturers with an organized supply chain.
We talked to government offices and offered to help them get this plan in motion. But no one could do anything except direct us to generic websites and phone numbers. We filled out forms and called numbers. Never heard back. One government office told us they were working as hard as they could, and there were numerous projects in the works... but they couldn't give us any more information. No transparency.
Weeks later, the hospitals are still in desperate need. There is still no plan to solve this problem. Corporations have stepped up to donate a million here and a million there. This is great. But it's not a replacement for the war-time effort we need to save thousands of lives.
Thank you to so many leaders who are working hard -- including those from Chicago. But we've got to do better than this. If our medical workers were soldiers, we would not send them to war expecting them to find their own community donated helmets.
> As a chief physician executive, I rarely get involved in my health system’s supply-chain activities.
This seems crazy to me. Maybe it's because I came from manufacturing, where even front-line managers are heavily involved in supply-chain activities. We constantly have discussions about how this-or-that global/regional/local event might affect x or y commodity and the tortuous potential paths that may have to affecting our business niches. However, high functioning bars and restaurants also generally seem to have an excellent grasp of their extended supply chain and market forces.
It blows my mind that hospital executives didn't understand much at all about where their necessary supplies came from.
Where is the ppe going? And why is dhs stepping in when hospitals are ordering them? Why cannot health care workers order ppe directly? Hospitals are having a difficult time time giving them out to workers because it is low.
Time to start manufacturing in country which now means that, in North America, we need to provide financial incentives to all manufacturing because you can’t start building one product without the local supply chain to accomplish that.
The time of cheap Chinese made goods must come to an end.
My fiancee is an ER doctor and her hospital is now getting considerably more N95s than they were a few weeks ago. It looks like the supply chain is finally ramping up.
In 2006, the US Congress funded the integration of protective equipment to a Strategic National Stockpile: 52 million surgical masks and 104 million N95 air-filtration masks were acquired and added. During the 2009 flu pandemic, tens of millions of masks were used, but during the Obama administration strategic stocks were not “significantly restored”, neither have they been during the Trump administration
I really hope (but doubt) that this crisis will finally annihilate this terrible line of thought we've been crippled by (it feels like especially in the last four years).
It's not political to accurately describe the sheer ineptitude and corruption. It's not political to call the staggering, unacceptable lack of leadership, candor, and morality out for what it is.
It's not apolitical to turn a blind eye to it in search of profit.
> Having acquired the requisite funds — more than five times the amount we would normally pay for a similar shipment, but still less than what was being requested by other brokers
Pay attention people, this IS the market price. Even most state's "price gouging" laws are limited to 30 days after the State of Emergency because if the emergency has lasted that long, it is probably external forces outside of the state. Just like is happening here.
This equipment has to be provided to the whole population, eventually, and each person needs a whole pack. So since this does not exist, the prices go up as every state and organization has its needs and tries to prioritize health care workers.
To those noticing you can wash N95 masks in certain procedures:
It is also possible to boil water from a stream to remove some impurities. Or you could just have more clean water, maybe even bottled. I wonder what people will choose?
We are still at the healthcare workers first, phase. The inventory does.not.exist, the inventory is not re-usable, there is a market that has no relation to what prices were before the state of emergency. Insatiable quantity and people just catching on can't effectively be in this market quickly. China limits factories and more.
You could not have invented a worse scheme for this, but somehow they have, AND they’re using federal manpower (in N95s, naturally) to intercept these shipments.