From Portside <[email protected]>
Subject How the World’s Richest Country Ran Out of a 75-Cent Face Mask
Date March 28, 2020 3:59 AM
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[A very American story about capitalism consuming our national
preparedness and resiliency] [[link removed]]

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Farhad Manjoo
March 25, 2020
New York Times
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_ A very American story about capitalism consuming our national
preparedness and resiliency _

Some health care workers have resorted to sewing their own masks as
supplies fall short, Jovelle Tamayo for The New York Times


Why is the United States running out of face masks for medical
workers? How does the world’s wealthiest country find itself in such
a tragic and avoidable mess? And how long will it take to get enough
protective gear, if that’s even possible now?

I’ve spent the last few days digging into these questions, because
the shortages of protective gear
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particularly face masks
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struck me as one of the more disturbing absurdities in America’s
response to this pandemic.

Yes, it would have been nice to have had early, widespread testing for
the coronavirus, the strategy South Korea used
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contain its outbreak. It would be amazing if we can avoid running out
of ventilators and hospital space, the catastrophe that has befallen
parts of Italy
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But neither matters much — in fact, no significant intervention is
possible — if health care workers cannot even come into contact with
coronavirus patients without getting sick themselves.

That’s where cheap, disposable face masks, eye protection, gloves
and gowns come in. That we failed to procure enough safety gear for
medical workers — not to mention for sick people and for the public,
as some health experts might have recommended if masks were not in
such low supply
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seems astoundingly negligent.

What a small, shameful way for a strong nation to falter: For want of
a 75-cent face mask, the kingdom was lost.

I am sorry to say that digging into the mask shortage does little to
assuage one’s sense of outrage. The answer to why we’re running
out of protective gear involves a very American set of capitalist
pathologies — the rise and inevitable lure of low-cost overseas
manufacturing, and a strategic failure, at the national level and in
the health care industry, to consider seriously the cascading
vulnerabilities that flowed from the incentives to reduce costs.

Perhaps the only way to address the shortfall now is to recognize that
the market is broken, and to have the government step in to
immediately spur global and domestic production. President Trump,
bizarrely, has so far resisted
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companies to produce more supplies and equipment. In the case of
masks, manufacturers say they are moving mountains to ramp up
production, and some large companies are donating millions of masks
from their own reserves.

But given the vast global need for masks — in the United States
alone, fighting the coronavirus will consume 3.5 billion face masks
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according to an estimate by the Department of Health and Human
Services — corporate generosity will fall short
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People in the mask business say it will take a few months, at a
minimum, to significantly expand production.

“We are at full capacity today, and increased production by building
another factory or extending further will take anywhere between three
to four months,” said Guillaume Laverdure, the chief operating
officer of Medicom, a Canadian company that makes masks and other
protective equipment in factories around the world.

And though some nontraditional manufacturers like T-shirt factories
and other apparel makers
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announced plans to rush-produce masks, it’s unclear that they will
be able to meet required safety standards or shift over production in
time to answer demand.

Few in the protective equipment industry are surprised by the
shortages, because they’ve been predicted for years
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In 2005, the George W. Bush administration called for
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coordination of domestic production and stockpiling of protective gear
in preparation for pandemic influenza. In 2006, Congress approved
funds to add protective gear to a national strategic stockpile —
among other things, the stockpile collected 52 million surgical face
masks and 104 million N95 respirator masks.

But about 100 million masks in the stockpile were deployed in 2009 in
the fight against the H1N1 flu pandemic, and the government never
bothered to replace them
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Alex Azar, secretary of health and human services, testified that
there are only about 40 million masks in the stockpile
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around 1 percent of the projected national need.

As the coronavirus began to spread in China early this year, a global
shortage of protective equipment began to look inevitable
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But by then it was too late for the American government to do much
about the problem. Two decades ago, most hospital protective gear was
made domestically. But like much of the rest of the apparel and
consumer products business, face mask manufacturing has since shifted
nearly entirely overseas. “China is a producer of 80 percent of
masks worldwide,” Laverdure said.

Hospitals began to run out of masks for the same reason that
supermarkets ran out of toilet paper — because
their “just-in-time” supply chains
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which call for holding as little inventory as possible to meet demand,
are built to optimize efficiency, not resiliency.

“You’re talking about a commodity item,” said Michael J. Alkire,
president of Premier, a company that purchases medical supplies for
hospitals and health systems. In the supply chain, he said, “by
definition, there’s not going to be a lot of redundancy, because
everyone wants the low cost.”

In January, the brittle supply chain began to crack under pressure. To
deal with its own outbreak, China began to restrict exports of
protective equipment
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Then other countries did as well — Taiwan, Germany, France and India
took steps to stop exports of medical equipment. That left American
hospitals to seek more and more masks from fewer and fewer producers.

People in the industry assured me they would prepare better next time.
“We are laserlike focused to ensure that our health care systems are
never in this scenario again,” Alkire told me. “There will be a
lot more domestic manufacturing of these products going forward.”

I don’t doubt it — but that we did not plan, as a nation, for this
entirely predictable shortage makes me wonder what other inevitable
pothole is lurking out there for all to trip over. Getting enough
protective gear was among the cheapest, most effective things we could
have done to slow down the pandemic. That we failed on such an obvious
thing reveals an alarming national incapacity to imagine and prepare
for the worst.

We will get enough masks in time for the next disaster. But wouldn’t
it be nice, for once, if we prepared for trouble before it hit us in
the face?


_Farhad Manjoo became a Times Opinion columnist in 2018. _

_Before that, they
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The Times’ State of the Art column, covering the technology
industry’s efforts to swallow up the world. They have also written
for Slate, Salon, Fast Company and The Wall Street Journal. To their
chagrin, their 2008 book, “True Enough: Learning to Live in a
Post-Fact World,” accurately predicted our modern age of
tech-abetted echo chambers and “alternative facts.”_

_Farhad Manjoo was born in South Africa and emigrated with their
family to Southern California in the late 1980s. They live in Northern
California with their wife and two children._

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