
Six months in, N95 mask shortages persist - mhb
https://www.npr.org/2020/09/17/913093387/why-cant-america-make-enough-n95-masks-6-months-into-pandemic-shortages-persist
======
blisterpeanuts
Capacity is ramping up. It's surprising that the reporter (Joel Rose) didn't
mention a new large Dräger plant in Pennsylvania that has begun manufacturing
completely made-in-USA N-95 NIOSH-compliant masks.

3M and Honeywell are responding to HHS and DoD contracts by double or tripling
their monthly output (admittedly, most of their factories are outside the
U.S., in China and other places).

According to Statistica, monthly production of these masks will rise from 45
million units in January 2020 to 180 million units by end of year. Maybe this
is insufficient but it's certainly better than nothing.

One issue is the difficulty and expense of producing meltblown textile, the
material that traps microscopic particles so effectively. Currently this
material is in shortage, and manufacturers are reluctant to build expensive
machinery to make it when the demand may not exist a year from now.

One could make a case that the government should guarantee such companies from
loss, to encourage short term investment.

1\. [https://www.statista.com/statistics/1135072/us-n95-mask-
prod...](https://www.statista.com/statistics/1135072/us-n95-mask-production/)

2\.
[https://www.usnews.com/news/politics/articles/2020-09-10/sca...](https://www.usnews.com/news/politics/articles/2020-09-10/scarcity-
of-key-material-squeezes-medical-mask-manufacturing)

3\. [https://news.yahoo.com/dr-ger-
increases-n95-respiratory-1555...](https://news.yahoo.com/dr-ger-
increases-n95-respiratory-155500945.html)

~~~
snarf21
The government should have stepped in. We probably don't even need more N95.
We could have a different kind of mask that is highly effective and made for
comfort with kids and adult sizes. The government could have ordered and
distributed these at cost. Then a national mask mandate is trivial. We could
have greatly cut the spread and job losses. Instead they did basically nothing
and said it would go away in a week or two.

~~~
murgindrag
Korea has a nice new mask. AirQueen. Reusable. Reasonably comfortable.
N95-equivalent for filtration.

The seal isn't quite as good as a proper N95, but it beat surgical, and even
surgical gets you almost all the way there.

~~~
light_hue_1
Be careful with AirQueen masks. They are of dubious quality.

The [CDC tested
them]([https://www.cdc.gov/niosh/npptl/respirators/testing/results/...](https://www.cdc.gov/niosh/npptl/respirators/testing/results/MTT-2020-173.5_International_Toptec_AirQueenNanoMask_TestReport_Redacted-508.pdf))
and their quality control leaves a lot to be desired.

If the variance for just 10 masks was so incredibly high, who knows how crappy
the 99th percentile mask they produce is?

------
londons_explore
Because 'anti price gouging' laws prevent the price going high enough to make
it worth someone going to extreme efforts to upscale production.

Without those laws, the price going from $1 per mask to $10 per mask would
still be very much affordable for everyone who _really_ needs a mask, and
factories who can successfully get decent production underway will earn lots,
making it worthwhile to take on the risk of chasing a (possibly short lived)
demand.

~~~
thedz
> $1 per mask to $10 per mask would still be very much affordable for everyone
> who really needs a mask

teachers and many essential workers who need masks the most are also most
vulnerable to unexpected expenses like PPE costs. and the organizations they
work for typically have strict budges and can usually only provide limited
supplies.

that statement feels wildly out of touch.

~~~
briffle
You mean the teachers at my school district that regularly spend $3m/year on
diesel fuel for busing students (and the drivers wages, half the drivers are
'temps') that are sitting unused?

~~~
Loughla
Are you saying you school isn't transporting students? Also, are you saying
the teachers have anything to do with that cost?

My district had to double its busing budget this year due to restrictions on
the number of students that could be on each bus. This led to even further
cuts into the classroom budgets.

So, I guess your experience may be different.

~~~
maxlybbert
I read it that way as well. But I think the idea was that the district would
normally spend $3 million on gas, and some unspecified amount on drivers.
Presumably, they aren’t spending that money now, so there should be money
available for masks for the teachers.

Except, they aren’t spending that much now because they aren’t bringing the
kids to school. Why would the teachers need masks?

My district is bringing half the students to school each day, with a different
half on different days. But they still drive the buses the same distance, and
still need the same number of drivers.

------
tinus_hn
Probably related to the tricks pulled cancelling the order for 30000
ventilators for $650000000 from Philips. (
[https://www.bloomberg.com/news/articles/2020-08-31/philips-c...](https://www.bloomberg.com/news/articles/2020-08-31/philips-
cuts-outlook-after-u-s-slashes-ventilator-contract) )

If you’re not a reliable partner how can you expect people to invest? If
someone builds a factory in the US, as soon as masks are available from China
again the administration will just drop them like a rock and start ordering
from China for rock bottom prices again.

~~~
WrtCdEvrydy
I mean, this was the story from the guy in America who was selling the masks.

He said he wasn't expanding or making his people pull overtime only for
hospitals to go to China.

How much was the cost difference? 10 cents versus 4 cents per mask.

~~~
notyourday
I'm genuinely curious when was the last time someone voluntarily and
constantly paid 250% of a cost of an equivalent product available from
somewhere else?

~~~
klodolph
US government does strategic planning when they make large purchases. There
are also a bunch of weird laws at play, so at times you might on one hand say
that "the law requires" and on the other hand consider it voluntarily paying
more, because it's the US government passing laws to restrict how its own
purchases are made.

You also might pay $5 for a hot dog at a stadium when you can buy them for $1
outside, so there's that.

~~~
rovr138
Popcorn or anything from the concessions at the movies.

------
curiousllama
First of all: "the market is glutted with face masks [and hand sanitizer]."
This is a massive success of the free market, mitigated only by the
unfortunate fact that, as it turns out, those are not the most useful bits of
PPE.

Second, contrary to the pro-price-gouging argument, the real issue is risk
aversion: nobody will sign the long term contracts required for manufacturers
to justify the investment (and, by the way, are functionally the same as a
higher price). Why? Because providers in places where shortages actually
manifest - largely poor & rural areas - are nearly bankrupt anyway. They can't
guarantee payment for sh*t in the long term.

Ultimately, this issue is exactly the type of thing we need collective action
for: pool our resources & buy together to defray long-term costs. Bluntly, the
government should be guaranteeing these contracts. But they don't AFAIK - and
that's the failing.

~~~
Terretta
> _glutted with face masks ... not the most useful bits of PPE_

What are the most useful bits of PPE against an airborne (breathed, not
sneezed/touched) virus?

~~~
curiousllama
Masks

Others are still useful (gowns, faceshields, sanitizer, etc.), but masks are
the most useful, from what I can tell.

~~~
ebg13
But you just said that they weren't.

~~~
curiousllama
Shields I meant shields. Blech

------
binarymax
I was able to buy 20 KN95 masks for $50 through an online retailer advertising
through my local business journal.

KN95 masks are the Chinese regulatory standard vs N95 which is the NIOSH
standard, but KN95 sales in the US still need FDA approval.

Here is a list of approved masks from the FDA: [https://www.fda.gov/medical-
devices/coronavirus-disease-2019...](https://www.fda.gov/medical-
devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-
medical-devices/personal-protective-equipment-euas)

~~~
jdm2212
My local Korean grocery store and Ace Hardware both have KN95 masks in stock
for $2 to $5 a piece. Maybe I'm just lucky, but I've heard of them just being
available in stores elsewhere too.

~~~
techdevangelist
We have the flat folded KN95 masks in Kroger costing 3 for $15

------
ComputerGuru
ISBE and IDPH asked us to open this school year with full in-person learning
for at least up to third grade, but left us to deal with the resource shortage
on our own. We scrounged for thermal scanners and face masks but the lead time
on refills for our wall/stand-mounted hand sanitizer dispensers is still 26
weeks. Back in February before the US wisened up to the threat, I placed a
large order that would have later qualified as “hoarding”† because I figured
it was a calculated precaution worth the investment and because we are
ultimately responsible for the health and safety of our students, teachers,
and their families; this was sufficient for us to continue until we closed in
March (of our own volition prior to the governor’s order shutting down all
schools) and we had enough left over for us to reopen, but we’re basically out
now. Anyone with ideas about how to procure more hand sanitizer in bulk for
schools, please reach out!

† No moral qualms here because there was no insane shortage in February,
because it was not for myself or for personal/corporate profit, and because it
wasn’t more than we could need in a worst case scenario which absolutely
materialized (reopening school in a pandemic); imho it’s not unlike a governor
who placed a large order for their state - for which they would be praised as
prescient and not shot down as hoarding.

------
ciarannolan
No mention of the Defense Production Act [1], which was talked about more
during the early days of this.

With the right declaration, the feds can make any American company manufacture
anything. Why haven't they used it for N95's?

[1]
[https://en.wikipedia.org/wiki/Defense_Production_Act](https://en.wikipedia.org/wiki/Defense_Production_Act)

~~~
bleepblorp
The DPA has not been used because the White House made an early decision that
it was not politically necessary to raise a maximum-effort response to SARS-
CoV-2. Because COVID-19 cases were primarily concentrated in Democratic
states, it was seen as politically useful to do little and blame Democrats for
the consequences.

> Most troubling of all, perhaps, was a sentiment the expert said a member of

> Kushner’s team expressed: that because the virus had hit blue states
> hardest,

> a national plan was unnecessary and would not make sense politically. “The

> political folks believed that because it was going to be relegated to

> Democratic states, that they could blame those governors, and that would be

> an effective political strategy,” said the expert.[0]

[0] [https://www.vanityfair.com/news/2020/07/how-jared-
kushners-s...](https://www.vanityfair.com/news/2020/07/how-jared-kushners-
secret-testing-plan-went-poof-into-thin-air)

------
kevin_thibedeau
I recommend Moldex. They are under the radar and their plastic mesh isn't
readily counterfeited, which is happening now with 3M. They are crushable and
pop back into shape. Plus the high end models have nicer sliding straps. Just
beware they have no metal bridge and have two different forms to accommodate
different nose shapes.

~~~
DoingIsLearning
>... their plastic mesh isn't readily counterfeited, which is happening now
with 3M

Speaking of 3M and N95's, can anybody with some unbiased knowledge explain
what exactly is the chinese manufactured 'KN95' mask?

Are they just conveniently using the name or are the KN95 masks made to
standard, to be P2/N95 grade masks?

~~~
ceejayoz
KN95 is the Chinese version of the standard. Similar requirements, just a
different regulatory body.

There's a good comparison chart on page 2 of
[https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2...](https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2-kn95-n95-filtering-facepiece-respirator-classes-tb.pdf).

~~~
_Microft
Did you know that e.g. Firefox's built-in PDF reader allows to jump directly
into PDFs by appending (here) _#page=2_ to the URL?

[https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2...](https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2-kn95-n95-filtering-facepiece-respirator-classes-tb.pdf#page=2)

~~~
ceejayoz
I did not; neat!

~~~
_Microft
You can also add _& search=N95 KN95_ to find and highlight search terms. There
might be other parameters but I do not know them off the back of my head. It's
a great and totally under-used feature. Almost like the timestamped,
searchable transcripts on Youtube...

[https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2...](https://multimedia.3m.com/mws/media/1791500O/comparison-
ffp2-kn95-n95-filtering-facepiece-respirator-classes-
tb.pdf#page=2&search=KN95%20N95)

Edit: there's at least "zoom" available as well. I think it takes a percentage
value as parameter.

------
seanca
From a product perspective this feels a lot like blaming the market instead of
taking responsibility that you didn't build the right product. "When Gujral
and other domestic manufacturers saw an opportunity to help protect frontline
workers ... many of them shifted gears to make face shields and hand
sanitizer, which are relatively simple to produce." Right, you built what was
easy (face shields) instead of what the market wanted most (N95 masks). Now
your product isn't differentiated and the market is flooded with a product
that doesn't best meet the market's needs. We knew six months ago that N95
masks were the critical product for frontline workers, not listening to that
market feedback isn't the federal government's fault but rather your own.

~~~
danenania
Given there has been an essentially infinite demand for _any_ PPE, even
insufficient PPE, it's very possible that producing face shields and hand
sanitizer was a better business decision from a purely financial perspective.
That's why the government needs to take leadership in these scenarios--market
incentives often aren't enough to produce what's needed in response to large-
scale disasters.

------
anthony_r
Is anyone tracking the current spot price of N95 masks on a chart?

Would need a true price, i.e. what do you have to pay if you have no "special
powers" like a hospital. Spot as close as is reasonable, maybe with 1 week
delivery; I am assuming that the forward curve is still in backwardation. That
would be the best tracker of shortage. The curve itself would be interesting,
if it ever flips to contango without spot going meaningfully down that'd mean
serious problems (nobody expects capacity increase).

------
12xo
Wait, I was under the impression that the spun material used to make the masks
was the challenge, not the actual manufacturing of the masks. Which is
actually rather simple.

------
blackrock
Well, what’s the point of an N95 mask, when every other idiot at the
supermarket wears the mask on their chin, while walking around the store
talking on their cell phones?

Or they just pretend to wear it, by only covering their mouth, and leaving
their noses exposed.

Regardless, this issue does not fix stupidity.

------
diebeforei485
Face shields are largely useless, except perhaps for healthcare workers.

They are relatively easy to manufacture, but what we really needed was mass-
production of N95/KN95 masks for essential workers.

------
indymike
This was a problem in the past. Even the local gas stations and grocery stores
are selling N95 masks (and KN95 masks and about thirty styles of fashion
masks) here in the Midwest.

------
justin66
Isopropyl alcohol is still difficult to obtain in stores, which is
interesting. It is insanely easy to make, unlike N95 masks, which are pretty
specialized.

------
nicolashahn
I'm not seeing anyone here talk about the actual reason that a factory owner
gave: no one knows if it's going to pay off, because if this whole thing blows
over (because of a vaccine, or some other treatment, or we reach herd immunity
sooner than expected, etc) then they've spent a huge investment on building
supply, and there's no demand for it.

------
horsemessiah
This is what is known as "anarchy of production" which is a key feature of
capitalism. A global crisis like this is not compatible with our existing
economic systems.

~~~
AlexTWithBeard
Oh, no.

Pay ten bucks per mask - and soon enough in every basement there will be a
masks factory.

At least until OSHA comes after them.

~~~
jschwartzi
Based on my experiences buying other things on Amazon, there will be a "masks"
factory. People will be churning out tons and tons of counterfeit N95 masks.
They will invest in printing believable CE marks and putting all the touches
that would be present on a medical-grade mask. And people will buy them
believing that the masks are high-quality and that they are safe wearing them.

------
11235813213455
When I see all the masks littered outside (in France), along the road, I can
see one of the reasons for the shortage

~~~
ceejayoz
Littering is a problem, for sure, but not the same one.

These masks are disposable. They should be disposed of _properly_ , but
throwing them away isn't the cause of supply problems.

~~~
deelowe
FYI, there are CDC guidelines for extended use/reuse:
[https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...](https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html)

~~~
ceejayoz
_Limited_ reuse. If you read it, "extended" here means "several patients in
the same day". Hours, not days/weeks.

~~~
deelowe
I have read it. Have you? I'm trying to be helpful. Here are a few key quotes:

 _Thus, the maximum length of continuous use in non-dusty healthcare
workplaces is typically dictated by hygienic concerns (e.g., the respirator
was discarded because it became contaminated) or practical considerations
(e.g., need to use the restroom, meal breaks, etc.), rather than a pre-
determined number of hours._

 _Extended use alone is unlikely to degrade respiratory protection._

 _If no manufacturer guidance is available, preliminary data(19, 20) suggests
limiting the number of reuses to no more than five uses per device to ensure
an adequate safety margin._

 _The most significant risk is of contact transmission from touching the
surface of the contaminated respirator._

Basically, the major risk factors for extended use and reuse is contamination
of the respirator resulting in infection from handling it and damage rendering
the respirator inferior (e.g. due to improper seal). Also, these guidelines
are for clinical settings where these specific risk factors significantly
elevated. For a normal person who uses the mask maybe once per week (assuming
they are rotating), a single n95 mask could last quite a long time.

~~~
ceejayoz
Yes, I did read it.

> Extended use refers to the practice of wearing the same N95 respirator for
> repeated close contact encounters with several patients, without removing
> the respirator between patient encounters.

You're reading it as "extended use" meaning multi-day use, but that's not what
the article defines it as. You will _eventually_ have to discard the thing as
it gets soiled or becomes harder to breathe through as it collects particles.

~~~
deelowe
Extended use is single instance. Re-use is multiple instances. These are
separate things.

If you read the linked papers, the reuse guidance is over the course of days
with rest periods in between.

