US hospitals have a critical shortage of N95 respirator masks, and the situation is so desperate that many physicians are resorting to reusing them. Although this is horrifically unsafe, since it has come to this the CDC has actually issued detailed guidance for the specific situations that masks may be reused. The shortage is even more worrying given that the real crush of patients from coronavirus has not even started yet. Doctors are frantically asking for donations of protective equipment, and have formed organizations to solicit these donations.
There are several reasons for the shortage. Part of it is due to widespread buying of masks by anxious citizens. Part is due to the fact that most masks are manufactured in China and other foreign countries, who have now banned masks from being exported due to their own critical medical needs.
The current distribution of the masks is haphazard. All over the country N95 masks continue to be sold at retail. In addition, corporations have large stocks of the masks, some of whom are donating them. On March 17th, Mike Pence asked for construction companies to donate protective masks to hospitals, and for manufacturers to forgo additional orders. Since demand is currently far outstripping supply, manufacturers and middlemen are making the decisions of who exactly is receiving the supply.
The Department of Health and Human Services has stated that it needs about 3.5 billion N95 respirator masks per year, or 291 million per month. The US Strategic National Stockpile currently holds 12 million N95 masks and 30 million surgical face masks.
Beside the critical medical need, it is likely that many workers will need to receive masks before they can return to their jobs. If every one of the 162 million workers in the United States were to receive a mask for every working day, this would require production of 3.5 billion masks per month.
The major manufacturer of N95 masks in the United States is 3M, who is currently producing 35 million respirators a month. The company expects to double its capacity within the next 12 months to 70 million respirators a month. The only other manufacturer I know of is Prestige Ameritech, which has increased its production from 250,000 masks a day to 1 million daily. If you know more about US mask production please comment or send an email.
There is currently no central government agency that is overseeing the medical supply problem in the United States. A centralized agency is necessary because the current system of state-by-state action is failing, for several reasons: (i) states lack the resources of the federal government, as they are constrained by their budgets (ii) states compete against each other for access to resources (iii) there is no shift of resources between states, i.e. to the states hit the hardest (iv) without a centralized response there is duplication of effort in research and strategy (v) for communication purposes it is much easier to have a single agency in charge.
To deal with this challenge, the United States Government must establish a centralized medical production board to direct conversions of industries to medical need and establish priorities in the distribution of materials and services.
The board will coordinate purchases, determining the economical and effective method of procuring items. It will have contract clearance across the federal and state governments, to ensure that agencies aren’t bidding against each other. It will guarantee payment of all output, even if the products are not ultimately needed. Orders will take priority over all private accounts or for export. It will aid in conversion to and construction of hospitals and factories, as well as adding capacity, through loans, grants, and direct ownership.
In the meanwhile, state governors should take emergency action to ensure masks end up in the hands of doctors that need them the most. They can: (1) require that middlemen and manufacturers fulfill only government and hospital orders (2) use emergency powers to commandeer masks from non-essential businesses and non-vulnerable citizens (3) distribute masks and other protective equipment to the areas with the greatest need.