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.<p>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.
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.<p>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?<p>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?
I'm actively on the hunt for PPE on behalf of hospitals and I can tell you the mark up comes from several places:<p>- 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.<p>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.)<p>The only thing we can do is ramp up supply.
We should give US doctors lots of PPE for no cost.<p>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.<p>If they have trouble paying we should let them know we have payment plans available.
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.<p>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.<p>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.<p>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.<p>It is not a question of availability of masks nor transportation capacity or lead times, just price.<p>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.
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.<p>Well, I suppose the real answer is: Because that's not how healthcare works in America...
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.<p>Is the U.S.A. simply not capable of this level of production any longer? What the heck is going on? It's sobering.
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!<p>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?
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.<p><a href="https://docs.google.com/document/d/1BKUmZgwrvPG47VMR8SFvvSVh7lrUiMv0dvrnzmrs1Is/" rel="nofollow">https://docs.google.com/document/d/1BKUmZgwrvPG47VMR8SFvvSVh...</a>
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.<p>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.<p><a href="https://twitter.com/syllablehq/status/1247891099324051462" rel="nofollow">https://twitter.com/syllablehq/status/1247891099324051462</a><p>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.<p>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.<p>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.<p>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.<p>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.<p>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.<p>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.
so many comments asking "how could this be?" and "what the heck is going on?" and so forth.<p>the answer is obvious, but i guess it's too "political" for people to accept.
> 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<p>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.<p>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.<p>To those noticing you can wash N95 masks in certain procedures:<p>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?<p>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.