The mask shortage may get worse as coronavirus outbreak intensifies

Public health officials are warning that restrictive trade measures tied to medical supplies could worsen the shortfall of products like masks

A large crowd of mask-wearing commuters walk through Shinagawa Station in Tokyo, Tuesday, March 3, 2020. The government has indicated it sees the next couple of weeks as crucial to containing the spread of COVID-19, which was discovered in China in late 2019. (AP Photo/Jae C. Hong)
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Michael Einhorn’s medical supply company may run out of the masks used to protect against coronavirus in two weeks unless the Chinese manufacturer of his branded equipment resumes production this week.

“We’re having to make tough decisions every day on who gets masks and who doesn’t,” said Mr Einhorn, the founder of New York-based Dealmed-Park Surgical, which employs almost 100 people. “Do masks go to the suburban hospital or the 911 responders? It’s a huge responsibility, and we know we’re going to make some mistakes.”

Mr Einhorn’s dilemma is playing out on a global stage. With the deadly virus now present in 100 countries, companies are unable to match demand for the masks needed by health workers. That’s led governments to jockey for supplies, including the US, which is stockpiling, and Germany and South Korea, which banned exports of masks altogether.

Public health officials are warning that restrictive trade measures tied to medical supplies could worsen the shortfall and risk making poorer nations more vulnerable to the coronavirus’ spread. In some countries, including Japan and Germany, doctors are being told to reuse the single mask they get daily because of a lack of supply.

“Most places are not prepared, so you now have a cascade of countries putting these export bans in place,” said Stephen Morrison, director of the Global Health Policy Centre at the Centre for Strategic and International Studies in Washington. “It’s not a long-term solution. Everyone throwing up export bans isn’t going to solve the problem of how you will get the products in time to serve these acute needs.”

Peter Navarro, a hawkish trade adviser to President Donald Trump, is also pushing the US to enact an export ban on certain medical supplies like face masks and compel pharmaceutical companies to manufacture drugs domestically.

Manufacturers need to boost production of masks by another 40 per cent to meet demand, said Tedros Adhanom Ghebreyesus, the World Health Organisation’s director -general. While the WHO has shipped supplies to 47 countries including Iran, Cambodia and Uganda, shortages will hit soon, especially of the N95 masks that block out 95 per cent of airborne particulates to combat the current virus.

“Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding,” Mr Tedros said in a statement on March 3. “We can’t stop Covid-19 without protecting health workers first,” he said, referring to the illness caused by the virus.

Despite Mr Tedros’s appeal, South Korea, Germany and Russia announced export bans of masks and other protective gear days after. They join others nation or territories including India, Taiwan, Thailand, and Kazakhstan that earlier put export bans in place. The novel coronavirus has now spread to more than 119,000 cases globally and killed over 4,280 people.

"We're having to make tough decisions every day on who gets masks and who doesn't"

Public health experts are concerned that should more developed countries ban exports of masks and protective gear, poorer nations could be at risk of widening outbreaks, particularly among medical workers.

“It will paralyse and freeze up the market,” said Mr Morrison of CSIS. “The accumulated impact of these measures is to create paralysis -- one big logjam.”

Export bans and other measures adopted by developed countries risk deepening global divisions over the virus, said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University in Washington, DC.

“It would entirely unravel global cooperation if Covid-19 turned into a major killer, and we see hundreds of thousands deaths in lower income countries with relatively few deaths in the global north,” said Gostin, who is also the director of the WHO’s Collaborating Centre on Public Health Law & Human Rights.

Before the epidemic, China produced about half of the world’s output of masks with daily production of about 20 million units, according to the state-run Xinhua news agency. Factories have since boosted production more than five-fold and are enlisting carmakers to manufacture them. That’s still not enough.

In the US, increased efforts by mask makers 3M and DuPont De Nemours are also falling short of demand. DuPont, which makes masks and protective body suits worn by first responders, said it has  increased production by more than three times its usual global capacity. 3M, the biggest American manufacturer of N95 respirators, has increased production since the outbreak in China.

“We’ve added staff, we’ve added overtime, we’ve added technology, we’ve been increasing manufacturing lines,” said 3M spokeswoman Jennifer Ehrlich. “We expect this demand for respirators and other supplies to continue to outpace supply for the foreseeable future.”

The dependence on China and a few other countries for masks has some calling for a rethink of supply chains. The World Medical Association, which represents doctors, wants governments to establish factories in major markets like the European Union and the US to ensure adequate supply of critical drugs, vaccines and other medical necessities.

The US only has about 1 per cent of the 3.5 billion masks it needs to combat a serious outbreak, Health and Human Services Secretary Alex Azar has said. The country plans to buy 500 million surgical masks and N95 respirators for the national stockpile.

Einhorn of Dealmed thinks the shortage isn’t likely to ease until the summer. The crisis may finally convince Americans to pay more for masks made in the US, he said. Dealmed is seeking bids for domestically-produced equipment.

“The world shouldn’t be relying on one country for health care products,” Einhorn said. “We absolutely need to look at the supply chain.”