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.
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.
And that's in the present. What's more frustrating too is that if we're still debating about the present, there will certainly not be any accountability for the lack of preparedness from all levels of government in the past to prepare for health crisis.
where even the random person checking your temperature at subway entrances and toll stations are armed to the teeth in PPEs in China. And that's coming from a country that wasn't even able to genetically map SARS themselves <20 years ago.
This is the point I've tried to convey to my peers in the West over, and over, and over for years.
I hope this would finally be a rude awakening moment for countries in the West. The decay of essential social institutes in the West has reached the point when issues begin to snowball uncontrollably.
I don't like many points of that guy called Neil Fergusson makes, but he is 100% on the spot pointing that the West is loosing the "institutional IQ" after 20 to 30 years of "ultrapopulism" in government.
Just look at the level of organisation being exhibited now, and how emergency response was handled few decades ago. Quarantines were not so unheard of in the West even for things like bad flu outbreaks in the 20th century, but, nowadays, some countries can't quarantine even a single city.
The US is not the entirety of the west and its political, social, academic, journalistic, health, regulatory, and administrative systems are not identical to those of the rest of the west.
The breakdown of trust and the resulting inefficiency that exist in US systems aren't happening everywhere.
They are to some extent. The US has some... unique problems[1] in this area, sure. But general bureaucratic decay is everywhere. France and Germany are seeing the same PPE shortages, the same hospital equipment snafus, and pretty much no one in the world outside the Korean peninsula has figured out how to do enough testing to contain this thing.
Again, it's true that the US has fallen farther (consider the federal coordination of industry in WWII and compare to the disaster today). But no one is doing "well" here.
[1] I despise that I have to euphemize that here on HN, but those seem to be the rules the community enforces.
Exactly. The playbook is cynical and vile, but very effective. You first starve the government, then when government inevitably fails at its job, you point to that failure as a reason to starve it even further, on the basis that the private sector can obviously handle things better.
What I've noticed is the political system seems to increasing lack coherence. Unable to decide on a course of action and wield power accordingly. Totally unable to resist pressure put upon them by powerful domestic and especial foreign actors.
And this feeling that actions that were once unremarkable now seem impossible.
> I don't like many points of that guy called Neil Fergusson makes, but he is 100% on the spot pointing that the West is loosing the "institutional IQ" after 20 to 30 years of "ultrapopulism" in government.
By the way Neil Ferguson is a mathematical biologist at Imperial College, London who was instrumental in getting the UK government to change directions.
Niall Ferguson (also from the UK though currently at Harvard) is a historian. He is an excellent and insightful observer (especially his earlier work) but like you I often find he ends up drawing the wrong conclusions.
I think the West's democratic model of loosely fitting parts (yes, even in a country like France) permits greater resilience against various threats....but permits is not the same as guarantees!
The article mentions the DHS which was created in November 2002 in response to 9/11 and is the youngest U.S. cabinet department [0].
The other thread of the creeping problems in the West - that it is growth of government rather than decay of government - has some evidence to show here.
Institutional IQ isn't the issue. The DHS was never clever and the FBI has been a corrupt mess for a long time. See also J. Edgar Hoover and imagine him as a current president.
DHS is one thing, but make no mistake most government agencies outside DoD have seen resources cut and leadership with explicit tasks to water down, remove, and erode the performance of duties. See: DoE, the EPA (where leaders wanted the agency shut down) and number of “acting” leaders right now as a percentage. This is explicit and has happened rapidly since 2017.
Zero new cases, according to https://www.ft.com/coronavirus-latest.
That's leading, together with Taiwan. From the news I gathered that your prime minister has mandated early and effective lock-down.
Are there other noteworthy measures taken by your government that explain the success?
Institutional IQ or leadership or anything else like that does you no good when your country no longer has the manufacturing infrastructure to make PPE anymore and the countries which can would rather use it to protect their own citizens, and it's mostly the anti-populists which seem to be doubling down on denying that simple fact.
It actually does. For example, for things that cannot be produced locally in sufficient quantities (such as oil prior to the fracking boom), the US did maintain a strategic reserve. Even to this day, it still has a strategic oil reserve.
Lack of institutional IQ/leadership manifests in myriad of ways, such as the dismantling of California's emergency medical supply reserve in 2011 [0], defunding of organizations that address the current risks [1], and so on.
Addressing potential systemic risks through domestic production is only one potential way that leadership can handle them. Creating reserves and funding preparedness are some of the other ways to handle such risks.
The trouble with stockpiling PPE is that it's bulky, it expires in storage, and you need an awful lot of it to handle a crisis of this size. For anything beyond a short-lived, localized crisis, building out the production capacity to actually be able to make PPE in sufficient quantities seems a lot more feasible than a massive billion-item stockpile. The strategic oil reserve has the advantage that it can just pumping oil into well-selected holes in the ground.
Maintaining emergency stockpiles is the only solution to these episodes of commodity shortages, whether they're caused by increased demand or interrupted supply.
During normal times, the US may use several million masks per week. During epidemics, we may need more than 2 billion masks per week (1 per citizen per day).
We can't financially maintain 1000x production capacity for every potential emergency item. Businesses get screwed when they try to provide surplus capacity for our nation that it doesn't need the other 99% of the time: https://www.dallasnews.com/news/watchdog/2020/04/03/if-you-i... Even if we could it would be cost wasteful vs. stockpiles.
People talk about bringing all the production home, but that may be like getting rid of all your off-site backups and doing all backups onsite. It concentrates risk. What if there's a fire/pandemic/regional event that makes it so you need the emergency supplies, but also knocks out your plants that produce those emergency supplies? At least with some plants here, some plants there...if one country gets sick before the other, the currently-not-sick country can provide some supplies to the now-sick country, and vice versa when the pandemic ends in that place and moves to the other.
We probably need at least a 90 day supply of this stuff for the next pandemic. For n95 masks, I guess that's potentially 350 million * 90 days = 31 billion N95 masks. If they expire in 5 years, then we only need to manufacture 500 million per month to keep them up-to-date, and can pay maintainers to keep the supply rotating. We don't have to throw out soon-to-expire masks, we can sell them from the back of the stockpile at a small discount to end-users who need them regularly, like normal hospital or industrial use.
> building out the production capacity to actually be able to make PPE in sufficient quantities
as you put it, would require us to be able to make 10 billion masks per month (350 million * 30days), instead of just half a billion per month. Thats way more expensive. And those plants would sit idle for decades - who knows if they'd even turn on again? A rotating stockpile can be sold to hospitals for regular use, so we could constantly validate that the goods are good.
There are a few practical issues with this massive stockpile idea. Firstly, this pandemic looks like it might go on for about a year rather than 90 days, which puts the stockpile size required to have one mask a day for everyone to more like 130 billion masks. With a five-year lifespan, that means producing about 2 billion a month, only a fifth the rate at which you'd have to produce them with no stockpile at all - except you have to do that all the time, whether there's a pandemic or not, and store, rotate, and dispose of all them. Secondly, you can't just dispose of the expiring masks by selling them to people who'd need them normally, because the pandemic-level demand is so much higher than normal demand that just refreshing the stockpile produces way more masks than we'd normally need. 3M's normal global production of these masks is apparently around 50 million a month, meaning that even your 90-day stockpile would involve continuously producing and disposing of about ten times the normal, non-pandemic demand.
Also, if countries bring their production home with some surge capacity, then this actually gives really great redundancy compared to the status quo because all the countries which do this end up with production capacity that can be used to sell supplies to other countries in the case of some regional crisis there. It's much better than centralizing it in the lowest-cost country as often happens now.
I figure that a 90-day (or so?) supply would buy us the time needed to build additional production facilities to bring us up to the necessary continuous supply.
Taiwan had a huge stockpile, and that let them increase their production from 100,000 N95 masks per day to 20 million per day while drawing down the stockpile. Asia has had success building these factories in ~14 days from pouring cement to startup, USA might need a bit more time of course.
The way forward is sturdier masks that last "forever", with removable filters that can be sterilized in boiling water, exposure to the UVC in sunlight, drenching in household bleach or thorough washing with water and detergent.
This is exactly the way the Czech Republic is going, with several companies now churning out such masks and the government being the bigger buyer. Stockpiling billions of expiration-sensitive disposable masks is more expensive, compared to pre-distributing one reusable mask to every citizen.
>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.
This is pretty much how it went here in Czech Republic - initially outright ban on sale on the PPE needed by medical personnel, that was only removed very recently. And the state (army & fire fighters to be precise) handling all the distribution of PPE. Mainly to hospitals, care homes and also to local municipality offices where local general practitioners could pick them up.
First state distributed the PPE from the (unfortunately rather small) existing emergency stockpile, later from a central warehouse located next to a suitable airport close to the middle of the country where most of the "aerial bridge" cargo aircraft with PPE ordered from China land.
Not everything is rosy though. Ministries buying 40m eur worth medical equipment from some company that had no revenues last year or year before that. One ministry paying double the price for the same thing as the other. And that's not even mentioning how many companies from prime minister's holding are benefitting disproportionately - subsidies, testing, hand sanitizer....
Firefighters played a crucial part in the distribution concept I came up with two weeks ago. Nice to see something like that being implemented!
Do you have any details of how the logistics are run, especially the last mile? Really curious, because I never heard back from German authorities so far.
I'm not sure there is much coverage of that in English - from the local news, it looks like this:
- stuff gets ordered via Czech economic mission in China, communication goes by Chinese speaking Czech experts remotely, coordinating even the planes being loaded and other details
- plane lands in Pardubice/Prague/Ostrava airport
- supplies go to government stockpile in Opočník, designated as the centrail distribution point (from PRague and Ostrava I guess it might go directly to the destination sometimes, as that could be quicker that getting to Opočník & then back)
- army and firefigter transport it from the central stockpile to hispitals/care homes/minicipal offices/to army/firefighters/police who need it
Whats even more nuts is that N95's have taken this level of importance in healthcare at all instead of reusable P100 masks. I read a post on medium the other day about a hospital in Texas that does that and it was being treated as some kind of amazing discovery as if this was some unknown miracle device.
> Whats even more nuts is that N95's have taken this level of importance in healthcare at all instead of reusable P100 masks.
The obvious drawback to using reusable respirators to manage a pandemic disease is that they're another item to become contaminated and spread infection.
Sure, but disinfecting a mask like that is a known protocol. I mean I'd rather wipe down a mask daily than worry about baking my disposable N95 in an oven because there aren't enough. P100's are also more effective at filtering 100% vs 95% filtration.
Those are great but you still have to replace the filters quite often, right? Doesn’t solve the problem as the P100 filters are also sold out, and were in shortages back in January from what I saw.
No, Unless you are using it in a very dirty environment the filters should last 30 days or more. I've had one I use occasionally for wood working for several years and am still using the original filters.
I've found that the P100s tend to make me feel lightheaded pretty quickly. I tried to wear one on a very smoky drive from LA to SF during the fire season last year, but had to take it off after ~45 minutes because I felt my ability to concentrate on the road was being weakened too much. That would definitely be an issue for healthcare workers. I haven't experienced anything similar with an N95.
You might not have been wearing it right. You might also want to get your lungs checked with a spirometry machine a standard test that is done to make sure peoples lungs are healthy before letting the wear a respirator.
I run 3-5 miles most days, so I don’t think it was a lungs issue. I was wearing it very tightly—maybe I made a mistake, but I’m pretty sure it was on right.
The elastomeric masks allow any filter to be used in them. I have N95 pads in mine. Once a week I swap in "OV" (Organic Vapor) cartridges before I go change the cat litter, the activated carbon in the OV cartridges filter out harmful gases like H2S or even Chlorine gas.
Part of the point, is that the flat, simple, small, replaceable pads for the elastomeric masks use less "melt-blown fabric" than the curved, complex, large N95 face masks. Right now lack of the melt-blown-fabric is preventing us from making enough masks. So being able to make more masks from the same fabric would help a lot.
However, the filters do need to be swapped out from time to time. I don't think there's clear guidance on that yet, but there needs to be science backing up any kind of replacement cycle. Once per year would be atrocious, I feel. And of course the rubber itself should be constantly/consistently disinfected as you move between environments or take it off/put it back on.
Industry has been using these masks for years. The masks and filters come with documentation from the manufacture on filter replacement intervals depending on the use case and exact filter medium.
I do largely agree with this, but this is slightly outside of the typical use case for these masks. I'm not an industrial hygienist or other true PPE specialist, but I am a chemical engineer who has decent experience with a wide variety of PPE and it's been difficult for me to determine when I should replace my 6006 cartridges or 5P716 filter pads for home use (cleaning cat litter, preventing coronavirus).
This other brochure essentially implies the OV cartridges last up to 6 months, but those don't filter particulates. It does say however, that N95 masks become more effective as they get "dirtier", at the expense of being able to breathe easily. In this case, a tight seal would be extremely paramount, because eventually it would clog enough that you'd be breathing "around" the mask instead of through it. http://multimedia.3m.com/mws/media/447121O/filter-change-out...
They do have a web tool for calculating service life but it assumes you have at least one chemical contaminant, so the tool simply fails to calculate anything at all for hospital or home use.
The filters meant for chemical contaminants usually have some kind of active absorber ingredient that get used up which is why the replacement intervals are more defined. With particulate (which includes viruses) the only thing you have to worry about is the filter getting clogged or the filter breaking down due to old age but that isn't going to happen with indoor use unless you are talking years. That's why the filter replacement guidelines seems less specific.
And even if you were, was the smoke so severe that the cartridge may have quickly collected so much particulate matter that it was rendered less capable of allowing a high flow of air at a low pressure difference?
Yes, search on Montana Mask. The 3D files are available and you could print them at home. Part of the mask is the filter holder which you can stuff with N1900 or greater furnace filters, vacuum cleaner HEPA bags or whatever.
Edit- sorry, it's not quite like the P100, the filter holder is a rectangle in the center of the mask as opposed to the mask in the article that has two filter holders.
I saw an article saying the 5x markup is because of the air freight, which costs more.
Normally, the masks and other gear, are shipped via boat, and it takes over 30 days to transport it. But this is an emergency, so that lag in transport would have killed even more people and health care workers. Hence, the need to deliver it by air.
The problem is that the air freight companies are now resource constrained, that they are charging 3 to 4 times more than normal. These are the people that are causing the price gouging.
Then, to make matters worse, some European countries went on a media blitz to complain about shoddy Chinese made products. They bought non-medical masks, and were expecting it to be medical grade products!
So they complained about it on Twitter, which forced the China central government to crack down on manufacturers, and only allow “medical grade” certified masks to be shipped. This placed an even larger burden on the supply chain. (However, other masks not stamped with a “medical” label on it, were allowed to normally ship, as a consumer-grade item. So buy it at your own risk.)
So, this resulted in news that some expensive air freight flights, were only returning half-full. The other half was still sitting in the warehouse, awaiting customs export inspection approval, from the new Quality Control regulation.
Then, to make matters even worse, all countries all over the world, are now competing for the same products from China. And the Americans are buying the product outright, and in cash, and paying double or triple, what European countries are paying.
This all adds to the cost per product, which ends up justifying the 5x increase.
The freight costs makes sense and that's a great counterpoint. Thanks!
That said, the government has the ability to cap mask costs per unit and then only charge for shipping or, you know, bring a bunch of C5s and do the freight themselves to get the cargo hours. Or charter planes to help with airline bailouts or...
Instead of hammering the hospitals we have all sorts of options to help here. The fact that the only thing that occurred was HARMFUL to the process says a lot. It must feel pretty weird to be told "you're on your own" and then also have that same crew confiscate your mask shipments. That's what the mafia would do. Would be a shame if something happened to your PPE...
> which forced the China central government to crack down on manufacturers, and only allow “medical grade” certified masks to be shipped.
There is way more to it than that. That was a very convenient pretext for China to legitimise its unofficial exports ban. It reduced the number of exporters to single digits per provice, and even few ones with appropriate licenses are now being turn arond at customs without explanations.
China's official Red Cross, however, seems to have zero problem exporting just anything off the shelf.
Even supplies for which there simply can't be a medical certification are stalling at customs. I know a person who works in medical clothing industry, and they ran into that with... hospital bedsheets.
As of now, the lion share of PPE coming from China is effectively being smuggled out.
> China's official Red Cross, however, seems to have zero problem exporting just anything off the shelf.
> Even supplies for which there simply can't be a medical certification are stalling at customs.
I don't think there is way more ongoing. That's just how things work in China and CCP's distinct way of being incompetent. CCP is known for its intolerance of critics, especially when covered by international news firm. They try their best to avoid it, not considering anything else. When someone in country create buzz, they censor it, sometimes arrest the author. When someone they can't arrest does it, they suppress what they can to "avoid the problem". This is politic and weighted more than anything else. A lot of party members still don't recognize free market and a strong private side as being important, especially Xi. After all they are communist.
In this case, the problem was seen as "some shady businessmen exporting unreliable masks for their own profit and got caught, it harms our 'global image'". So they took them down, switched to assuming everything coming from private side are garbage unless you can prove otherwise.
OTOH, government-ran Red Cross have zero problems because they are "trusted and endorsed".
> In this case, the problem was seen as "some shady businessmen exporting unreliable masks for their own profit and got caught, it harms our 'global image'". So they took them down.
No, no, no, no. The point I make is very different. Don't think of them as that dumb.
While, yes, a giant amount of PPE is now being exported in contravention of the ban, the very few well connected companies are making 8 digit sums per day thanks to it.
Also, the Chinese red cross is now very happy with PPE makers having no way to sell their stuff to the West, because now they can buy piles of it on the cheap for export through their "special channel."
The same thing has happened during the ASF outbreak last year. Pork prices soared N-fold, state media were all screaming murder, the national pork reserve was unsealed, but... at the same time, pork importation was quietly banned using overzealous sanitary inspections, culls of otherwise healthy pigs were ordered, and somebody made billions.
it's not cheap even domestically, N95 china retail price is 20RMB right now (not like 3M, domestic brands). Compare to US price ~$6-7 most of that difference is shipping. The price inflation goes all the way to the source production equipment and raw materials, it's every step.
I haven't seen N95 prices that cheap here in weeks. Anything I see is mostly around 30RMB right now (like a 3Q with NIOSH certification). KN95s are still lower.
We've talked with multiple vendors who simply can't get non-woven material stock at all and are having to turn away orders.
It reminds me of Operation Barbarossa. Many reconnaissance pilots rang the alarm about the huge buildup of German forces near the Soviet border (in Poland). They weren't only ignored, but threatened. That continued even early into the German attack. German soldiers swam across the river to warn the Soviets. They were shot as enemy agents.
You don't prevent a fire by taking the piles out of the smoke detector.
If you build a culture where reporting problems is dangerous, you'll only hear good news that can be shared and catastrophic news that can't be ignored.
I know the Chinese government has been pushing the narrative that it was those European countries fault for buying the wrong product, but it's just not true. Everyone is perfectly OK with using non-medical industrial filtration masks under the circumstances. The reason that European countries have had to recall a bunch of Chinese masks is that they didn't meet the filtration standard they claimed to be made to, full stop. They let through substantially more particles than the standard allowed when tested. They also failed fit testing, which would make them unusable anyway.
These masks failed quality tests, but they were made by private manufacturers in China, that had no relation to the China government.
However, because they are stamped, “Made in China”, then they tarnished China’s international image.
And the European countries really didn’t help themselves here, when they did their media blitz, and claimed that the China-made masks were defective. Thereby insinuating that every single mask that is shipped out of China, is under the control and responsibility of the central China government.
Then, the entire Twitterverse lit up in laughter as: “Ha ha! See, we told you so! China only makes piece-of-shit crap! Now, they are selling us crappy medical products too!”
No it doesn't support that narrative. The claim in the comment I'm replying to is that the masks made by those private manufacturers weren't defective at all, and that the European purchasers went on an unfair "media blitz to complain about shoddy Chinese made products" when actually it was their fault for ordering the wrong kind of masks. That claim is completely and utterly false. The kind of mask they'd ordered would've worked perfectly well for their purpose if it was actually as described rather than a shoddy imitation that was, to quote the Dutch media reports, "some sort of FFP0.8 at best" instead of the roughly FFP2 it should've been.
Price ceilings cause shortages. Every time. Let’s not use Venezuelan-style economic illiteracy as a model for how to incentivize the flow of critical supplies to those who need it most during a crisis.
It's not hard to argue in favour of temporary emergency price controls using Econ 101. The field already makes a big distinction between the short-term and long-term, defining the later by the time required for new investments in production. That distinction is the crux of the shortage, so it seems it's with the bounds of what an introductory microeconomics course could handle.
No, this isn’t really true. Look at all the people hoarding toilet paper because the price is below market equilibrium. If the price were higher, there would be less hoarding, and more people could wipe themselves.
Not this BS again. For the nth time, the model of supply and demand you are familiar with depends on perfect competition, which involves transparency, substitutability, and frictionless entry and exit. When those conditions don't exist your idealized economic model will not operate efficiently and may not clear at all.
this is in every economics textbook and students are cautioned about differences between idealized models and real markets, but economic ideologues never seem to read that part.
I wonder how anyone can write a comment like this and think that our economic model is not completely broken for anything other than making one group richer.
This is only true if you can’t make more. If you can high prices are a powerful incentive for entrepreneurs to make more. When something is needed really badly for public health reasons the government should either be paying top dollar for delivery as close as possible to right now or paying up front for later delivery at a premium to normal prices. That way the manufacturers of what you want don’t pass on the extra sales for fear of going bankrupt.
They can't - and that's simply because there's not enough of them and nothing can circumvent that fact quickly. Let's not pretend you can solve a public health crisis with monetary policy.
Venezuela's problems come from international banking controls combined with hyperinflation and mandates to not increase prices. When you have a currency losing its value every week and the government mandating 10 cent gas with no way to transact with the outside world and escape your currency, things are going to get very distorted.
Venezuela has much bigger problems than price caps, it is not indicative of systemic ramifications either way here.
I also help with buying PPE currently and it's not 5x markup by the seller only. Everything got more expensive. Input material, machines, shipping. This results in the final price being 5x (or more). It's not the greed of one sales person (mostly).
Most factories I work with are NOT looking to take advantage of the situation. It actually hurts them because they can't accept new orders when they don't know the future cost of raw material next week.
> Instead, the government could institute price controls and distribute directly to those in need or allow all private purchases to go throug
Every country in the world is hunting for N95s right now. For the US to institute price controls just means the supply will shift to another country that doesn’t.
If the top 10 bidders are all Americans (which is plausible, given America's wealth and inflated healthcare costs), the U.S. government could use price controls to drive the price down from the 2nd highest to the 10th highest bid without losing supply to other countries. There's still the possibility that driving prices down would push manufacturers out of the business (or more likely, fail to pull in manufacturers who otherwise would have started producing PPE).
The 5x markup is basically in line with the increase in material cost and increase in risk of importing. The melt blown fabric prices have been increasing dramatically since January when China ramped up production.
I'm not sure what you're complaining about then. This is exactly what those federal agents attempted to do (and chose not to do). Are you saying it'd be preferable if these masks were seized by the Feds and sent to e.g. New York?
>> institute price controls
That's a very good way to ensure those masks go to other buyers. I'm just not sure that's what you were aiming for.
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.