I do China sourcing and have decent access to 3-ply surgical masks and limited access to N95 masks.
It's really hard to sell either of those to government bodies, even near cost. Already talked to the Red Cross, wholesale pharmacies and different ministries. They generally insist on payment on delivery, which we can't do for larger orders, as factories sell to whoever has the cash at the factory gate.
Some also want EU certifications (FFP2), while many factories in China only have the local Chinese standard (KN95). And some refuse to pay to a company outside Europa, while wanting to buy stuff from China.
So while I'd love to ship some of this stuff to Europe, currently people there are still blocking themselves. Hoping to work something out soon.
Why don't they just charge a higher price to buyers who don't pay cash now? I understand there is a lot of demand, but this does not compute with me. My spidey senses would be going off.
Can you email me? Can connect you to US hospitals in hotspots in California that are looking to buy. They’re currently not using PPE in all the situations they should be due to shortages.
You might not see this anymore, but in the hope: I'm saurik@saurik.com and am an elected government official in Southern California (in the United States) working with a nearby regional government, and have just learned that we are also interested in surgical masks (I had previously thought we were only interested in N95 masks). Are you also interested in shipping to the US?
I’m working on a fundraiser to help with Corona. Initially our idea was to donate straight to e.g. the WHO. What is the most efficient way to spend money right now?
Last I heard, my employer (large hospital in New York) is looking to buy. If you could reach out by email, I will pass it along to the relevant people. Thanks!
Let this be a lesson to learn for western democracies to not put all of their eggs in one basket. Diversification, localization and strategic globalization of the supply chain should be at the forefront of the issues to be discussed, ratified and acted upon after this pandemic is over. When one country manufactures 90% of world's goods (not accurate, to make a point), while the top 1% gets their bonuses for increasing profit margins, this is what we have. We've lost skills, we've lost our stance to manufacture things in our own homeland. It is depressing, deeply worrying and feels like the entire world has been gutted out by one country. Just to make it clear - think about this scenario - what would happen if one country made the food for the rest of the world? (Thankfully, we don't, but it can happen). What about pharmaceuticals? (Unfortunately, 90% of the world's generic drugs are made in Asia, primarily in India who in turn depends on China) [1].
Edit: I just realized that some of the startup and entrepreneurs around the world are on this forum, if you'd like to get into manufacturing, want to learn about more abstract concepts of manufacturing, I implore you to checkout: Manufacturing Planning and Control for Supply Chain Management reference book - https://books.google.com/books/about/Manufacturing_Planning_...
This book is absolute gold. Manufacturing is like playing this game Factorio (google it) but in real life. It is an exciting field ripe for innovation, many very hard problems and unlimited potential (and a lot of risk as well).
It is not about autarky, but diversification and resiliency of the supply chain. Automakers are experts at this - BMW cars made in USA (South Carolina) have US made parts and ones made in Germany have locally sourced parts from Germany, yet the ones made in South Africa have diversified sources - both local and international. If you're in the US, you can see this % of locally made parts right on the window price sticker. It's not just for show - if there is a shortage of headliners in US, it can import it for a short term needs from Europe and vice-versa.
No one is suggesting complete in-house isolation aka Autarky, but to avoid SPOF (single point of failure) supply chains - probability of each link breaking adds up when your supply chain is 18 levels deep from an iPhone to the copper mine.
You can't stockpile everything you could need for every potential crisis. At an individual level, think of extreme preppers that have huge tanks full of water, years of storable food, an arsenal of guns, etc. This only covers a small set of scenarios, but the cost is unaffordable on a national scale.
What makes a country resilient is not stockpiles, although those help, but the ability to quickly switch production to whatever is needed in the moment. Flexible production capacity trumps stockpiles, because you don't have to decide in advance what the crisis will be.
Unfortunately all of the flexible production is now in a country that's accusing the U.S. of deploying SARS-CoV2 as a bioweapon over Wuhan.
I thought before that it was someone eating a bat, but the hard propaganda push is making me suspect something more sinister that the Chinese are afraid will come out eventually, and they want to muddy the waters before it does.
But can this be done without abandoning capitalism as a primary driving economic model? It would require a reversal in economic steering (tariffs, government intervention, etc) of enormous scale. The only thing that has come to matter is the hunt to squeeze every penny, we have forgotten to do anything else.
The government funds some percent of our food production by putting in place limited price and production controls for American-produced goods.
The hand of the market is not completely removed: producers still want to be as efficient as possible. The cost of food has gone down over time. And inefficient producers still go bankrupt.
Is this a good model? I have no idea. It certainly has drawbacks. (Ex: we subsidize too much corn and wheat.) But the US can feed itself without China or OPEC, so that's nice.
This is what will happen to the 1000 bucks that they deposit in all accounts.
People don't get the number of systems that will automatically target the most vulnerable/easily exploitable as soon as a deposit shows up, is a much bigger issue than actually handing cash out to people.
The "squeeze every penny" mega machine has grown so complex and large its hard to see how it can be dismantled.
Tariffs result in domestic industries that can't compete. Germany has an export oriented manufacturing sector that employs lots of people and the US doesn't not because of Chins but because of US management.
I don't have a good answer. First and foremost, the shipping rates for consumer goods from China is outrageously low. People buying from Germany to Australia to USA - $2 shipped PCBs and $4 toys shipped - all have one thing in common: Shipping cost is highly subsized because of this treaty - https://www.vox.com/2018/10/19/17996378/trump-china-universa...
Locally made goods can benefit from some tax breaks and government subsidies as well, but the aforementioned problem needs to be resolved. Alas, it won't be because executives keep lobbying and paying off key decision makers.
The whole thing is corrupt. I don't agree with President Trump on majority of things, but I try to not let bias triumph over logic, pragmatism and rational ideas; no matter who is pushing them.
There is reason to believe that the hospital mask shortage is due in no small part to employee (and patient/family) theft of masks and not necessarily due to dramatically increased need at hospitals (at least not yet).
I say this as a resident physician at an urban hospital in the US. We're now severely low on N95 masks and moderately low on surgical masks but we have only had less than a dozen confirmed covid-19 cases (granted about 100 tested negative cases) so there's no way even 100 additional patients requiring masks suddenly plummeted our stockpiles of masks. Indeed, hospital administration noticed and sent out a mass email imploring employees to return unused masks in personal possession.
EMS provider in WA state - our current plan is "Assign N95 to provider. Use on calls as appropriate. If pt has flu-like symptoms/ upper respiratory/ etc, place mask in paper bag in warm space, write date. Re-use after two weeks (i.e. a safe time for virus to die)". Otherwise, re-use as needed. Disposal in case of blood/sputum/etc contamination, only.
Perhaps theft can explain the reduction, but isn't that equivalent to (for example) a leaky toilet destroying the room that the masks are in? In other words, perhaps it is still indicative a weakness in the hospital's supply chain that they can't make up for a sudden shortage of masks due to rare circumstances.
Oh there's definitely a supply chain issue now; we're not going to be able to re-stock anytime soon is my understanding. So there was absolutely a high degree of unpreparedness at many levels. However, we already nearly depleted our masks and we haven't even had a significant spike in need yet.
If people hadn't been stealing masks for their own personal use outside the hospital, we probably could have had our supplies last another few weeks, which is significant.
I'm honestly very conflicted now that you mention this. Yesterday some friends hit me up to donate to a gofundme page to support getting masks for a hospital a friend works at. It's a state university hospital with hundreds of millions in endowment in a red state.
It's easy to become jaded and cynical, but I'm beginning to believe this is the wake up call a lot of people need and anything less than an unmitigated disaster will be converted into a win to all these science denying, public health de-funding radicals running some governments.
It's probably the stress, anxiety and anger at the impotence caused by all this, but I can't help but feel a desire to lash out those people who have made things worse.
This. There are barely any covid 19 patients yet hospitals are low on masks due to panic. Beds are still open and ventilators contrary to media claims are not currently on a shortage.
There are also not nearly as many tests being run as there are patients with suspect symptoms. Yes, the number of confirmed COVID-19 patients may be low, but that doesn't mean that the number of people with the disease is low.
According to the CDC[1], you can contact your healthcare provider for the possibility of a test if (and only if) you are in close contact with someone with the disease or if you're in a community where there's ongoing spread. That's still a very limited subset of people who might have the disease.
There's very limited insight into who does or does not have the disease in the US.
My family (and myself) work as various healthcare providers.
One of them said a few days ago masks and other supplies were stolen from a delivery truck that was broken into as the driver went in to start the delivery to the hospital.
My sense is there's a lot of leakiness in supply of various forms.
My experience is similar to those of others here: it's not really clear there's a substantial increased patient count at the hospitals here, test or not, but supplies are getting scarcer. Maybe other areas of the country or world are creating shortages.
Testing is a mess, but that's a different issue, one maybe more relevant to public health and policies in some ways.
Again severe failure on the govt’s part. Their inaction in when it was needed the most led to all these circumstances that makes it ripe for situations like these. As the number of infections spread and economic situation get worse these kind of things will get really really bad. Once the second and third order effects kick in it’s going to be a catastrophe. And our leaders answer to all of this is to give $1200 checks to people. All they care is about the economy as it gives them higher odds for their reelection. I don’t understand how such incompetence can be tolerated and why they are not fired and instead have to wait till next election.
Agree. Active citizenry is the cornerstone of democracy. That’s why we have elected officials. But when they are unfit for the job and it doesn’t mean you blindly follow them to the abyss. There is something to be said for course correction and not waiting for the next cycle to make changes while millions of people get impacted. There is no doubt that people will needlessly die due to our abject failure to provide these test kits in a timely manner. Maintaining status quo / Dealing with things just for sake of tradition dosnt make sense in 2020. By that logic we should still not have women’s rights and continue on slavery because that’s the way it had been for so long? The leaders can do whatever they want and we have to wait for the next cycle beastie that’s the way things have always been?
I elected people to govern. If I have to govern for them, what exactly are they being paid to do again? Besides, what we need during a crisis is expedient, logical decision making, not incredibly slow and decentralized power.
That seems like a complete non sequitur, but it reminds me of an old joke.
1. Elect people who don’t believe in government 2. Get shocked when they do a poor job. 3. ??? 4. Profit
More seriously, I don’t think this is the kind of situation where people are ever going to be happy with how it’s handled. But, governments can do a better or worse job.
Would private industry have won WW2 on its own, or put humans on the moon? That’s the level of commitment and organization that is now required. Private industry is great at many things, but sacrificing profit for a shared goal is not one of them.
I would say I want more tests kits, more protective gear for health professionals, more unified and clear communication. What use are said laws and elections if they are not able to provide security for the citizens. They sound great in theory and that about it. Because of these clowns so many people are going to pay with their lives or their daily livelihoods or both. If the only option to removing incompetent people from gov is a military coup then we have a bigger fundamental problem. It can’t be binary. World can and does operate in shades or gray. So no military coup is not what I want.
I keep seeing articles like this pop up. During one of the first coronavirus press conferences, the White House invited CEOs from Walmart, Target, CVS, etc. – presumably to show strength of the private sector.
On the flip side, why can't we enlist money and resources from the private sector to quickly fix some of these supply issues? For example:
- Convert car factories to produce masks and ventilators.
- Convert construction companies to build makeshift hospitals. (Or use hotels.)
- Use tech companies to improve national information access with regards to CV19 testing and track and help patients using their software on their phones to help with contact tracing.
I realize that it's not as simple as pressing a button and instantly converting a factory that makes Teslas into one that makes masks. I also realize there are potential privacy concerns with nationalized information tracking.
But, we're about to enter an unprecedented public health crisis. We have resources that can lessen the impact if we just align and get behind this direction.
I can't help but think we could do more and not just wait for the shortage to happen, and for the curve to spike.
We stockpile enough nukes to basically destroy the whole Earth (exaggeration but you get the idea), but we can't stockpile some ventilators and face masks in case of a pandemic? You can't fight a pandemic with diplomacy. At least you can fight a foreign enemy with that.
Turns out N95 masks are quite high-tech, and even China is having trouble scaling up its production. They're made of a material, meltblown fabric, which only a limited number of factories are capable of producing.
IDK. I get that it's a hard problem, but it's a solvable one. It's not like it's some equation or law of science that needs to be discovered. It can be solved with money and effort. :\ I get the economics don't work out in normal times for a reserve like this, but that's exactly what an insurance policy (i.e. a federal reserve of medical supplies) is for.
It's just like nukes. We have a stockpile of them that are maintained... nukes are very hard to produce... etc. etc.
The only real facility for high volume production in the US is 3M in Minnesota, I believe. Current estimates place supply chain matching demand in 80-90 days (though I don't know if that's domestic or worldwide).
The problem is harder if we demand flexible fabric. That isn't how gas masks are done. With a canister filter, all sorts of options become possible. We could use sintered glass, ceramic, or metal. We might be able to use aerogel, diatomaceous earth, or metal foam. We could even go electronic, with a UV light.
Filters with greater air flow resistance can be used if we add a blower. Remember that the virus can enter via eyes. Eyes need protection. Eyes also need air, and it can't be humid or the protection will fog up. For this too, a blower would help.
You need the tools, but you don't have them. So you need the tools that make the tools. But you don't have those either. So you have two layers of tools you need to make from basic tools. Then you need supply chains for all the inputs. It's not as easy as waving a magic wand. But I do suspect that if we had started in January something could have been done.
> we're about to enter an unprecedented public health crisis.
this is where you lose me... it’s not unprecedented, quite the opposite. Throughout all human history this has been common. Recently (since WWII), we’ve been able to limit the lethality of most diseases and/or reduce transmissions.
But this should have been prepared for. They (the government) even had a playbook for it, they had evidence it could even be from this family of viruses.
This is a massive mistake by hundreds of our leaders.
While it's obviously not unpredictable, it was a widespread failure, across a range of political systems - EU, China, and US. We've seen success at scale in SK, which is a smaller, homogenous, high-conformity democracy.
In theory, a free-market democracy would solve the misallocations caused by these blunders more efficiently than the other systems. But the US doesn't have a free-market healthcare system -- or even a free-market mask manufacturing system. As this thread indicates, we're about to see a lot of people die from red tape in Western countries.
I understand. But, it's about keeping a reserve. On one hand, it's wasteful. On the other hand, a maintained reserve can save lives. This is a problem that can be solved with money.
Planet Money did a great episode recently on how the US government is currently paying for a year-round supply of chicken eggs to produce vaccine for a pandemic flu. (https://www.npr.org/transcripts/812943907).
I understand this situation is different from eggs, as an egg not used for a vaccine can be converted to feed, but in the end it's all about money. It's like an insurance policy. I pay for auto insurance but don't use it until I really need it.
> But in a subsequent tweet on Wednesday evening, Trump indicated that even though he invoked the act, he is in no rush to use it.
> "I only signed the Defense Production Act to combat the Chinese Virus should we need to invoke it in a worst- case scenario in the future," he said. "Hopefully there will be no need, but we are all in this TOGETHER!"
The ER docs at my wife’s hospital this morning were wearing pediatric masks with Disney characters emblazoned on them. And this is in a major suburban hospital.
The inability to just requisition, demand resource, mobilize people and so-forth, is breathtaking here. The start of WWII saw the quick re-purposing of industries for the war effort.
Today, it seems an inability to see what's necessary and get it to people is disturbing. The situation is effectively a war and one that's being fought very quickly.
I could brainstorm and mention the "fast fashion" is renown for creating conventional clothing to a variety of specifications, quickly. It seems like that talent could be harnessed for various kinds of safety equipment. Just an example, I'm sure there are a hundred similar things conceivable but despite the looming collapse of conventional procedures, somehow all bureaucratic hurdles remain in place.
Readit News
It's really hard to sell either of those to government bodies, even near cost. Already talked to the Red Cross, wholesale pharmacies and different ministries. They generally insist on payment on delivery, which we can't do for larger orders, as factories sell to whoever has the cash at the factory gate.
Some also want EU certifications (FFP2), while many factories in China only have the local Chinese standard (KN95). And some refuse to pay to a company outside Europa, while wanting to buy stuff from China.
So while I'd love to ship some of this stuff to Europe, currently people there are still blocking themselves. Hoping to work something out soon.
Deleted Comment
[1] China is the world's largest raw materials exporter for Drugs: https://www.wsj.com/articles/china-opens-door-to-foreign-dru...
Edit: I just realized that some of the startup and entrepreneurs around the world are on this forum, if you'd like to get into manufacturing, want to learn about more abstract concepts of manufacturing, I implore you to checkout: Manufacturing Planning and Control for Supply Chain Management reference book - https://books.google.com/books/about/Manufacturing_Planning_... This book is absolute gold. Manufacturing is like playing this game Factorio (google it) but in real life. It is an exciting field ripe for innovation, many very hard problems and unlimited potential (and a lot of risk as well).
No one is suggesting complete in-house isolation aka Autarky, but to avoid SPOF (single point of failure) supply chains - probability of each link breaking adds up when your supply chain is 18 levels deep from an iPhone to the copper mine.
What makes a country resilient is not stockpiles, although those help, but the ability to quickly switch production to whatever is needed in the moment. Flexible production capacity trumps stockpiles, because you don't have to decide in advance what the crisis will be.
Unfortunately all of the flexible production is now in a country that's accusing the U.S. of deploying SARS-CoV2 as a bioweapon over Wuhan.
I thought before that it was someone eating a bat, but the hard propaganda push is making me suspect something more sinister that the Chinese are afraid will come out eventually, and they want to muddy the waters before it does.
Sum({Some percentage of total use / year} * {Storage costs}) over {All strategic materials}
And remember, all strategic materials would have to extend to things like non-woven fabric to be useful here.
The government funds some percent of our food production by putting in place limited price and production controls for American-produced goods.
The hand of the market is not completely removed: producers still want to be as efficient as possible. The cost of food has gone down over time. And inefficient producers still go bankrupt.
Is this a good model? I have no idea. It certainly has drawbacks. (Ex: we subsidize too much corn and wheat.) But the US can feed itself without China or OPEC, so that's nice.
People don't get the number of systems that will automatically target the most vulnerable/easily exploitable as soon as a deposit shows up, is a much bigger issue than actually handing cash out to people.
The "squeeze every penny" mega machine has grown so complex and large its hard to see how it can be dismantled.
Specifcally, the problem is the Universal Postal Union: https://en.wikipedia.org/wiki/Universal_Postal_Union
Locally made goods can benefit from some tax breaks and government subsidies as well, but the aforementioned problem needs to be resolved. Alas, it won't be because executives keep lobbying and paying off key decision makers.
The whole thing is corrupt. I don't agree with President Trump on majority of things, but I try to not let bias triumph over logic, pragmatism and rational ideas; no matter who is pushing them.
I say this as a resident physician at an urban hospital in the US. We're now severely low on N95 masks and moderately low on surgical masks but we have only had less than a dozen confirmed covid-19 cases (granted about 100 tested negative cases) so there's no way even 100 additional patients requiring masks suddenly plummeted our stockpiles of masks. Indeed, hospital administration noticed and sent out a mass email imploring employees to return unused masks in personal possession.
https://www.phe.gov/about/sns/Pages/default.aspx
Perhaps theft can explain the reduction, but isn't that equivalent to (for example) a leaky toilet destroying the room that the masks are in? In other words, perhaps it is still indicative a weakness in the hospital's supply chain that they can't make up for a sudden shortage of masks due to rare circumstances.
If people hadn't been stealing masks for their own personal use outside the hospital, we probably could have had our supplies last another few weeks, which is significant.
It's easy to become jaded and cynical, but I'm beginning to believe this is the wake up call a lot of people need and anything less than an unmitigated disaster will be converted into a win to all these science denying, public health de-funding radicals running some governments.
It's probably the stress, anxiety and anger at the impotence caused by all this, but I can't help but feel a desire to lash out those people who have made things worse.
According to the CDC[1], you can contact your healthcare provider for the possibility of a test if (and only if) you are in close contact with someone with the disease or if you're in a community where there's ongoing spread. That's still a very limited subset of people who might have the disease.
There's very limited insight into who does or does not have the disease in the US.
[1]https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/t...
One of them said a few days ago masks and other supplies were stolen from a delivery truck that was broken into as the driver went in to start the delivery to the hospital.
My sense is there's a lot of leakiness in supply of various forms.
My experience is similar to those of others here: it's not really clear there's a substantial increased patient count at the hospitals here, test or not, but supplies are getting scarcer. Maybe other areas of the country or world are creating shortages.
Testing is a mess, but that's a different issue, one maybe more relevant to public health and policies in some ways.
Dead Comment
If you live in a democracy, then you are part of the government. You can't just blame other people for this.
Deleted Comment
Not that I think it would have really mattered. All the western countries were struck by surprise it seems, even though they had months to prepare.
Dead Comment
Just imagine how bad it would be if we turned industry over to the government to run, too.
1. Elect people who don’t believe in government 2. Get shocked when they do a poor job. 3. ??? 4. Profit
More seriously, I don’t think this is the kind of situation where people are ever going to be happy with how it’s handled. But, governments can do a better or worse job.
Because we still have laws, and elections. What do you want a military coup?
On the flip side, why can't we enlist money and resources from the private sector to quickly fix some of these supply issues? For example:
- Convert car factories to produce masks and ventilators.
- Convert construction companies to build makeshift hospitals. (Or use hotels.)
- Use tech companies to improve national information access with regards to CV19 testing and track and help patients using their software on their phones to help with contact tracing.
I realize that it's not as simple as pressing a button and instantly converting a factory that makes Teslas into one that makes masks. I also realize there are potential privacy concerns with nationalized information tracking.
But, we're about to enter an unprecedented public health crisis. We have resources that can lessen the impact if we just align and get behind this direction.
I can't help but think we could do more and not just wait for the shortage to happen, and for the curve to spike.
We stockpile enough nukes to basically destroy the whole Earth (exaggeration but you get the idea), but we can't stockpile some ventilators and face masks in case of a pandemic? You can't fight a pandemic with diplomacy. At least you can fight a foreign enemy with that.
https://www.npr.org/sections/goatsandsoda/2020/03/16/8149292...
It's just like nukes. We have a stockpile of them that are maintained... nukes are very hard to produce... etc. etc.
Filters with greater air flow resistance can be used if we add a blower. Remember that the virus can enter via eyes. Eyes need protection. Eyes also need air, and it can't be humid or the protection will fog up. For this too, a blower would help.
If we (America) can't scale up we are in deep doodoo. Trump has been pissing off China by calling the Corona virus the "China Virus".
this is where you lose me... it’s not unprecedented, quite the opposite. Throughout all human history this has been common. Recently (since WWII), we’ve been able to limit the lethality of most diseases and/or reduce transmissions.
But this should have been prepared for. They (the government) even had a playbook for it, they had evidence it could even be from this family of viruses.
This is a massive mistake by hundreds of our leaders.
In theory, a free-market democracy would solve the misallocations caused by these blunders more efficiently than the other systems. But the US doesn't have a free-market healthcare system -- or even a free-market mask manufacturing system. As this thread indicates, we're about to see a lot of people die from red tape in Western countries.
Planet Money did a great episode recently on how the US government is currently paying for a year-round supply of chicken eggs to produce vaccine for a pandemic flu. (https://www.npr.org/transcripts/812943907).
I understand this situation is different from eggs, as an egg not used for a vaccine can be converted to feed, but in the end it's all about money. It's like an insurance policy. I pay for auto insurance but don't use it until I really need it.
> But in a subsequent tweet on Wednesday evening, Trump indicated that even though he invoked the act, he is in no rush to use it.
> "I only signed the Defense Production Act to combat the Chinese Virus should we need to invoke it in a worst- case scenario in the future," he said. "Hopefully there will be no need, but we are all in this TOGETHER!"
Today, it seems an inability to see what's necessary and get it to people is disturbing. The situation is effectively a war and one that's being fought very quickly.
I could brainstorm and mention the "fast fashion" is renown for creating conventional clothing to a variety of specifications, quickly. It seems like that talent could be harnessed for various kinds of safety equipment. Just an example, I'm sure there are a hundred similar things conceivable but despite the looming collapse of conventional procedures, somehow all bureaucratic hurdles remain in place.
Dead Comment