Hospitals in the New York City area are turning to a private distributor to airlift millions of protective masks out of China. The U.S. military is flying specialized swabs out of Italy. And a Chicago-area medical supply firm is taking to the skies as well — because a weekslong boat trip across the ocean just won’t do.

The race to import medical supplies reflects a nationwide panic over a dwindling supply of the masks, gowns and other protective gear that health care workers need amid the growing coronavirus pandemic. Demand is outstripping what’s available due to a damaged supply chain heavily reliant on China and a struggling Strategic National Stockpile. U.S. manufacturing giants like 3M have not yet made up the difference.

A sweeping national survey out Wednesday drives home that nearly a quarter of hospitals have fewer than 100 N95 masks on hand and 20% report an immediate need for ventilators. In the hardest-hit areas, like New York City, the shortages are potentially life-threatening to patients as well as health care workers.

About 260 health systems representing 990 major hospitals responded to the March 16-20 survey by Premier Inc., a group purchasing organization that negotiates with suppliers for discounts. While the survey provides a fresh picture of nationwide hospital operations, the number of U.S. COVID-19 cases has soared tenfold since the survey began ― from fewer than 5,000 to more than 55,000 as of Wednesday afternoon.

“Absent additional interventions from the government or private sector, we don’t foresee the current status quo changing,” said Soumi Saha, senior director of advocacy for Premier. “And the current status quo is not acceptable.”

Saha said the national stockpile “is intended to be a band-aid, not a long-term solution.” Premier called on the Trump administration to either further implement the Defense Production Act to ramp up domestic manufacturing or provide more clear direction on which medical supplies are needed and streamline distribution. FEMA announced Tuesday it did not use the Defense Production Act for test kits after previously stating it would.

The alarm bells ringing from the hospital community come in contrast to a more subdued message from FEMA, which is helping hospitals procure needed goods.

“The private sector can directly purchase [personal protective equipment] from manufacturers and distributors, as they normally do,” FEMA press secretary Lizzie Litzow said in a statement. “The private sector can also accept donations from other private sector entities.” The statement pointed to a “how to help” document that outlines how individuals and companies can share supplies or other resources.

In recent days, volunteer efforts have ramped up to help health providers who’ve taken to Twitter and other social media with pleas for more protective gear. Grassroots efforts have sprung up, with veterinary, computer, construction and industrial businesses donating goods while sewing circles churn out cloth masks.

During a White House press briefing Tuesday, President Donald Trump said FEMA is distributing more than 8 million N95 respirators, 14 million surgical masks and 2.4 million face shields.

“The federal government is using every resource at its disposal to acquire and distribute critical medical supplies,” the president said.

3M, a major American manufacturer of the N95 masks, said on March 20 it had doubled its global output of the crucial N95 respirators and plans to further increase output. Currently, over 30 million industrial and health care specific N95s are being produced for U.S. health care use by the company each month. Shipments totaling half a million 3M masks were scheduled to start arriving in New York and Seattle on Monday from its South Dakota plant.

The influx of goods comes as health care providers are now using four to 10 times more protective gear once a COVID-19 patient enters their doors than they typically use. This has forced hospitals already dealing with cases to scramble even more than health care facilities yet to get any cases, though shortages are crippling all areas of the health care industry.

“It’s a total change in what we are used to as a society around availability,” said Cathy Denning, senior vice president of sourcing operations for Vizient, an analytics and advisory firm that also does health care group purchasing. “From our perspective, it’s this unbelievable place we find ourselves in — realizing we have a vulnerable supply chain.”

As the coronavirus crippled China, the center of commerce for low-margin products like face masks and sanitizing wipes, the U.S. supply chain began to fall apart. With global competition for the same safety gear, the crisis deepened, and big national suppliers aren’t coming up with enough products to meet the crushing demand.

And waiting about a month for a cargo ship of supplies to arrive from China is a luxury of time that hospitals cannot afford ― even though ships can carry over 10 times more supplies than a cargo plane could.

Medline, a Chicago-area medical supplier, started delivering face masks by airplane last week after manufacturing resumed in China. According to spokesperson Stacy Rubenstein, flying the supplies in will shorten the “manufacturing-to-dock” time by three to four weeks, and the firm will not be passing along the “significant increase in cost” to customers.

But the demand is still 300% higher than traditional inventory levels, Rubenstein said in an email.

Elsewhere, hospitals are reaching out to Michael Einhorn, president of Dealmed, the medical products distributor and supplier working with 12 New York metro area hospitals — desperate for products he cannot always secure.

“Does it cost the hospitals a lot of money? No question about it. But right now, that’s what they need to do to secure product,” Einhorn said. “We can’t wait for it to come overseas.”

He’s paying up to $40,000 for shipments arriving on multiple planes from Shanghai to New York’s John F. Kennedy International Airport and Los Angeles International Airport — and sometimes losing money due to the high shipping costs.

The other backstop for hospitals was the national stockpile, which has come up far short.

Despite receiving 49,200 N95 masks, 115,000 surgical masks, 21,420 surgical gowns, 21,800 face shields and 84 coveralls from the national stockpile, the Colorado Department of Public Health and Environment estimated in a press release Monday that those supplies would last approximately one full day of statewide operations.

Einhorn said that hospitals are panicking, having lost faith in the supply chain as they cannot find products they so desperately need.

“The strategic national stockpile, with all due respect, was a failure,” he said.

The hospitals reported in the survey that their supply of N95 masks are their chief concern, with the best-supplied hospitals having about a 10-day supply on hand.

Hospitals identified hand sanitizer as the second-most pressing shortage, with 64% of respondents saying they were already running out. Next was surgical masks, which provide less protection than the N95 masks. Nearly half of hospitals had fewer than 1,000 on hand; a quarter of them reported going through 1,000 per day.

To keep up with that kind of demand, Einhorn said, more needs to be done to secure the products from China.

“One of the things we have been asking for is assistance getting these products quickly from China to here,” said Einhorn. “Instead, we’re doing drives of people dropping off three boxes of face masks.”

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