How the world’s richest country ran out of a 75-cent face mask


Some health care workers have resorted to sewing their own masks as supplies fall short. – Một số nhân viên y tế đã phải tự may khẩu trang cho mình khi nguồn cung bị thiếu hụt.

[Reading level: C1 – Advanced]

Why is the United States running out of face masks for medical workers? How does the world’s wealthiest country find itself in such a tragic and avoidable mess? And how long will it take to get enough protective gear, if that’s even possible now?


I’ve spent the last few days digging into these questions, because the shortages of protective gear, particularly face masks, has struck me as one of the more disturbing absurdities in America’s response to this pandemic.


Yes, it would have been nice to have had early, widespread testing for the coronavirus, the strategy South Korea used to contain its outbreak. It would be amazing if we can avoid running out of ventilators and hospital space, the catastrophe that has befallen parts of Italy. But neither matters much — in fact, no significant intervention is possible — if health care workers cannot even come into contact with coronavirus patients without getting sick themselves.


That’s where cheap, disposable face masks, eye protection, gloves and gowns come in. That we failed to procure enough safety gear for medical workers — not to mention for sick people and for the public, as some health experts might have recommended if masks were not in such low supply — seems astoundingly negligent.


What a small, shameful way for a strong nation to falter: For want of a 75-cent face mask, the kingdom was lost.


I am sorry to say that digging into the mask shortage does little to assuage one’s sense of outrage. The answer to why we’re running out of protective gear involves a very American set of capitalist pathologies — the rise and inevitable lure of low-cost overseas manufacturing, and a strategic failure, at the national level and in the health care industry, to consider seriously the cascading vulnerabilities that flowed from the incentives to reduce costs.


Perhaps the only way to address the shortfall now is to recognize that the market is broken, and to have the government step in to immediately spur global and domestic production. President Trump, bizarrely, has so far resisted ordering companies to produce more supplies and equipment. In the case of masks, manufacturers say they are moving mountains to ramp up production, and some large companies are donating millions of masks from their own reserves.


But given the vast global need for masks — in the United States alone, fighting the coronavirus will consume 3.5 billion face masks, according to an estimate by the Department of Health and Human Services — corporate generosity will fall short. People in the mask business say it will take a few months, at a minimum, to significantly expand production.


“We are at full capacity today, and increased production by building another factory or extending further will take anywhere between three to four months,” said Guillaume Laverdure, the chief operating officer of Medicom, a Canadian company that makes masks and other protective equipment in factories around the world.


And though some nontraditional manufacturers like T-shirt factories and other apparel makers have announced plans to rush-produce masks, it’s unclear that they will be able to meet required safety standards or shift over production in time to answer demand.


Few in the protective equipment industry are surprised by the shortages, because they’ve been predicted for years. In 2005, the George W. Bush administration called for the coordination of domestic production and stockpiling of protective gear in preparation for pandemic influenza. In 2006, Congress approved funds to add protective gear to a national strategic stockpile — among other things, the stockpile collected 52 million surgical face masks and 104 million N95 respirator masks.


But about 100 million masks in the stockpile were deployed in 2009 in the fight against the H1N1 flu pandemic, and the government never bothered to replace them. This month, Alex Azar, secretary of health and human services, testified that there are only about 40 million masks in the stockpile — around 1 percent of the projected national need.


As the coronavirus began to spread in China early this year, a global shortage of protective equipment began to look inevitable. But by then it was too late for the American government to do much about the problem. Two decades ago, most hospital protective gear was made domestically. But like much of the rest of the apparel and consumer products business, face mask manufacturing has since shifted nearly entirely overseas. “China is a producer of 80 percent of masks worldwide,” Laverdure said.


Hospitals began to run out of masks for the same reason that supermarkets ran out of toilet paper — because their “just-in-time” supply chains, which call for holding as little inventory as possible to meet demand, are built to optimize efficiency, not resiliency.


“You’re talking about a commodity item,” said Michael J. Alkire, president of Premier, a company that purchases medical supplies for hospitals and health systems. In the supply chain, he said, “by definition, there’s not going to be a lot of redundancy, because everyone wants the low cost.”


In January, the brittle supply chain began to crack under pressure. To deal with its own outbreak, China began to restrict exports of protective equipment. Then other countries did as well — Taiwan, Germany, France and India took steps to stop exports of medical equipment. That left American hospitals to seek more and more masks from fewer and fewer producers.


People in the industry assured me they would prepare better next time. “We are laserlike focused to ensure that our health care systems are never in this scenario again,” Alkire told me. “There will be a lot more domestic manufacturing of these products going forward.”


I don’t doubt it — but that we did not plan, as a nation, for this entirely predictable shortage makes me wonder what other inevitable pothole is lurking out there for all to trip over. Getting enough protective gear was among the cheapest, most effective things we could have done to slow down the pandemic. That we failed on such an obvious thing reveals an alarming national incapacity to imagine and prepare for the worst.




tragic /ˈtrædʒ.ɪk/ [B2] (adj): bi thảm

mess /mes/ [B1] (n): mớ hỗn độn

protective gear /prəˈtek.tɪv ɡɪər/ (n): đồ bảo hộ

dig into sth /dɪɡ/ (v): nghiên cứu, tìm hiểu về điều gì

strike /straɪk/ (v): khiến ai cảm thấy, khiến ai phải suy nghĩ về điều gì

absurdity /əbˈsɜr·dɪ·t̬i/ (n): điều phi lý

contain /kənˈteɪn/ (v): ngăn chặn, kiểm soát

outbreak /ˈaʊt.breɪk/ [C2] (n): sự bùng phát

ventilator /ˈven.tɪ.leɪ.tər/ (n): máy thở

catastrophe /kəˈtæs.trə.fi/ [C2] (n): thảm họa

befall  /bɪˈfɔːl/ (v): xảy ra (thảm họa, điều tồi tệ)

intervention /ˌɪn.təˈven.ʃən/ [C2] (n): sự can thiệp

disposable /dɪˈspəʊ.zə.bəl/ [C2] (adj): dùng một lần

procure /prəˈkjʊər/ (v): kiếm được, mua được

astoundingly /əˈstaʊn.dɪŋ.li/ (adv): đáng kinh ngạc

negligent /ˈneɡ.lɪ.dʒənt/ [C2] (adj): sơ suất

shameful /ˈʃeɪm.fəl/ [C2] (adj): đáng xấu hổ

falter /ˈfɒl.tər/ (v): chùn bước

want of sth /wɒnt/ (n): sự thiếu cái gì

assuage /əˈsweɪdʒ/ (v): khiến ai đó thấy có chịu

outrage /ˈaʊt.reɪdʒ/ (n): sự phẫn nộ

pathology /pəˈθɒl.ə.dʒi/ (n): bệnh lý

inevitable /ɪˈnev.ɪ.tə.bəl/ [C1] (adj): không thể tránh khỏi

lure /lʊər/ [C2] (n): sức hấp dẫn

cascade /kæsˈkeɪd/ (n): thác nước

vulnerability /ˌvʌl.nər.əˈbɪl.ə.ti/ (n): sự dễ bị tổn thương

incentive /ɪnˈsen.tɪv/ [C2] (n): động cơ, động lực

spur /spɜːr/ [C2] (v): thúc đẩy

bizarrely /bɪˈzɑː.li/ (adv): một cách kỳ lạ

resist /rɪˈzɪst/ [C1] (v): kháng cự, chống lại

move mountains to do sth (idiom): làm mọi việc để làm gì

ramp up /ræmp/ (v): đẩy mạnh

generosity /ˌdʒen.əˈrɒs.ə.ti/ [B2] (n): sự hào phóng

apparel /əˈpær.əl/ (n): hàng may mặc

stockpile /ˈstɒk.paɪl/ (v): dự trữ

Congress /ˈkɒŋ.ɡres/ (n): Quốc hội

respirator mask /ˈres.pɪ.reɪ.tər mɑːsk/ (n): khẩu trang phòng độc

bother /ˈbɒð.ər/ [B2] (v): bận tâm

testify /ˈtes.tɪ.faɪ/ [C2] (v): minh chứng

inventory /ˈɪn.vən.tər.i/ (n): hàng tồn kho

resiliency /rɪˈzɪl.jən.sɪ/ (n): phục hồi

redundancy /rɪˈdʌn.də [C1] (n): sự dư thừa

brittle /ˈbrɪt.əl/ (adj): giòn, dễ vỡ

laserlike /ˈleɪ.zər.laɪk/ (adj): như tia laser

pothole /ˈpɒt.həʊl/ (n): lỗ hổng

lurk /lɜːk/ (v): ẩn nấp


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