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Health Workers Still Face Shortages Of Critical Medical Supplies

SARAH MCCAMMON, HOST:

First, it was medical masks, then oxygen tanks and plastic pipette tips. Pandemic shortages have sent the country's hospitals, workers, labs and consumers scouring for critical medical supplies, and that does not include the shortage of vaccine. Many of those supplies are made overseas, and manufacturers are scrambling, too. NPR consumer health correspondent Yuki Noguchi joins us now to talk about why we're still facing shortages all these months later. Hi, Yuki.

YUKI NOGUCHI, BYLINE: Good morning.

MCCAMMON: So which supplies are the hardest to come by right now?

NOGUCHI: Well, you know, that list keeps evolving. But right now I'm hearing most about exam gloves. Also, sterilized water and portable oxygen cylinders are hard to find, particularly where COVID is sending a lot of people to the hospital because those are items that are used for respiratory treatment, and those supplies, you know, obviously become stressed when there's a lot of people in the hospital. But there's also stuff used in labs, like plastic pipette tips. You wouldn't normally think of that. So sometimes it's just the piece parts that are in short supply, but that affects a lot of other things. So now that mass vaccinations are about to get underway, that could also lead to different shortages of other items.

MCCAMMON: OK, President Biden invoked the Defense Production Act to compel companies to make more of these medical supplies. Is that going to solve this?

NOGUCHI: Well, you know, that prioritizes U.S. production of supplies, and government agencies have been using that since March, but it's just not a fast fix for a lot of things. Companies are already trying to boost production, and they have been; it's just that the crush of demand is global and sustained, and it's just very hard to meet that kind of demand. You need access to raw materials, and sometimes in order to make more, you need to make a factory first. So the situation with gloves, for example, the rubber components are running low, plus the machines to make them can take two years to build.

So David Hargraves is an executive at Premier, which buys medical products for, like, 40% of the country's hospitals, and he told me this.

DAVID HARGRAVES: There'll be new capacity that'll come online in 2022. Prices then should start to fall. But for this year, we've been urging our members to conserve the gloves they have.

MCCAMMON: So more factories have to be built to make the things that need to be made. Will any of those be here in the U.S.?

NOGUCHI: I think there's, you know, definitely domestic ramp-up here, and that may continue. But, you know, that's reversing a very long trend where we've come to rely on cheaper Asian medical supplies. And when that became unreliable, you know, to start the pandemic, everyone in America went looking for local suppliers. But there just aren't a lot of them.

And I talked to one of them, Prestige Ameritech. It has a factory in Texas making N95 respirators. Those are those molded medical masks that filter the virus. I think this company story's, especially over the last year, is really instructive. And I first talked to the co-owner, Mike Bowen, in February of last year. At the time, of course, supply of N95s were critically low, and the U.S. at the time only had 17 COVID cases. But nearly 3,000 Chinese people had died, and China stopped exporting N95s.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

MIKE BOWEN: We got a request for maybe a billion and a half masks, if you added up all the requests that I've got.

NOGUCHI: A billion and a half - wow.

BOWEN: Yeah.

NOGUCHI: Hospitals, clinics and average people were begging him for supply.

BOWEN: Scared Americans and moms and old people and people saying, help me.

NOGUCHI: This might sound like a huge business windfall, but in fact, the overwhelming demand put Bowen in a tough spot. In order to make more masks, he needed to build more custom machines, each costing as much as a million dollars. But he couldn't justify spending that if American hospitals simply went back to buying much cheaper Chinese masks after the pandemic. Bowen had learned that lesson the hard way. A decade earlier, during the H1N1 flu pandemic, he boosted capacity. Afterward, business dried up as abruptly as it spiked, and Prestige nearly folded. So I recently reached back out to Bowen to see where things stood. Turns out his frantic pace hasn't abated.

BOWEN: Sorry, I'm out of breath.

NOGUCHI: Prestige since tripled its staff. It struck multiyear deals with U.S. hospitals. That helped fund nine new mask machines, and it now makes 80 times as many N95s, all earmarked for U.S. hospital workers.

BOWEN: We were selling 75,000 respirators a month. We're now selling 6 million, and we have another 4 million coming on board.

NOGUCHI: The last year, he says, has felt like five.

BOWEN: It's been the craziest year of my life. I mean, I'm in a movie. How weird is that?

NOGUCHI: We'll get to his Hollywood turn in a minute. Meanwhile, his business has seen lots of plot twists and villains. Fraudulent mask upstarts, Bowen says, sprouted everywhere.

BOWEN: For the last year, everybody's been able to sell anything that looks like a mask.

NOGUCHI: And not just copycat masks. Bowen himself had a fake replica.

BOWEN: There's a Mike Bowen LinkedIn right now. It's not me.

NOGUCHI: Fighting fakes sucked up precious time.

BOWEN: Our website was copied by somebody in India. Several months ago, I was getting calls from people saying, we're about to wire you $1.6 million. Can you make sure it's you? And I said, it's not me - you're being scammed.

NOGUCHI: What irks Bowen most is that he predicted this crisis. Over 13 years, he wrote dozens of letters to presidents and federal officials warning of vulnerabilities in the U.S. supply chain. A pandemic, he told them, would put health workers and the public at risk. As recently as January a year ago, as COVID raged in China, Bowen frantically warned the Trump administration of a coming mask shortage. He says he was ignored. Now, of course, everyone's paying attention. Congress called Bowen to testify in May. He's even featured in the documentary "Totally Under Control," about the Trump administration's pandemic response.

(SOUNDBITE OF DOCUMENTARY, "TOTALLY UNDER CONTROL")

BOWEN: I thought, you know, if I contact enough people in the administration, somebody, one of these people, are going to look at this and go, hey, this is a problem - maybe we ought to call this guy. And no, I couldn't get any - I didn't get any response there.

NOGUCHI: And the drama isn't over. Bowen worries the last year still hasn't changed how hospitals and government think about medical supply.

BOWEN: The entire supply could fail catastrophically if they continue to buy most of their products from outside the United States because when there's a pandemic, countries take care of themselves.

MCCAMMON: OK, Yuki, that raises an interesting question. What would the U.S. government need to change in order to avoid a situation like this in the future?

NOGUCHI: Well, it needs to start with mapping the supply chain, you know, detailed accounting of where and how our medical supplies are made. Right now there's no arm of government that really tracks that. And when you know that, then you can take steps to diversify the sources so the country's less susceptible to major disruptions like these.

MCCAMMON: That's NPR consumer health correspondent Yuki Noguchi. Thanks so much.

NOGUCHI: Thank you, Sarah.

(SOUNDBITE OF HELIOS' "ISOSTACY") Transcript provided by NPR, Copyright NPR.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.