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Why the U.S. still has a shortage of N95 masks



Although federal officials have not changed their guidance on medical masks, experts’ suggestions are prompting questions about whether and how to access these face coverings as the new virus variants threaten the country’s tenuous progress against the outbreak.

Do we have enough medical masks yet?

While the initial shortage has abated, there still aren’t nearly enough medical masks for health-care workers, let alone other people. Demand for N95s is 500 to 1,000 percent higher than it was a year ago, said Megan Ranney, co-founder of Get Us PPE, which helps frontline workers obtain personal protective equipment.

Even many health-care workers at well-financed hospitals wear N95s for anywhere from a day to a month, instead of changing them in between patients like they did pre-pandemic. Smaller facilities are struggling even more, Ranney said. Some are relying on KN95s, a Chinese equivalent that U.S. health-care workers consider less desirable.

N95s, which once cost $1 or less each, now sell for up to $5. And for both N95s and KN95s, a surge of fraudulent or faulty products on the market has sometimes made identifying high-quality options difficult.

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“Everyone is cutting corners,” Ranney said. “There is no health-care facility in the country that is using PPE the way that it did pre-pandemic.”

Why is there still a shortage?

Both the market for N95 masks and the national stockpile were small before the pandemic began. The U.S. imported at least half of its PPE, including medical masks, from China, where exports shrank for months when the virus outbreak began, said Scott Paul, president of the Alliance for American Manufacturing, a nonprofit that advocates for public policies to benefit U.S. manufacturers.

Major suppliers, like 3M and Honeywell, dramatically scaled up production last spring and summer, but didn’t come close to the 3.5 billion masks that federal officials estimated were needed to fight the pandemic. Barriers to entry, like uncertainty about demand post-pandemic, discouraged other companies from entering the market, Paul said.

The Trump administration took a relatively hands-off approach to incentivizing the manufacturing of N95s. Federal officials arranged contracts with manufacturers, but Trump mostly avoided using the Korean War-era Defense Production Act to compel companies to produce more masks.

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“I think it’s fair to say that there were some efforts,” Paul said, “but those fell short, as well-intentioned as they may be.”

How can I tell if a medical mask is high-quality?

Unlike N95 masks, KN95s are easy to find through online retailers, major chain stores and pharmacies.

If you’re going to buy KN95s, choose a type that has gotten emergency use authorization from the Food and Drug Administration, said Anne Miller, executive director of Project N95, a nonprofit that helps health-care and essential workers access protective equipment. The FDA keeps a list of approved products, which the agency refers to as “respirator models manufactured in China.”

The CDC’s National Institute for Occupational Safety and Health also maintains a website about counterfeit N95s for reference.

Whatever face covering you choose should form a tight seal around your face so that air can’t easily escape.

If I buy medical masks, am I taking them away from health-care workers?

It’s not clear whether buying N95s on the open market affects the number of masks available to doctors and nurses, whose contact with covid-19 patients puts them at heightened risk of infection. Health-care facilities don’t usually get N95s from the retailers where a non-health worker might buy them, said Tom Frieden, former director of the Centers for Disease Control and Prevention.

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But Ranney cautioned that while shortages persist, there’s no way to guarantee that buying an N95 doesn’t mean one fewer mask for a doctor. Instead, she suggested choosing KN95s or KF94s, a Korean-made equivalent.

Do other countries have enough N95s?

Several countries have made N95s or their equivalents widely available to the public.

In Europe, medical masks have recently become more easily accessible and are widely available in pharmacies. Austrian grocery stores distributed free masks last month after the government mandated them in stores and on public transportation.

Germany launched a $3 billion program in December to give three free medical masks to older people or those with preexisting conditions — about one-third of the population. The southern state of Bavaria recently made N95 equivalents mandatory in some public settings.

Will the U.S. supply of these masks increase?

Although President Biden signed an executive order last month expressing a need to develop a sustainable PPE supply chain, his administration has not released a specific plan to increase manufacturing. White House press secretary Jen Psaki has suggested that any additional supply would be directed toward health-care workers involved in vaccinations.

Biden’s stimulus proposal also requested $30 billion for “supplies and protective gear,” but Congress has yet to strike a deal on a plan.

Ensuring greater access to medical masks, for health-care workers and others, should be a critical part of the U.S. response as more transmissible variants threaten to reverse declining infections, said Abraar Karan, an internal-medicine doctor at Brigham and Women’s Hospital and Harvard Medical School.

“As the virus gets better,” he said, “we need to get better in our response.”

Fenit Nirappil, Rick Noack and Isaac Stanley-Becker contributed to this report.



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