Defying the Laws of (Mask) Supply and Demand

History is repeating itself in North Richland Hills, Texas, these days, much to Mike Bowen’s dismay.

Cases of N95 respirators are piled high outside the headquarters of Prestige Ameritech, a medical supply company on Iron Horse Boulevard. “I’m drowning in these respirators,” he told the press in February.

Facemask production has slowed significantly in recent months following a dropoff in orders. Prestige no longer operates its manufacturing lines 24/7, which has prompted talk of layoffs.

Bowen has been down this road before—specifically, 12 years ago during the H1N1 pandemic. Then, like now, Prestige Ameritech ramped up N95 respirator production, hiring extra staff and churning out masks around the clock to meet demand.

That demand eventually waned when the pandemic ended, forcing Bowen to lay off the additional workers he hired. “…we nearly went bankrupt afterward…it was a very brutal situation,” he recalled last spring in an NPR interview.

Although insolvency is not (yet) a danger this time around, the situation is just as brutal for Bowen and other manufacturers caught in the void of a puzzling purgatory-like disconnect between mask supply and demand.

Economics is partly to blame for the disconnect, as U.S. hospitals, medical supply distributors, and state governments prefer cheaper, foreign-made masks for their reserves. Such proclivity has left companies like Prestige with huge stockpiles and no buyers, at home or abroad.

In February, the company received federal permission to export its N95 respirators, a decision that irked clinicians forced to reuse face masks due to lack of supply. Even with the waiver, though, Bowen has still had trouble finding buyers.

“There is a disconnect someplace, and I don’t know where it is,” he grumbled to Kaiser Health News a few months ago. “Why aren’t my phones ringing off the hook if there’s a shortage?”

Luis Arguello Jr., John Bielamowicz, and Lance Brown have asked themselves that same question. Their phones are silent too, leaving them prone to financial loss, layoffs, and potential bankruptcy. Arguello has already furloughed one quarter of the extra workers he hired to manufacture one million masks daily at Miami Lakes, Fla.-based DemeTECH. The pricey new machines Arguello purchased for mask production now sit idle amid the 15 million federally certified N95s that have yet to find homes.

“It’s insane that we can’t get these masks to the people who desperately need them,” Arguello griped to The New York Times.

The paradox is so insane it almost is comical: N95 respirators are in high demand—particularly among front-line healthcare workers—yet mask manufacturers are having trouble finding customers.

Crazy indeed.

Like most forms of lunacy, the disconnect between mask suppliers and buyers is multi-faceted and complicated. Part of the blame goes to miscommunication and poor governance (the Biden administration, for example, has directed federal agencies to boost domestic PPE manufacturing and purchase American-made products, but has failed to link manufacturers and potential customers). Another contributing factor is market mistrust—companies that overpaid for counterfeit or undelivered PPE last year are now wary of new (unknown) manufacturers. These newcomers also are handicapped by ingrained purchasing habits and price; American-made masks typically cost more than their Chinese counterparts (DemeTECH’s 20-count box of N95s retails for $80), but their quality is better. In fact, a study conducted by the non-profit patient safety group ECRI found that up to 70 percent of Chinese KN95s do not meet U.S. standards.

“We’re very expensive,” admitted Arguello, DemeTECH’s vice president. “We’re creating jobs and paying really good salaries—the economic ripple effect is great. But how do we compete? We don’t.”

It’s almost impossible for DemeTECH and other rookie mask manufacturers to compete, really. Not only are their higher prices a deterrent, but the novelty of their products is as well.

Before using a new N95 brand, hospitals must conduct time-consuming fit tests on employees. The fit test requirement was set aside amid the pandemic, however, giving hospitals little incentive to switch from industry-standard models like 3M that have been used for years.

Selling directly to consumers is just as difficult, thanks to Facebook and Google bans on N95 sales and advertising. The tech giants instituted the bans to ensure vital PPE is funneled to front-line healthcare workers but public health experts and mask manufacturers contend the ban is outdated in light of the more contagious variants and glut of domestically-made N95s sitting in warehouses across the country.

“The difficulty I have is I’m not able to advertise, so I can’t let people know [about my masks] on Google, Facebook or Instagram. We’re blocked,” Arquello told NPR. “Chinese face masks that don’t work as well as my NIOSH-approved mask can advertise but I can’t. It’s taken a big personal toll because it’s not like we’re selling a product that’s not needed. We’re laying people off making a product that’s needed, that is in huge shortages in this country. It defies all logic, to be honest with you.”

It defies explanation, too. Disconnect be damned.