Nurses are complaining they are screening possible COVID-19 patients in the emergency room and being sent into COVID-19 patients’ rooms without proper personal protective equipment. The problem is, there isn’t enough personal protective equipment. And why that is so basically boils down to two things: The normal operation of the supply chain, and the orange underwear skid mark.
It’s not a problem of short-sighted administrators not buying PPE. PPE is in short supply for the same reason that toilet paper is in short supply — the supply chain isn’t capable of meeting the demand. Nobody keeps a six month supply of PPE in their supply closet in case of a pandemic, just as nobody keeps a six month supply of TP in their bathroom closet in case of a pandemic — it just won’t *fit*. Hospitals have at most a month’s supply of PPE under *normal* usage, because it’s bulky, has a short lifespan, and has a reliable supply chain where every week they order their usual amount, and a few days later it arrives with the rest of their shipment from their local medical supplies vendor.
Until it doesn’t, because demand for it has basically quadrupled while the supply… hasn’t.
At this point it doesn’t matter how much money administrators want to spend, they can’t get it. The supply chain will at most deliver their “usual” amount, because that’s all the supply chain is *capable* of delivering right now, because no government entity intervened to ramp up the production and stockpiling of PPE months ago despite lack of orders from hospitals for PPE months ago because they had no place in their store rooms to put more PPE. And attempts by suppliers to increase their supplies of PPE are being impacted by the pandemic because much of the economy is shut down and we are finding out just how interrelated the parts of the economy are, as critical things needed to get new PPE factories running turn out to be in as short of supply as PPE.
In January 1942, less than a month after Pearl Harbor, President Franklin D. Roosevelt created the War Production Board comprised of the CEO’s of the biggest manufacturing companies in America to devise a plan to produce all of the weapons needed to win the war. By March 1 2020, over a month after being warned that we had a pandemic that was going to require more supplies than were available in the supply chain, the response of the Trump administration was… [crickets]. That, in the end, is the problem. Not only do we not have the PPE, we don’t even have a *plan* to get the PPE, other than to beg the Chinese for it, which isn’t a plan, it’s an abdication.
One last thing: Should governors have been stocking up on personal protective equipment in February?
Answer: Not really. Look at the supply chain I described above. It’s basically a just-in-time supply chain. The manufacturers make what the distributors order, with as little slack above that as possible because slack resources aren’t making them money. The distributors order what the hospitals order, because keeping large warehouses of PPE around doesn’t make them money, either. And the hospitals order what they can fit into their supply closets, which generally is going to be what they usually use in a month. Unlike the Federal Government with its Defense Production Act, states don’t have the authority to order manufacturers to open up more production of PPE and doesn’t have authority to order distributors to warehouse larger amounts of PPE. The only thing states could have done by attempting to stock up in February would have been to take PPE away from hospitals that needed it, because there wasn’t any more PPE being made than what hospitals already needed. And manufacturers aren’t going to voluntarily add capacity to manufacture more PPE just for a short time use. It takes a lot of money to build a factory, and if the pandemic is only going to last six months or so, that’s not enough time to amortize the cost.
What was needed was a President, a President willing to invoke the Defense Proeduction Act and force manufacturers to act back in January, even, a President willing to declare a state of emergency and order the production of everything needed to fight this thing. What we got was an orange charlatan.
– Badtux the Manufacturing(*) Penguin
* Yes, I’ve been a manufacturing engineer before.