The COVID-19 pandemic has thrown the international market for personal protective equipment (PPE) into chaos. So physicians across Texas have found they have to go big or go home when it comes to obtaining those critical supplies.
Companies selling masks are either ignoring small, private orders from individual physicians, or pushing them so far into the future they're useless, says Javier Vazquez, executive director of the Cameron-Willacy County Medical Society in the Rio Grande Valley. Physicians are now pooling their resources through county medical societies to buy bulk shipments of N95 respirators (or masks), face shields, gloves, and other equipment.
Even then, obtaining PPE isn't easy, Mr. Vazquez says.
"It had taken us at least two weeks to secure a legitimate order for legitimate masks, and our officers were getting anxious about not having anything on hand," he said.
U.S. physicians are anxious because they likely will need up to 3.5 billion N95 masks to handle a pandemic respiratory virus, while normal U.S. production is around 1.5 billion, according to a 2017 report in the journal Health Security.
State officials have encouraged physicians to follow their normal channels for obtaining PPE, but that is difficult in part because some PPE vendors seem to be trying to defraud buyers, Mr. Vazquez says. Some deliberately try to sell fake or inferior-grade masks while others don't know one type of PPE from another.
"I was literally meeting with people in parking lots [to determine if masks were real or not]," he said. "It looked almost like a Godfather scene, but we're looking at masks, not drugs. We've become pretty good at spotting counterfeits, and a lot of stuff being pushed out there was counterfeit or straight surgical masks."
Mr. Vazquez was able to find a reputable vendor though a local pharmacist, but his troubles did not end there. The vendor gave him 24 hours to come up with the funding – which was eventually paid for through the county society’s reserve fund. And Mr. Vasquez had to find partners willing to buy enough PPE to make the deal worthwhile to the vendor.
In that 24-hour period, major partners dropped out of the original transaction for 50,000 N95 masks, and it looked like the deal might fall through. Finally, Mr. Vasquez got local emergency medical services and the City of Brownsville to commit to taking a share, pushing the order close to 20,000 masks – enough for the vendor to go through with it.
Wary of being scammed, Mr. Vasquez demanded video of the vendor opening boxes with the masks and taking them out to prove their authenticity. And when they were ready to be shipped, he rented a trailer and drove to Austin to pick them up from the supplier.
Opening the boxes to check their contents was an emotional experience.
"I've got to tell you, I cried," he said. "It was just the anxiety of wanting to deliver for our doctors and knowing all that was riding on these masks." Physicians now routinely reuse masks – a previously unusual practice – and the Texas Medical Association has provided resources for extending the life of PPE. Also, many county societies have held drives to solicit PPE contributions from their communities.
The shortage has been made worse by federal intervention. The U.S. Federal Emergency Management Agency has been quietly seizing PPE orders, though it's not clear what the agency is doing with them, according to the Los Angeles Times. On Wednesday, staff from the Department of Health and Human Services told the U.S. House Oversight and Reform Committee that PPE in the Strategic National Stockpile is nearly gone, and states can expect no more shipments, The Hill reported.
On the private market, prices for medical supplies – especially N95 masks – have soared, Mr. Vazquez says. A mask that typically cost $1 in 2019 can now cost up to $9, he says.
Not all Texas county societies have had as much trouble obtaining PPE as Mr. Vasquez. For instance, the Collin-Fannin County Medical Society in North Texas has been able to obtain consistent shipments of PPE through suppliers in the U.S. and China, says Sam Barbee, the society’s executive director.
However, it's paying a "premium price" of about $4.50 per N95 mask for about 10,000 masks, and nothing about the current procurement process is normal.
"I feel like I work at Chick-fil-A," he said. "We order a product, it comes on a truck, and we distribute it in parking lots, and people are driving up and taking their orders through their window."
The Collin-Fannin County Medical Society also has found local companies that have retooled their production in ways that help. For instance, the Garland leather cutting company Cut Form changed its production process to create useful medical face shields, Mr. Barbee says.
Obtaining reputable equipment is mostly a matter of making good contacts and watching out for rip-off artists, he says.
"You've got to talk to them and get follow up, and you've got to get referrals," he said. "And if those don't pan out – and they won't [if they're fraudulent] – you know it's a dead deal."
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