#15,727
Over the past 15 years, probably the most anticipated failure point in pandemic preparedness has been our woeful lack of PPE stockpiles, and our dependence on offshore manufacturers for its supply. In May of 2009 (and not for the first time), we looked at problem and the HHS's estimate of N95 and surgical masks needed in a pandemic (see Caught With Our Masks Down).
While our Strategic National Stockpile contained more than 100 million N95 and surgical masks the HHS estimated the nation would need 30 billion masks (27 billion surgical, 5 Billion N95) to deal with a major pandemic.
Since the shortfall was obvious to everyone, we saw a push for alternatives (see 2014's NIOSH: Options To Maximize The Supply of Respirators During A Pandemic). And while numerous promises were made, the Strategic National Stockpile's cupboard was no better stocked a decade later, when COVID hit.
On January 7th, 2020 - just 8 days after the first Wuhan pneumonia cases were reported - Hong Kong reported PPEs were already in short supply. Just two weeks later (see Caught With Our Masks Down (Revisited)), I checked Amazon for masks, and while some were still available, a great many of the listings carried this warning:
Somehow, more than a year later, Health Care and other essential workers are still struggling to get proper PPEs, or are forced to wear and/or reuse equipment much longer than is recommended. The market has been flooded with Counterfeit Respirators, which provide uncertain protection, and the majority of the public are still wearing homemade or cheaply manufactured cloth facecovers.
Basic PPEs should have been the foundation of our public health pandemic response, not an afterthought.
Although the development of several COVID vaccines in the first year was a great accomplishment - our late adoption of face covers - and our failure to domestically manufacture and distribute billions of badly needed N95 respirators and quality face masks, has undoubtedly been our biggest failure.
Now, with new, more transmissible COVID variants emerging around the world, some governments are considering mandating the use of more protective masks, for both healthcare and essential workers, and for the public in certain settings.
An idea that would seem to make sense, as long as there are enough PPEs available. Which is doubtful.
One of the first to act is Germany's state of Bavaria, which ordered the use of FFP2 face masks (equivalent to our N95) by the public in shops and on public transport starting on January 18th.
(translated)
Munich, January 12, 2021
Report from the cabinet meetingCorona pandemic / infection situation remains very tense / FFP2-Mask compulsory in public transport and in retail from January 18The infection situation due to the corona pandemic is in Bavaria and Germany remains very tense. The measures taken so far unfortunately have not yet made the hoped-for noticeable and sustainable Led to a decrease in the number of infections. The aim is to achieve a seven-day incidence of less than 50 cases per 100,000 population.
Only from this incidence value is a safe follow-up of routes of infection guaranteed. The occurrence is strong at the moment, which is particularly worrying infectious virus mutations in some countries, their entry and Spread in Bavaria and Germany must be avoided.With a view to the continued very high infection dynamics and to the stronger The Council of Ministers therefore has to contain the infection process today an obligation to wear an FFP2 mask in public Local public transport and retail from Monday 18th January 2021, decided. signed Carolin Mayr Press spokeswoman for the State Chancellery and Deputy Press Spokeswoman for the State Government ++++
January 19, 2021The Bavarian Ministry of Health has started distributing 2.5 million FFP2 masks to the districts and urban districts. The technical relief organization brought the protective masks from the state government's pandemic central warehouse to all parts of the Free State on Tuesday morning.
While Bavaria, with a population of 13 million, may be able to cobble together enough FFP2 masks to make this work, there are reports that the rest of Germany (pop 83 million) may follow suit (see Bavaria mandates FFP2 masks, all of Germany may follow).
- Although not officially published, France's health advisory council has reportedly said homemade cloth masks may not provide enough protection (see France advises against fabric face masks due to new Covid variants) and is advising the public use commercial surgical masks or FFP2 masks.
- And yesterday Austria announced a new control offensive after 46 B.1.1.7 variants were identified in country, and will require the use of FFP2 masks in shops and on public transport starting January 25th.
It seems likely that other European nations will follow, assuming they can secure enough PPE to make it feasible. How much of a difference surgicals masks would make over cloth face covers is debatable - but when properly worn - FFP2 and/or N95 respirators are clearly superior to both.
Regardless of whether any of the new COVID variants are going to be sufficiently transmissible to invalidate the use of cloth face covers, this is not going to be our last pandemic. And the next one might have a fatality rate much higher than COVID.
We need to get PPE manufacturing (and stockpiling) sorted out now, before we find ourselves behind a much bigger 8-ball down the road.
Because no one can ever say again that `. . . no one could have predict it would be this bad'.
