Barriers to masks

I’ve been working with a generous donor to get a million PPEs (masks) to the myriad healthcare workers in NYC who constantly tell us they’re facing shortages. Yet, hurdle after hurdle of dysfunction is severely inhibiting us from getting donated masks to those in need.

Here’s a catalog of all the ways various forces conspire against this effort at EVERY level: – Employers threaten to fire doctors & nurses if they speak frankly about shortages so it’s hard to determine the most at-need hospitals & if everyone in the chain is doing their job

– CDC and WHO messaging about “no need for masks” provide cover for hospitals, limiting reputational damage and protects them from class-action lawsuits for not providing adequate PPE to their staff (which should be their job)

– US PPE compliance is messy and confusing (different agencies setting different rules) which limits supply  – All 50 states, Federal agencies, hospitals, NGOs, and businesses bid against each other, pushing prices up

– US authorities punishes anyone for “price gouging” so importers and suppliers are reluctant to order PPEs from vendors for fear of being penalized  – As a result, US importers and suppliers of N95 masks get outbid by foreign competitors so the US loses out

– Because there are no export controls, local supplies of N95 masks get purchased by foreign buyers and are exported – FDA fails to authorize KN95 masks thus choking off total mask supply as KN95s are cheaper & available in larger quantities than N95s (they have similar specs)

– As a result, US Importers are hesitant to order KN95s (mostly produced overseas) because they’re worried they’ll get held up at customs or that hospitals would refuse to accept them even as free donations as they fear legal liability if healthcare worker gets ill using them

– Healthcare workers don’t get the protection they need but they can’t complain to the press – Rinse, wash, repeat – (Chinese state propaganda uses this as proof that the US is just as bad as the CCP for silencing whistleblowers)

That is a tweet storm by Melissa Chen.

Comments

“(Chinese state propaganda uses this as proof that the US is just as bad as the CCP for silencing whistleblowers)”

Surely the Chinese state propaganda aren’t admitting the CCP is bad and has silenced whistleblowers?

-mebbe the chinese studies/models/trials we should look at first are the ones where the authors have been disappeared by the ccp
-hey postmodern monetary theorists
come out come out where ever you are

The term you're looking for is "whataboutism"—used extensively by the Soviet Union yesterday, China today, and the paid (and volunteer!) apologists for both in American media all the time.

At a guess, I’d say they probably say “of course we don’t and also everyone else is just as bad as us”. An “of course I didn’t kill him; also, he had it coming” sort of thing.

Whataboutism and false equivalence is their stock in trade.

I can get masks and medical supplies... all FDA approved and ready to go. Feel free to contact me at Daniel.kongwraps@gmail.com and I will send you over our product information.

From yesterdays links, detailing events from roughly 10 days before talking about exporting - "The masks in play are those we’ve been hearing about in every press conference since the pandemic began: N95 3M™ brand masks, mainly in model types 1860 and 8210, which, according to 3M™, are “NIOSH (National Institute of Occupational Safety and Health) approved for at least 95% filtration efficiency against certain non-oil based particles.” Some buyers are also looking for alcohol-based sanitizer sprays, hospital gowns and a few other items, but mostly the demand is for N95 masks. And the demand is only getting more intense as hospitals rapidly run low on the supplies they have due to increased need for masks to protect staff as numbers of COVID-19 infections, and suspected infections, increase each day. ... By the end of the day, roughly 280 million masks from warehouses around the U.S. had been purchased by foreign buyers and were earmarked to leave the country, according to the broker — and that was in one day.

To his knowledge none of the masks had been purchased by buyers in the U.S. "

The china version is equivalent and cheaper and more easily purchased so foreigners are total idiots to pay more for fewer US masks?

Or foreigners agree with Trump: china is lying and cheating those masks are crap?

60 Minutes, or News Hour, explained N95 history which started with mining or industry and filters only "dust". Which clogged cloth, and various mesh, leading to a disorganized jumble of fiber that passed air easily while trapping dust in twisty paths. By using/treating the fiber to have an ionic charge, they attracted the moist particles carrying bacteria, viruses, etc.

So, the 3M filters have optimized fiber in the filter for each application.

Trapping particles uses up the filter. Just sterilizing will not restore the mask. Washing the mask will likely change its ionic charge.

Basically, the discussion of masks treats safety like Boeing after Lockheed's management took over. Its named the same as 3M so it must be the same quality as Lockheed safety with the boeing name.

It figures that would be your attitude, a slave to bureaucracy even if it kills people.

Mulp, currently the choice is not between KN95 and N95 - it may be between KN95 masks and nothing at all. Can they be that crappy?

Trump's Economic Wall - go around, under or over.

Send to a 3rd part country – to a co-conspirator – then send to the USA as gifts to first responders willing to receive personal contributions as a thank you for their service – distributed provision (website anyone – for personal delivery) – open the box – of wow pleasant surprise “masks”.
Amazon needs to be brought into the fold to provide the logistics in the 3rd Part Country – assuming no laws broken and Jeff gets to “smile” at Trump just one more time.

Probably lose a few days, but many lives would be saved.

Let’s stretch the interpretation of the First Amendment - Freedom of Speech; surely, this also captures a right to keep your mouth shut. The masks are an aid to doing so (not figuratively but literally – wearing a mask reminds you of such) – therefore nothing to do with COVID-19. By the time the (REDACTED) act closing any loopholes on this, the masks would have probably been already utilised.

What a vigorous display of ass-covering this crisis is provoking.

Differently put, it's a nice display of how incentives shape human behavior. I'm actually kind of glad things are shutdown. It gives us a moment to turn off the autopilot and really see in 4K HD how much society needs to change.

Now is the time to effectively combat the scourge of minimum wage laws while protecting price gouging from being disparaged, and especially making sure that the current structure of financial incentives in the American health care system remain undisturbed.

I was just thinking the same thing. This is revelatory for a lot of the public. I'm even seeing stuff about KN95 masks on Facebook. We should have epidemics regularly so as to see how much regulatory crap has cluttered up the landscape and clear it away.

"All 50 states, Federal agencies, hospitals, NGOs, and businesses bid against each other, pushing prices up"

Why is she upset at that? That is market capitalism in it's purest form.

And it allows price gougers to blame their customers for forcing the price to go ever higher.

Railing against "price gouging" is nothing more than virtue signaling.

Actually, you are right. Railing against it is a waste of time.

Using the full power of the state to ensure that medical supplies are directed to where they are required during a pandemic as a public health measure is not virtue signalling, it is a well established way to use resources as effectively as possible, based on a couple of centuries of experience in dealing with the spread of disease.

Remember this, everyone: prior wants Donald Trump to decide how many masks each hospital needs.

What does Trump have to do with how countries direct public health resources to fight a pandemic? South Korea, and to a lesser extent Germany, put major resources into testing, tracing, and quarantining, apparently with at least (some) demonstrable success to show for their efforts. Italy and Spain are overwhelmed, but they certainly do not allow profiteers to determine who receives medical supplies. The world has been responding to this problem for weeks longer than the U.S., which still seems to have no effectively organized response to this novel pandemic.

But Trump hasn't figured out that fewer deaths = better.

I want 3M to raise their prices of masks they are selling. I want retailers (like many local big box stores) charging normal prices for the first item but increasing the price on any bulk purchases. What I don’t want is some jackass clearing off the shelf, walking into the parking lot and announcing the bidding starts at 10 times the price. The only reason he is doing it is because he can hide behind the protection of the very people he is exploiting. Remove the protection and he can gouge all he wants. Just like the guy in Tennessee who suddenly changed his mind about his stockpile when a couple of locals knocked on his door to have a chat.

Korea rationed masks, two per person per week. At first, they didn't have quite enough, but the state basically commandeered the bulk of the national output for allocation to pharmacies so they were able to meet demand and calm everyone down enough to stop hoarding.

I notice Amazon doing something similar as supplies come in from China. They will only sell certain items to health care providers and the like.

The free market sucks at allocating necessities during a crisis. That's why war profiteers used to be crucified.

She is a US taxpayer? Or remembers the 70s and stagflation?

Governments are people, so it's people paying really high prices, not governors or government workers.

I get the feeling that money has no meaning in a crisis. The US spent a mind-boggling $2 trillion dollars. That's unprecedented. Almost 3 times the previous record setting 2009 stimulus. If you spend that much money then it's easy to think that spending $7-$12 for masks that are usually $1 is not a problem.

As noted by Napoleon, who could be asked for anything but time. Spending even 100 dollars a mask will not put it in the hands of the ER worker lacking one right now.

Oddly, enough this is a troll posting as me. I suspect it's prior, pretending to be me, and the countering with his (in his own mind) clever post.

Who knows? There's a special breed of troll on this blog.

It's like you and your sister bidding against each other for the same auction to buy your mother a birthday present where you were going to split the cost.

If it's spread through droplets, clearly masks on (asymptomatic) people who have the virus could prevent spread to others if nothing else. The advice not to wear a mask was always a cry for help for hospitals, which continue to prevent nurses from wearing masks.

This is a bad tweet storm. Whining.

"Employers threaten to fire doctors & nurses"
Yes, that's called at will employment. If you don't like it then leave.

"CDC and WHO messaging about “no need for masks”"
Yes, it's called scientific studies. What's your evidence?

"All 50 states, Federal agencies, hospitals, NGOs, and businesses bid against each other, pushing prices up"
Yes, that's called capitalism. The highest bidder wins. Do you have a better way to ration?

" US importers and suppliers of N95 masks get outbid by foreign competitors so the US loses out"
Another complaint about how markets work.

"Because there are no export controls, local supplies of N95 masks get purchased by foreign buyers and are exported "
Then pay up. Like a broken record, that's how markets work.

"hospitals would refuse to accept them even as free donations"
If I tried to donate a bag of white pills to a hospital and told them it was aspirin, what do you think will happen?

"Healthcare workers don’t get the protection "
Then leave. Nobody is holding a gun to their head.

And everybody else loses. Strange how the Australians seem to understand that too - "The Federal Government on Wednesday officially banned the exporting of protective equipment such as masks, gloves and gowns from Australia during the coronavirus outbreak.

It foreshadowed the plan last week, and Home Affairs Minister Peter Dutton and Health Minister Greg Hunt have now signed off on the new regulations.

New rules are also stopping people buying up supplies of protective equipment to then resell locally at an inflated price."

The only thing you have to fight a pandemic right now is what you have right now. And how it is distributed is a public health question, not a market one.

The troll used to come here to make fun of those who opposed free trade. Keep in mind that he's just shit-stirring.

+1. NY has the financial ability to outbid almost everyone except a handful of other large states and the federal government. So Cuomo needs to quit being a cheap crybaby and pay up.

NY does not have the ability to outbid many places currently, and paying up won't miraculously speed up production and shipping of products already earmarked for those places that are using more supplies than they can possibly produce. Think Italy, Spain, and France - and if you think that NY is richer than Milan (whose region likely produces considerably more medical supplies than NY) or the French state, well, you are a typical MR commenter.

Of course, if Cuomo and other governors had started doing this back on Feb. 5, when HHS was asking 2 billion dollars (of which it received only 500 million) for pandemic preparation, one assumes you have mocked how Cuomo was a crybaby afflicted with TDS.

"So Cuomo needs to quit being a cheap crybaby and pay up."

That infinite supply of money comes from taxpayers, either in tax payments, or inflated prices.

Perhaps you are a boomer who bought and paid for capital long ago so you profit from price inflation of assets and the rent extraction from younger generations, and likely being dead before the taxman cometh.

When depreciating capital inflates in price, that's inflation, and while wages have stagnated inflation has been making living costs go up faster and faster for the increasing population with no capital.

And capital is not money. It's a car with no debt, a house with no debt. Even education with no debt.

CDC and WHO messaging about “no need for masks”"
Yes, it's called scientific studies. What's your evidence?

Oh, there are no scientific studies that say masks are helpful? Why then do ER doctors need them?

"Here’s a catalog of all the ways various forces conspire against this effort at EVERY level: – Employers threaten to fire doctors & nurses if they speak frankly about shortages so it’s hard to determine the most at-need hospitals & if everyone in the chain is doing their job"

This one sounds solvable with an anonymous portal for Doctor's and Nurse's to post this info.

The internet offers an infinite number of such places.

That's far too many.

What you want is one, that specific, and easy to use and easy to hide from hospital management.

A simple form that looks like another website. When you submit it logs your IP address, so it knows where you are, perhaps even down to the hospital.

This does not exist.

"proof that the US is just as bad as the CCP for silencing whistleblowers"

An empirical question.

Here's an idea for anonymous, authenticated whistle-blowing:

The local union holds a meeting in which they generate public-private key pairs on usb plugs, cross-sign them all, and then distribute the plugs randomly among the members. The members can then use their private keys to sign whistle-blowing posts to social media. In order to minimize the risk of key pairs being stolen, a fresh batch of key pairs can be made periodically.

Urbit.org is the only chance-and still just a chance-of anything as sensible as that ever happening. Go down to the union hall and propose this: you will be reminded that people aren't smart and they don't like being reminded of that.

If average medical professionals are not intelligent enough to learn to encrypt messages, why do we trust them to save lives?

Don't underestimate the difficulty of using cryptography. It's notoriously difficult and non-intuitive for normal people. See for example:

Why Johnny Still Can’t Encrypt: Evaluating the Usability of Email Encryption Software

http://cups.cs.cmu.edu/soups/2006/posters/sheng-poster_abstract.pdf

Dut we're straying off topic here.

"– CDC and WHO messaging about “no need for masks”"

Trump's surgeon general looks like he will walk back his recommendation against using masks.

"Seriously people — STOP BUYING MASKS!" Adams said via Twitter on Feb. 29.... Adams told NBC's "TODAY" show on Wednesday that he has now asked the Centers for Disease Control and Prevention to investigate whether this recommendation should change."

Nothing like empirical proof it worked in Asia to overturn the strange policies set our leaders. From the most authoritarian governments to the most democratic, Asia understands how to resolve it. The West is still on training wheels.

https://www.cnbc.com/2020/04/02/coronavirus-us-surgeon-general-asks-cdc-to-see-if-face-masks-are-effective.html

Why not place the blame where it belongs: Trump and his sycophants. https://www.nytimes.com/2020/04/02/opinion/governors-states-coronavirus.html

So Trump started to lock things down, advised the states to do the same, and the ones who listened are in a better position. Odd to see Newsome being called a sycophant though.

Newsom has a strange connection to Trump. His ex-wife is Trump Jr's current girlfriend. But definitely not a sycophant.

'“You have to remember that Gavin is almost an in-law to Trump by extension,” said one Newsom friend.'

https://en.wikipedia.org/wiki/Kimberly_Guilfoyle#Personal_life

https://www.sfchronicle.com/bayarea/matier-ross/article/Awkward-moments-between-Newsom-and-Trump-13410168.php

– CDC and WHO messaging about “no need for masks” provide cover for hospitals, limiting reputational damage and protects them from class-action lawsuits for not providing adequate PPE to their staff (which should be their job) [Haven't these always been couched in terms of saving the PPE for health workers?
This sounds like an excuse given to conceal a different reason.

– US authorities punishes anyone for “price gouging” so importers and suppliers are reluctant to order PPEs from vendors for fear of being penalized – As a result, US importers and suppliers of N95 masks get outbid by foreign competitors so the US loses out

So this inhibits any vendor whose price is greater than what?

I follow this person on Twitter who tries to be a good entrepreneur in corona times. He tweets about his progress and also the hurdles that he encounters. It is interesting:
https://twitter.com/Jaffer22915438/

For example this one:

eBay took down our sanitizer product...Amazon took down our entire store on their site... Customs holding up masks...attorney generals from several states hounding us while we deal with Covid. No sympathy needed, but this piles up when working around the clock.

https://twitter.com/Jaffer22915438/status/1245139788090486785?s=19

My reaction is to see this as every actor's optimization for a previous status quo.

We might like immediate change for a dramatic new situation, but I don't think we can realistically expect that.

We should realistically expect (and demand) "quick" adaptation, but there's the difference between quick and immediate to live through.

How quick can it be? I don't know. I think a couple weeks would still be pretty good, even if it is very frustrating for us all living through it.

To put it differently, "I demand immediate action" is easy to say, but "immediate" is already over. You missed.

It's a lot more complicated to determine what is "all due haste."

"Employers threaten to fire doctors & nurses if they speak frankly about shortages so it’s hard to determine the most at-need hospitals & if everyone in the chain is doing their job"

Interesting that this went without comment from our hosts. Traditionally, the right to publicly speak out on matters of public interest and not be fired for it by your private sector employer is something that has been almost exclusively the domain of the left (very selective outrage from the right with respect to big tech retaliating against people for being politically incorrect doesn't count). I mean real left-wing people of the sort who may question Bernie Sanders' bona fides and approvingly cite Marx, not moderate liberals.

In the same way 9/11 was supposed to make moderates and liberals into conservatives when it came to foreign policy and anti-terrorist actions, perhaps this crisis is making many Americans into Keynesians and supporters of labor rights and a Euro-style social safety net?

The claim that American socialism was already "excess" is looking pretty threadbare.

Or maybe making many liberals understand what conservatives have been complaining about when it comes to "regulation".

Do you seriously think lax standards on masks for healthcare workers is a good, background, status quo?

Maybe they should just order the cheapest?

Unless you’re trolling, even you understand marginal cost vs marginal benefit. And you’re also probably familiar with regulatory capture and public choice economics. You can disagree with people here without being intentionally obtuse. Do you honestly believe that doctors and nurses know less about their PPE than Jared Kushner? Because it’s people like Trumps son-in-law that write and enforce the regulations and standards you’re preaching for.

BTW - hats off to your Gov Newsome. He appears to be doing a superior job. He’s no Gov Walz but he’s showing what good government can look like.

Every bit of that was hand-waving.

Either you think "in normal times" there should be some governmental agency to set safety standards for medical masks, or you don't.

I think there should, because we've seen what lax standards do. Melamine milk.

And no, a hospital worker does not have a percent catch apparatus for testing every mask that comes in the door.

"Every bit of that was hand-waving."

You don't seem to understand what the phrase hand-waving actually means.

hand waving: insubstantial words, arguments, gestures, or actions used in an attempt to explain or persuade.

There was nothing insubstantial about Slappy McFee's post. He gave a cogent and on-topic rebuttal.

BTW. It's actually instructive if you watch the YouTube videos on how to make a 3-d printed mask. They reach the point where they are taking apart a home heater filter and they say "pull the metal screen off, be careful not to tear it."

"Be careful not to tear it?"

Think about that, and what a hospital worker would need to know, when handed such a mask. Was there a tear? Visible to the naked eye? Invisible, but plenty big for virii?

No, you don’t need any of that.

1) put respirator on
2) spray scented liquid in face

If you can smell it, it’s damaged or not fitted properly.

3) repeat as necessary

This is disinformation, and it's so blatant that you can only be a bad actor.
Scent molecules are much smaller than viruses, you stop them with a carbon filter not a particle filter.
Don't be a fucking psychopath.

PANIC buying & FIT testing // UK DOCTOR // Covid-19 Vlog #2
https://www.youtube.com/watch?v=7XZ2_xSHKMw

Think about that, and what a hospital worker would need to know, when handed such a mask. Was there a tear? Visible to the naked eye? Invisible, but plenty big for virii?

An intact filters has holes "plenty big for virii(sic)".

N95 means that a filter captures at least 95% of particles down to 0.3 micrometers.

What the fuck are you talking about handmade masks for? I'm talking about letting hospitals purchase mass produced KN95 masks to give to nurses. Perhaps they are of "inferior" quality compared to 3M produced N95 masks, but then the CDC says they don't need masks at all. So KN95 for people that supposedly don't even need them is at least better than nothing.

This tweet storm by Melissa Chen provides multiple examples of economic agents, and how they are responding in a dual market (see pp 101 M Olson quotes Hans Ritschl in LOCA). The ‘dual’ refers to action in a traditional paid-by-dollars market *in conjunction* with a market steered by a social objective, in this case to minimize lives lost to COVID-19.
The groups she lists are:
CDC and WHO are funded, or compete for dollars, based on their reputations, which they are now trying to preserve (although I don’t see how that will work for them at this point). They are trading lives for their future ability to obtain funding.
All 50 states, Federal agencies, hospitals, NGOs, and businesses are using dollars to purchase protective gear in the traditional market at any cost, this release of cost constraint caused by an evaluated value of the social mandate.
US authorities, I think- US Attorney General’s Offices, whose mandate is to protect consumers from price gouging, are prioritizing their core mandate (for which they receive their funding) over and about the saving lives mandate (present day over-reaching social mandate).
Producers of the product are responding to traditional market forces and exporting to foreign buyers. Note this is not at odds with the social mandate as-long-as you are not a populous/nationalist.
US importers would respond to their role as go between in the market, bringing in product for both traditional dollars and over-reaching social mandate but decline to due to the authority of regulations in place to negate the dollar value of such an exchange.
Not listed by her, but hanging somewhere behind the curtains, is the legal industries ability to extract money from the system for negligence.
And the result is market failure for the social objective to provide health care workers with protective gear.
Once you pull these groups apart and identify their financial as well as social responses, you can release the pressures that are constraining the fulfillment of the ‘saving lives’ objective. But most important to note is the ‘dual’ aspect occurs at time of transaction. There is no delay, back-and-forth, dual movement or embedding.
By understanding our economic agents and the nature of combined transactions, all within the structure of limited resources, we can solve these eminent and life-threatening problems.

This is an example of our current leadership problem. Someone should be working to get things where they are needed. It has to be someone with enough power to do so, and it has to be done at the national level. It's not Nancy Pelosi, though she could play a supporting role. It's a hard problem, and no solution is going to make everyone happy, but right now, no one is even trying.

There is a leadership role to play in this moment, as the dramatic outcome of a pandemic exposes regulations to be inflexible. Long term, it is a more general understanding of the entire economic system and the ever adjusting individual and community exchanges that will necessitate regulations to be responsive.

She missed one I think. If you order masks from overseas they may get confiscated by the Feds. Eventually the confiscated masks make it to FEMA I suppose.

Why are the foreign purchasers not shifting their expensive N95 purchases to less-expensive KN95 purchases till both are equally expensive?

"Because there are no export controls, local supplies of N95 masks get purchased by foreign buyers and are exported"

Bare minimum for a country that doesn't consider itself a doormat: Producing nations that ban exports to the US should have exports banned to them in return.

Taiwan is talking about donating 10 million masks -7 million to Europe and 2 million to the US. Hopefully this is sign of Taiwan having more of a surplus to sell going forward - they make 12.6 Million/week so they should, but if US importers are going to have to compete on the open market and pay high prices they should be able to sell at a profit without being accused of price gouging.

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