How factories are making face masks, ventilators, and hand sanitizer

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Employees work at AST Sportswear, one of a coalition of American brands working to make masks to meet the coronavirus demand. | Mindy Schauer/MediaNews Group/Orange County Register/Getty Images

Manufacturers, fashion designers, and 3D printing companies are making face masks, ventilators, and hand sanitizer.

In mid-March, amid mounting outcry over the critical shortages of masks, ventilators, and other medical supplies facing American hospitals fighting Covid-19, Jonathan Schwartz was one of the countless entrepreneurs scrambling to answer one question: How can we help?

Schwartz is a co-founder of Voodoo Manufacturing, a 3D printing company with two factories in Brooklyn, New York, including one that makes clear orthodontic aligners for companies like Smile Direct Club.

Because of that, the team already had experience getting clearance from the US Food and Drug Administration (FDA) to make medical devices — but it still wasn’t immediately clear where their resources were most urgently needed.

“There was just a lot of noise that we were trying to filter out,” says Schwartz, recalling the cacophony of engineers, makers, and megacorporations jumping into the fray all at once.

Voodoo is part of a private-sector push that in recent weeks has mobilized fashion designers, automakers, distilleries, perfume producers, and others to repurpose their manufacturing lines to make health care products that traditional supply chains can’t provide fast enough. A similar effort began in China in early February as the coronavirus swept through Wuhan and put hundreds of millions under lockdown: Factories that usually made sneakers and iPhones switched over to masks to meet the unprecedented demand.

These initiatives are ongoing and have been expedited by a mandate from the Communist Party, according to Stanley Chao, managing director at All In Consulting, which helps Western companies do business in China. “The government is saying, ‘Whatever you make, we will buy.’ So you don’t worry about the supply and demand issues,” he said.

Today, the virus has become a global pandemic, and the countries with the most urgent needs don’t have the manufacturing infrastructure or labor pool that has made China the “world’s factory.” Even in the US — where Detroit automakers famously churned out military aircraft, artillery, and tanks in World War II in their efforts to “outbuild Hitler” — companies have run into hurdles as they’ve tried to scale up.

For one, while state and local governments have welcomed the assistance — and President Donald Trump has begun attacking companies who don’t produce fast enough — most of the work is still being coordinated from the ground up. Absent any central resources for private companies to find out what’s most needed and what the government itself will commit to buying, many have resorted to researching online, cold-calling medical institutions, and tracking down personal protective equipment (PPE) through their own supplier networks abroad (in some cases inadvertently driving up prices by outbidding other offers).

While the US saw its first confirmed case of Covid-19 on January 21, and the WHO warned about global shortages of PPE in early February, the Trump administration dragged its heels in invoking a federal act that would compel American companies to manufacture more medical equipment to fill the gaps in the supply chain. The Defense Production Act (DPA) of 1950 can compel companies to prioritize orders from the federal government, and while Trump announced he had signed it on March 18, he said he only did so “should we need to invoke it in a worst-case scenario in the future.”

Apart from a somewhat confusing invocation just over a week later — ordering General Motors to go forward with a plan it had already announced — the administration’s first announcement that it would use these powers came on April 2 when it said it would work to procure 100,000 ventilators by the end of June along with tens of millions of PPE units.

Throughout the third week of March, Voodoo talked to dozens of doctors, health care organizations, and hospital procurement teams, eventually settling on protective face shields as the device it could produce quickly and safely at scale.

Face shields are typically worn in conjunction with N95 respirators or surgical masks, and like other forms of PPE, inventories are so limited at some hospitals that doctors have been forced to fashion their own using office supplies.

For a company like Voodoo, though, the product is fairly simple: a 3D-printed headband, interchangeable plastic sheeting, a foam pad for comfort, and elastic to help secure it to the wearer’s head.

“We can go from just a design file to the first 500 units in a single day, and so we’re really here trying to just act as a stop-gap to get these urgently needed supplies to hospitals so they can start ramping up their care of patients,” says Schwartz, acknowledging that major medical equipment suppliers will ultimately need to step in to provide long-term scale. For now, the company is producing 2,500 units per week and has set up a Shopify site — CombatingCovid.com — to sell directly to health care institutions.

Typically, hospitals don’t shop for medical equipment the same way the rest of us shop for leggings or mattresses, but these are extraordinary times.

As the coronavirus crisis has progressed in the US, doctors and nurses across the country have raised alarms about dwindling supplies of PPE. The shortfall not only puts front-line workers at risk of infection, it may also limit testing capacity (because someone wearing PPE is generally required to administer the tests) and reduce the number of doctors attending to patients at the most critical moments.

Similarly urgent is the need for ventilators, the machines that help the sickest Covid-19 patients breathe when they can’t do so on their own; too few, and doctors could be faced with the same horrifying triage scenarios as in Italy, where doctors had to decide which of their patients would be hooked up to the lifesaving equipment based on their odds of survival.

To help prevent the spread of the coronavirus so hospitals don’t become even more overwhelmed, the Centers for Disease Control and Prevention (CDC) recommends using hand sanitizer if soap and water aren’t available. A ready supply is needed to protect essential workers like grocery store clerks, delivery drivers, and warehouse workers, but many have complained they don’t have access to it since it has been sold out almost everywhere since February.

With work slowing to a trickle across much of the economy due to store and restaurant closures, grounded flights, and supplier delays, American companies aren’t just motivated to help fight the virus — they also want to keep their teams employed if they can do so safely. Here’s how some are pitching in:

Fashion brands are sewing face masks and medical gowns

With the coronavirus battering the fashion capitals of Milan, New York, and Los Angeles, the industry has enlisted an army of seamstresses to come to their defense.

On March 20, designer Christian Siriano tweeted to New York Gov. Andrew Cuomo to offer the services of his 10-person atelier to make face masks for local health care workers. A week later, he delivered a box of 1,000 washable cotton-blend masks to front-line workers at a temporary medical center at the Javits Center in Manhattan, and more are on the way.

Siriano’s masks aren’t medical-grade, but they can be worn by nonclinical workers to free up supplies or over tight-fitting medical-grade N95 masks to extend their life — a tactic some institutions have instructed doctors and nurses to use in order to help conserve supplies.

According to the Department of Health and Human Services’ own estimates, the US would need as many as 3.5 billion N95 face masks over the course of a year fighting a “full-blown” pandemic. At the outset of the coronavirus crisis, the country’s emergency stockpile held about 1 percent of that: 12 million N95 masks, which filter out at least 95 percent of all airborne particles when worn correctly, and 30 million surgical masks, which are looser-fitting and provide a physical barrier against large droplets, Health and Human Services Secretary Alex Azar testified on March 3.

In part because of this scarcity, the World Health Organization (WHO) and CDC have for months advised that healthy people need only wear masks if they’re caring for someone infected with the virus, despite evidence of the effectiveness of even homemade masks at helping reduce the risk of transmission. Because even asymptomatic carriers are thought to be able to spread the coronavirus and the US has been plagued with months of testing delays, many people could well have put others at risk while believing that they themselves were healthy.

On April 2, President Trump confirmed that the government will soon release new guidance on wearing face masks, though he erroneously claimed that scarves would “in many ways … [be] better” than a mask because of their thickness. (In its guidance for health care workers, the CDC says coverings like scarves and bandanas should be considered a “last resort” after respirators, surgical masks, and non-FDA-regulated face masks.)

Initiatives like Siriano’s have sprung up throughout the industry: Fellow Project Runway alum Michael Costello has made more than 2,500 masks so far — some cotton-blend, some with HEPA filters, and some medical-grade, thanks to a fabric donation from a surgeon friend. For Days, a closed-loop T-shirt line, has dedicated its sewing capacity to making 10 masks for every purchase on its site. OESH Shoes, a Charlottesville, Virginia-based brand, is 3D printing flexible masks and mask adjusters based on insight from co-founder Casey Kerrigan’s experience as an MD.

Apparel companies with scalable US-based supply chains are a vanishingly rare group these days, but a coalition of them is working with the Federal Emergency Management Agency (FEMA) and the White House Office of Trade and Manufacturing Policy to produce up to 10 million face masks per week in domestic and Central American plants.

The group includes Hanes, Fruit of the Loom, and yarn manufacturer Parkdale Mills, which is supplying the raw material for the cotton masks. American Giant, a San Francisco-based brand that specializes in hoodies, T-shirts, and other casual apparel, has redirected its two North Carolina cut-and-sew plants to make masks full-time.

Separately, Brooks Brothers has committed to producing 150,000 masks a day as well as gowns for health care workers at its plants in New York, Massachusetts, and North Carolina. Nordstrom, the country’s largest employer of tailors, is working with its partner Kaas Tailored and health care network Providence Health & Services to sew more than 100,000 masks made from surplus surgical wrap.

In Los Angeles, former American Apparel chief Dov Charney is hiring sewers, forklift operators, and other warehouse workers to help produce and distribute hundreds of thousands of masks and gowns for FEMA and other organizations. His new brand, Los Angeles Apparel, is selling three-packs of cotton-terry masks online for $30 to support the cost of labor, operations, and donations of masks to hospitals and first responders.

LA’s garment industry is focusing its efforts on non-medical masks through a program called L.A. Protects. Conducted by the mayor’s office in partnership with millennial-favorite brand Reformation and health care company Kaiser Permanente, it aims to provide 5 million masks to front-line workers like delivery drivers, grocery store clerks, and non-clinical health care staff.

Other countries are also seeing corporations and small brands work in tandem: In Italy, Prada and Gucci are manufacturing masks alongside family-owned facilities like the Everyn Calzaturificio factory, which produces shoes for luxury footwear brands like Nomasei.

The few American brands that have managed to procure medical-grade masks have done so mostly through their suppliers in China, where half of the world’s masks were produced before the crisis and where mask manufacturing has accelerated nearly twelvefold since, according to the New York Times. Even there, N95 masks account for less than 2 percent of daily mask production due to a shortage of melt-blown fabric, one of the key materials needed to make them. The ultra-fine particle-blocking material is made using expensive, highly specialized machines, so companies haven’t been able to simply pivot to producing it even as global demand has skyrocketed.

On March 21, luxury group LVMH announced plans to secure 40 million surgical masks and FFP2 respirators (the European equivalent of N95 masks) to help France fight Covid-19. Chairman and CEO Bernard Arnault funded the first delivery of 10 million masks at a cost of 5 million euros ($5.4 million), while the government is expected to finance the remaining shipments over the coming weeks.

Eddie Bauer is importing 20,000 masks, including 5,000 N95s, for donation to the Washington State Department of Enterprise Services, after some of the brand’s suppliers of technical outerwear pivoted to PPE.

Eugenia Kim, a New York-based designer of luxury hats and accessories, says she taught herself how to import masks in six days after seeing Cuomo’s call for aid and witnessing what her sister and father were experiencing as doctors on the front lines. Her hat factories in China, she says, “had previously been reaching out about mask production and I realized I could help the cause.” The facilities can produce between 10,000-50,000 units per day of N95 masks, surgical masks, and other PPE, and Kim is working with hospitals and government agencies to arrange direct shipments.

Booze, hemp, and perfume brands are getting into the hand sanitizer biz

The great Purell shortage of 2020 is still well underway, but other industries with access to hand sanitizer’s key ingredient — alcohol — are doing their best to fill in the gaps.

Morgan McLachlan, co-founder and chief product officer at LA distillery Amass, says she first started making the label’s “alcohol-based botanic hand wash” at the beginning of March when she couldn’t find any hand sanitizer in stores or online. Initially, it was just to protect herself and her friends and family, but as more and more people caught wind of the idea, it became something much bigger.

“We were going to have our people give it out to all of our accounts as a friendly thing to do to keep all of the service staff safe,” she recalls. “Well, bars and restaurants got shut down. But we’re getting orders from across the country now.”

The craft-distillery price tag — $38 for a 16 ounce bottle, with 10 percent going to the US Bartenders Guild Emergency Assistance Program, compared with $2.50 for a 10 ounce bottle of Purell, pre-price-gouging — hasn’t deterred customers, nor has the 10- to 14-day wait for shipping (a result, in part, of delays from packaging suppliers). On top of its direct-to-consumer sales, the distillery is also working with public health agencies to distribute the sanitizer more broadly.

“I think we all have our desert island skills,” she says. “As distillers, we’re usually creating little quotidian pleasures to help people get through the day — but now we’re keeping people safe.”

Some of the biggest liquor companies in the world have since taken a similar attitude: Diageo, whose brands include Smirnoff and Tanqueray, is donating up to 2 million liters of ethyl alcohol to hand sanitizer manufacturers, while the vodka maker Tito’s said it would produce 24 tons of its own hand sanitizer to give away to first responders and other front-line workers. (Initially, the Texas brand was forced to caution the public that its vodka didn’t meet the 60 percent alcohol threshold required by the CDC to make hand sanitizer after frustrated shoppers began formulating their own at home.)

Uncle Bud’s, a hemp-based personal care line, was already in the process of creating its hand sanitizer when the coronavirus outbreak arrived on its doorstep. The shortage convinced the team to push the October launch date up to March, which meant sidelining other projects and shifting manufacturing lines to make millions of units of hand sanitizer, all while scaling up the company’s online business as more and more of its retail partners closed stores.

“Being a smaller company, we were able to pivot quickly and fast-track finalizing formulation and production,” says co-founder Bruno Schiavi. The sanitizer launched online on March 23, selling for $9.99 per 8 ounce bottle.

Perfume producers, another major alcohol consumer, have also joined the fight: On March 16, LVMH began producing and delivering free hand sanitizer to French health authorities and hospitals, using the production lines that typically manufacture fragrance for Dior, Givenchy, and Guerlain. The luxury conglomerate pulled from its reserves of purified water, ethanol, and glycerine to create the sanitizing gel and bottled it in the same plastic dispensers used for Dior hand soap, getting the initiative up and running within 72 hours.

L’Oréal is distributing millions of bottles of hand sanitizer throughout Europe through two of its brands: La Roche-Posay is heading the initiative for hospitals, nursing homes, and partner pharmacies, and Garnier is doing the same for its food distribution clients so grocery workers can be protected on the job.

Stateside, the Estée Lauder Companies Inc. has pledged to reopen a factory in Long Island, New York, to manufacture and donate 10,000 bottles of hand sanitizer to its home state every week. Coty Inc. — which makes fragrances for brands like Marc Jacobs and Gucci — likewise said it plans to donate tens of thousands of units per week, including through a partnership with Kris and Kylie Jenner. Coty, which recently bought a majority stake in Kylie Cosmetics and Kylie Skin, plans to distribute the hand sanitizer to health care workers and first responders in Southern California.

As companies have rushed to get sanitizing products out the door, US agencies have eased some of the regulations around them: On March 27, the FDA updated its policies to allow producers of fuel ethanol to sell the product to hand sanitizer manufacturers provided it meets certain standards of purity. Prices of the ingredients typically used in hand sanitizer — either isopropyl alcohol or ethanol for food and drug manufacturing — shot up in March due to the surge in demand.

The Trump administration’s $2 trillion stimulus package also includes a temporary exemption for excise taxes on alcohol used to produce hand sanitizer during the course of the Covid-19 crisis.

Car companies are shifting production to ventilators

Even before Covid-19 was declared a national emergency in the US on March 13, ventilator manufacturers around the world were ramping up production to meet the escalating demand. Even at maximum capacity, though, they haven’t been able to keep up with health care needs caused by the rapidly spreading respiratory illness.

To help move the needle, American automakers have stepped in to offer their support. General Motors is working with Ventec Life Systems, a Seattle-area manufacturer that typically makes about 200 ventilators per month. On its own, Ventec expected to be able to increase production to 1,000 units per month, but with the help of GM, it has been able to source enough of the 700 components that go into the device to increase its capacity tenfold, according to the New York Times.

Ford, too, announced on March 30 that it is partnering with General Electric’s health care division to produce ventilators based on a “simplified” design licensed from Florida-based Airon Corp. The car company will reopen one of its plants in Ypsilanti, Michigan, to produce the devices beginning the week of April 20.

Even working around the clock, both of these initiatives will take time, however. Ford expects to be able to deliver 1,500 new ventilators by the end of April, 12,000 by the end of May, and 50,000 by July, ramping up to a capacity of 30,000 per month. Once they’ve finished overhauling a GM electrical components facility in Kokomo, Indiana, Ventec and GM expect to produce 10,000 units per month, with “hundreds” shipping by the end of April, according to The Verge.

Prior to the coronavirus crisis, the US had around 170,000 ventilators available for patient use spread among hospitals, smaller health care facilities, and the national emergency stockpile, according to a February report from the Center for Health Security at Johns Hopkins Bloomberg School of Public Health. While that number is normally more than enough to serve the population, the report’s authors found that “the need for ventilation services during a severe pandemic could quickly overwhelm these day-to-day operational capabilities.”

Despite this, the federal government has waffled on its commitment to obtaining more ventilators, delaying the current production efforts.

As recently as March 26, President Trump questioned the need for more of the devices on Sean Hannity’s Fox News show. “I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they’re going to be,” he said. “I don’t believe you need 40,000 or 30,000 ventilators.” (New York state, Gov. Cuomo has said, will need a minimum of 30,000 to deal with the crisis.)

The next day, Trump changed course, berating GM on Twitter for charging “top dollar” and not working fast enough to produce the ventilators, though the company had announced its partnership with Ventec just hours earlier and said it would sell the items at cost.

The administration said it would invoke the DPA to require the automaker to prioritize the government’s ventilator orders. As of March 30, the federal government still hadn’t indicated how many ventilators it planned to buy or what price it was willing to pay, according to the Times, though at a news conference the day prior, Trump changed his tune again. “General Motors is doing a fantastic job,” he said. “I don’t think we have to worry about General Motors now.”

Tesla, too, is chipping in, despite CEO Elon Musk’s tweets downplaying the severity of the pandemic. The company has donated more than 1,200 ventilators to the city of Los Angeles and hundreds more to New York City, shipping surplus stock from China while it works to establish production lines to manufacture more at several of its US plants.

3D printers and sportswear brands are manufacturing face shields

Schwartz and the Voodoo Manufacturing team aren’t the only ones that have latched onto the idea of face shields: Nike is prototyping a design in partnership with Oregon Health & Science University in the company’s home state, and according to a recent earnings call, its innovation and manufacturing teams are working on other PPE concepts for further down the road.

With the NHL season on hold, hockey equipment manufacturer Bauer has also shifted to face shields, effectively switching one type of protective gear for another. At its factories in upstate New York and Quebec, Canada, it’s currently producing 20,000 to 25,000 units per week, which will increase to 70,000 units per week later in April.

Demand, though, has far outstripped supply: The company has received inquiries from around the world for more than a million units and has taken orders for 300,000. It has also posted the product’s specs online, and so far, at least one other hockey company has joined in the effort. Bauer’s face shields cost about $3 each including shipping, which covers the cost of raw materials and overhead; it says it does not expect to make a profit on the sales.

At its own 3D printing and manufacturing facility in Nashville, Tennessee, Smile Direct Club has produced thousands of face shields for customers including St. Luke’s Boise Medical Center in Idaho and The Hospital for Sick Children in Toronto, Canada. It’s also working to prototype respirator masks and nasopharyngeal testing swabs. The crisis has mobilized all corners of the 3D printing community, from the thousands of engineers and hobbyists organizing in private Slack groups to Carbon, the multibillion-dollar company that makes 3D printers for brands like Adidas and Johnson & Johnson.

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This article was first featured at https://ift.tt/3bU9d6h on April 6, 2020 at 08:55AM by Hilary George-Parkin

John Jason Fallows

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