Phones have been ringing off the hook lately for Brian Edwards, a sales manager of a small medical supply company in California. And he has to say “No” to all the people who called.

Edwards used to buy tens of thousands of facemasks from China. But not in the past three months.

His company, the First Choice Industrial Supply Company, has not been able to get any masks from China since the outbreak of coronavirus in late December while the demand is soaring in the U.S.

"You can’t get a product. You are not going to get a product for months. " said Edwards, whose company advertises itself as "If it’s something you use, it’s something we stock".

Edwards said in the interview with Voice of America last Friday that he gets about 50 calls and 50 emails every day from all over the country trying to find masks. But now in the U.S. "no body can get anything".

"The worst you could possibly have." said Edwards.



Shortages

Edwards is at the center of a major problem that the nation faces now: There aren't enough critical medical supplies, such as facemasks, because China has stopped shipping them to the world.

In the fight against the coronavirus, facemasks have become the most visible symbol of the deadly pandemic, worn by millions of people around the globe every day.

Various N95 respiration masks at a laboratory of 3M, that has been contracted by the U.S. government to produce extra marks in response to the country's novel coronavirus outbreak, in Maplewood, Minnesota, U.S., March 4, 2020.

In the U.S., officials project the country has just one percent of the 3.5 billion surgical masks and respirators needed to fight the outbreak for a year.

Hospitals across the country are now "conserving supplies and allocating with oversight", said Arika Trim, Associate Director of Media Relation at the American Hospital Association.

She said in an email to VOA that hospitals are "grouping patients accordingly as means of preserving personal protective equipment."

Doctors, nurses and other medical staff caring for the growing number of novel coronavirus cases are reportedly making DIY (do-it-yourself) face shields to help deal with the shortage.

U.S. President Donald Trump said Wednesday he will be invoking a federal law called "Defense Production Act" to marshal the private sector for the supply shortage. In addition, the White House has asked construction companies to donate their stocks of N95 respirator masks to their local hospitals.

The shortage has also prompted the Centers for Disease Control and Prevention (CDC) to loosen its recommendations on the face protection that healthcare workers should use. Instead of recommending using specialized masks known as N95 respirators, which filter out about 95 percent of airborne particles, the CDC now says that looser fitting surgical facemasks “are an acceptable alternative."

“The supply chain of respirators cannot meet demand.” the CDC said Tuesday.

A Broken Supply Chain

Thousands of miles away, among millions of manufacturers on the other end of the supply chain, Cai Mingxian, the owner of a mask factory based in China's virus epicenter in Hubei province, is trying to get his business restarted.

Like many small businesses in China, his factory was devastated during the lockdown and not able to produce anything.

Cai’s 150 employees are now back at work making 200,000 masks per day. But he said all of them are being sold to China’s government and none for export.

“We previously exported to the U.S., Spain and other parts of Asia,” Cai said. “But at the moment we can’t export anything.”

Chinese officials deny they are banning exports. Li Xingqian, director of the foreign trade department at the Ministry of Commerce, said at a press conference last week that it would abide by free trade and market principles. “Masks are freely traded products …companies can trade them in line with market principles.”

However, another Chinese official, Chen Hongyan, secretary-general of the Medical Devices Branch of the China Pharmaceutical Materials Association, admitted "key medical supplies such as masks are uniformly managed and allocated by the government", according to a report published last Wednesday by the official Xinhua news agency.

As the virus’s spread escalates all over the world, the government is under growing pressure to share and meet the world’s needs. There are signs recently that China may now be willing to share some of what it has.

"China pledges continuous support for its export enterprises in providing face masks and medical supplies to foreign countries, said foreign trade director Li last Thursday.

Li's claim was confirmed by mask factory owner Cai who said he has heard that the regulation prohibiting mask exports is lifted. “Mask export was authorized yesterday" Cai said in the telephone interview last Saturday. "I am following the situation every day.”

As part of goodwill packages, the Chinese government has begun some shipments to Iran, South Korea, Japan and Italy. Last week, it said it would send five million masks to South Korea and export two million surgical masks to Italy.

FILE - An Indian laborer works at a surgical mask production unit in Ahmadabad, India, Feb. 1, 2020.

Production Ramp-Up

China made half the world’s masks before the coronavirus emerged there. The government has been undertaking a massive mobilization of wartime proportions to expand its output since then. Daily production soared from about 10 million before the crisis to 116 million now, according to the latest number released late last month by China's National Development and Reform Commission.

More than 2,500 companies in China have reportedly started making facemasks, among them are some of the country's powerful state-owned enterprises and technology companies, including iPhone assembler Foxconn.

The maker of China’s new J-20 stealth fighter jet, Chengdu Aircraft Industry Group, repurposed part of its factory to design a mask production line, according to local media, The Sichuan Daily's recent report.

BYD Co., a leading Chinese electric-carmaker backed by American investor Warren Buffett is now the world’s biggest facemask maker with the capacity of making 5 million masks a day.

The Limits China faces

Even with the daily output of masks in China now 116 million, given the sheer size of its population, the country is likely to continue facing shortages.

In many parts of China, facemasks are required by local governments to protect against infection in public spaces.

A recent report by a leading Chinese financial services firm, Huachuang Securities, says China has 38 million people working in healthcare, transportation, and manufacturing industries. If one person uses one mask per day, China would need 238 million masks every day.

Yuan Fajun, the secretary general of the medical materials committee at the China Medical Pharmaceutical Material Association, estimates manufacturers still needed to produce about 230 million surgical masks for its domestic market.

In addition, there are some technical limits. The production of sophisticated facemasks like the N95 model requires nonwoven polypropylene, a special fabric that is in short supply. As a result, N95 respirator masks, which help keep health workers safe from contracting the virus through particles released by mucus and cough sputum when they are around infected individuals, has barely increased.

The investment in a new production line for such material will cost millions of dollars, and will take two to three months to complete, local media reported.

The other bottleneck the country faces is with its mask-making machines. Demand for such machines skyrocketed as hundreds of companies altered their business and have started making masks. For the big companies that are unable to obtain the equipment rapidly enough, they are making their own. A General Motors joint venture in southwestern China and BYD have already built dozens of the machines and are beginning bulk production.

But the majority of mask makers, which are small and mid-sized businesses, can only wait.

Mask maker Cai said he has placed a back order and machines would come in a month. "I will be making 400,000 masks per day after the machines arrive" Cai said.

As for the U.S., the Trump administration is invoking special powers to quickly expand domestic manufacturing of protective masks. But in order to ramp up the production, "They have to build the machine, and that is going to take 6 months." said Edwards.