Just two weeks ago, John Carrington was looking at the stock market’s collapse, mulling which of his 20-person staff to lay off, and seeing investors bail on another round of funding.

Today, his whole life has been upended. His company, ZVerse, a maker of 3D-printing software in Columbia, South Carolina, is one of the most important players in the battle against the pandemic, producing millions of reusable face shields for major hospital systems, municipalities, and the U.S. Veterans Administration. Carrington is hiring dozens of new employees to keep up with the demand, raising millions from investors, and having tearful conversations with desperate healthcare workers and relatives of victims.

Amid the apocalyptic economic news—tens of millions newly unemployed and the vast majority of small businesses shut down and facing potential bankruptcy—some companies have pivoted in ways that meet the urgent healthcare needs of the moment. Their bootstrap remedies are essential, but they also illustrate how unprepared the country has been for such a pandemic, with stories abounding of price gouging and supply chain bottlenecks.

For example, Oregon state officials said on Monday that the state had ordered more than 4.6 million face masks for hospitals and has received only 10,000. Oregon “has also not yet received millions of surgical masks, gowns, face shields and gloves it has ordered from the private sector or requested from the federal government,” reports The Hill’s Reid Wilson. Such lags have forced states to take matters into their own hands, getting local businesses to pivot to production of shields and ventilators, for example.

Part of the problem lies with distributors and third-party administrators, who have a stranglehold on medicines and medical supplies, says Leah Houston, an ER physician who is the founder of HPEC.IO (Humanitarian Physician Empowerment Community), a startup offering a blockchain-based network for doctors. She says that she’s hearing from friends who are doctors about their desperate struggle to obtain personal protection equipment.