Michael Einhorn’s medical supply company may run out of the masks used to protect against coronavirus in two weeks unless the Chinese manufacturer of his branded equipment resumes production this week.

“We’re having to make tough decisions every day on who gets masks and who doesn’t,” said Einhorn, the founder of New York-based Dealmed-Park Surgical, which employs almost 100 people. “Do masks go to the suburban hospital or the 911 responders? It’s a huge responsibility, and we know we’re going to make some mistakes.”

Einhorn’s dilemma is playing out on a global stage. With the deadly virus now present in 100 countries, companies are unable to match demand for the masks needed by health workers. That’s led governments to jockey for supplies, including the US, which is stockpiling, and Germany and South Korea, which banned exports of masks altogether.

Public health officials are warning that restrictive trade measures tied to medical supplies could worsen the shortfall and risk making poorer nations more vulnerable to the coronavirus’ spread.

In some countries, including Japan and Germany, doctors are being told to reuse the single mask they get daily because of a lack of supply.

Airports empty as Coronavirus affects aviation industry Show all 11 1 /11 Airports empty as Coronavirus affects aviation industry Airports empty as Coronavirus affects aviation industry Ben Gurion International airport, Israel Empty El Al Israel Airlines check-in counters are seen at Ben Gurion International airport in Lod, near Tel Aviv, Israel February 27, 2020. REUTERS/Amir Cohen AMIR COHEN Reuters Airports empty as Coronavirus affects aviation industry Daxing International Airport, Beijing This picture taken on February 14, 2020 shows two men wearing face masks walking through a nearly empty terminal at Daxing international airport in Beijing, as travel has ground to a halt in the wake of the the COVID-19 coronavirus outbreak. (Photo by NICOLAS ASFOURI / AFP) (Photo by NICOLAS ASFOURI/AFP via Getty Images) NICOLAS ASFOURI AFP via Getty Airports empty as Coronavirus affects aviation industry Taoyuan International Airport, Taiwan epa08238057 The empty departure hall of the No 2 Terminal at the Taoyuan International Airport in Taoyuan City, northen Taiwan, 22 February 2020. The coronavirus causing COVID-19 disease which originated from Wuhan, China, has devastated Taiwan's tourism and aviation industries, forcing airlines to cancel flights and travel agencies to lay off workers or close. EPA/DAVID CHANG DAVID CHANG EPA Airports empty as Coronavirus affects aviation industry Noi Bai International Airport, Vietnam A woman walks in the nearly empty arrival hall of Noi Bai International Airport in Hanoi on February 27, 2020, as the number of air travellers has plummeted amid fears over the spread of the COVID-19 coronavirus. (Photo by Mladen ANTONOV / AFP) (Photo by MLADEN ANTONOV/AFP via Getty Images) MLADEN ANTONOV AFP via Getty Airports empty as Coronavirus affects aviation industry Haneda Airport, Tokyo A man wearing protective face mask, following the outbreak of the coronavirus, pushes his luggage past desks, closed for construction, at Haneda Airport in Tokyo, Japan, March 4, 2020. REUTERS/Stoyan Nenov STOYAN NENOV Reuters Airports empty as Coronavirus affects aviation industry Changsha Huanghua International Airport, China A woman wearing a face mask stands in the empty luggage collection hall at the airport in Changsha, Hunan Province, as the country is hit by an outbreak of a new coronavirus, China, January 27, 2020. REUTERS/Thomas Peter THOMAS PETER Reuters Airports empty as Coronavirus affects aviation industry Shanghai Pudong Airport in Shanghai, China epaselect epa08194188 A passenger wearing a protective mask stands in the empty hall of Shanghai Pudong Airport in Shanghai, China, 04 February 2020 (issued 05 February 2020). Major global airlines have canceled their flights to mainland China to contain the spread of the deadly coronavirus, which has so far killed at least 493 people and infected more that 24,000, mostly in China. EPA/ROMAN PILIPEY ROMAN PILIPEY EPA Airports empty as Coronavirus affects aviation industry Daxing International Airport, Beijing This picture taken on February 14, 2020 shows a salesclerk wearing a protective face mask and gloves (R) at an empty duty free shop at Daxing international airport in Beijing, as travel has ground to a halt in the wake of the the COVID-19 coronavirus outbreak. (Photo by NICOLAS ASFOURI / AFP) (Photo by NICOLAS ASFOURI/AFP via Getty Images) NICOLAS ASFOURI AFP via Getty Airports empty as Coronavirus affects aviation industry Haneda Airport, Tokyo An empty departures gate is pictured at Haneda Airport in Tokyo, Japan, March 4, 2020. REUTERS/Stoyan Nenov STOYAN NENOV Reuters Airports empty as Coronavirus affects aviation industry Shanghai Pudong Airport in Shanghai, China epa08194181 Passengers wearing protective masks sit in the empty hall of Shanghai Pudong Airport in Shanghai, China, 04 February 2020 (issued 05 February 2020). Major global airlines have canceled their flights to and from mainland China to contain the spread of the deadly coronavirus, which has so far killed at least 493 people and infected more that 24,000, mostly in China. EPA/ROMAN PILIPEY ROMAN PILIPEY EPA Airports empty as Coronavirus affects aviation industry Noi Bai International Airport, Vietnam Passengers with protective facemasks walk with their luggage in the empty arrival hall of Noi Bai International Airport in Hanoi on February 27, 2020, as the number of air travellers has plummeted amid fears over the spread of the COVID-19 coronavirus. (Photo by Mladen ANTONOV / AFP) (Photo by MLADEN ANTONOV/AFP via Getty Images) MLADEN ANTONOV AFP via Getty

“Most places are not prepared, so you now have a cascade of countries putting these export bans in place,” said Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington. “It’s not a long-term solution. Everyone throwing up export bans isn’t going to solve the problem of how you will get the products in time to serve these acute needs.”

Peter Navarro, one of President Donald Trump’s trade advisers, met last week with a group of pharmaceutical companies to discuss supply chain vulnerabilities and ways to ensure that critical parts of the drug supply chain could move away from China -- or better, back to the U.S., people familiar with the meeting told Bloomberg. Navarro didn’t respond to requests for comment.

Manufacturers need to boost production of masks by another 40 per cent to meet demand, said Tedros Adhanom Ghebreyesus, the World Health Organization’s director general. While the WHO has shipped supplies to 47 countries including Iran, Cambodia and Uganda, shortages will hit soon, especially of the N95 masks that block out 95 per cent of airborne particulates to combat the current virus.

“Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding,” Tedros said in a statement 3 March. “We can’t stop Covid-19 without protecting health workers first,” he said, referring to the illness caused by the virus.

Despite Tedros’ appeal, South Korea, Germany and Russia announced export bans of masks and other protective gear days after. They join others nation or territories including India, Taiwan, Thailand, and Kazakhstan that earlier put export bans in place. The novel coronavirus has now spread to more than 113,000 cases globally and killed over 3,900 people.

Public health experts are concerned that should more developed countries ban exports of masks and protective gear, poorer nations could be at risk of widening outbreaks, particularly among medical workers.

“It will paralyze and freeze up the market,” said Morrison of CSIS. “The accumulated impact of these measures is to create paralysis -- one big logjam.”

Export bans and other measures adopted by developed countries risk deepening global divisions over the virus, said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University in Washington, D.C.

“It would entirely unravel global cooperation if Covid-19 turned into a major killer, and we see hundreds of thousands deaths in lower income countries with relatively few deaths in the global north,” said Gostin, who is also the director of the WHO’s Collaborating Center on Public Health Law & Human Rights.

Before the epidemic, China produced about half of the world’s output of masks with daily production of about 20 million units, according to state media Xinhua. Factories have since boosted production more than five-fold and are enlisting carmakers to manufacture them. That’s still not enough.

In the US, increased efforts by mask makers 3M Co. and DuPont De Nemours Inc. are also falling short of demand. DuPont, which makes masks and protective body suits worn by first responders, said it’s increased production by more than three times its usual global capacity. 3M, the biggest American manufacturer of N95 respirators, has increased production since the outbreak in China.

“We’ve added staff, we’ve added overtime, we’ve added technology, we’ve been increasing manufacturing lines,” said 3M spokeswoman Jennifer Ehrlich. “We expect this demand for respirators and other supplies to continue to outpace supply for the foreseeable future.”

The dependence on China and a few other countries for masks has some calling for a rethink of supply chains. The World Medical Association, which represents physicians, wants governments to establish factories in major markets like the European Union and the U.S. to ensure adequate supply of critical drugs, vaccines and other medical necessities.

The US only has about 1 per cent of the 3.5 billion masks it needs to combat a serious outbreak, Health and Human Services Secretary Alex Azar has said. The country plans to buy 500 million surgical masks and N95 respirators for the national stockpile.

Einhorn of Dealmed thinks the shortage isn’t likely to let up until the summer. The crisis may finally convince Americans to pay more for masks made in the US, he said. Dealmed is seeking bids for domestically-produced equipment.

“The world shouldn’t be relying on one country for health care products,” Einhorn said. “We absolutely need to look at the supply chain.”