Securing personal protective equipment for frontline health care workers is forcing administrators to develop a new set of operating skills.

Dr. Andrew W. Artenstein, who heads Baystate Health’s command center for COVID-19, described his experiences attempting to acquire N95 face masks and related gear for workers in a letter published by the New England Journal of Medicine.

In the past, getting needed face masks and supplies for Baystate was a relatively straightforward process. Amid the growing health care crisis, hospital workers were “stymied by a lack of personal protective equipment,” he said, “and the cavalry does not appear to be coming.”

Then, the hospital had a lead on equipment from “an acquaintance of a friend of a team member" willing to take $5 per mask — five times the normal price. Still, even at that rate, the masks were a bargain in lives saved.

The first step was to make sure the alleged broker was, indeed, capable of getting the materials and in the quantities needed. It took hours to vet the supplier who, as it turned out, was a player at the level Artenstein needed.

Samples of the Chinese-made masks were sent via overnight express and were exactly what was needed for health workers in Western Massachusetts. Then, they had to find a way to get the pallets of masks to Springfield without losing it to the federal government.

Earlier deals had disappeared, Artenstein said when prohibitive counteroffers from other states or federal officials meant the supplies were not coming to Springfield.

Despite all the planning, just hours before the scheduled handover of the product, the Baystate group learned they would only get a quarter of what they ordered. The deal had to continue because the masks were desperately needed. Fewer masks were better than none.

Finally, Artenstein and his group met with the supplier in a warehouse and watched as pallets of the materials were unloaded. A final quality check made sure they were as advertised and the load was packed into the two tractor-trailer rigs disguised as food-service vehicles and bound for Massachusetts.

“When fully loaded, the trucks would take two distinct routes back to Massachusetts to minimize the chances that their contents would be detained or redirected,” Artenstein wrote.

Just then, two FBI agents walked into the warehouse. The short supply of PPE around the world has created a very lucrative black market for medical gear, and the agents wanted to know who was moving such a large quantity of masks.

A credential check and much cajoling worked for the group and the agents released the shipment. While the FBI was done with him, to his horror Artenstein found out the Department of Homeland Security was looking into redirecting the masks to federal use.

A quick call to congressmen who could help finally convinced DHS this particular shipment was more trouble than it was worth. The two trucks pulled out of the warehouse and on their respective ways.

Artenstein kept looking over his shoulder until both trucks pulled into Springfield and all the pallets were safely locked in a Baystate storage facility.

“Did I foresee, as a health-system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organization would ever be faced with such a set of circumstances? Of course not,” Artenstein said. “This is the unfortunate reality we face in the time of COVID-19.”