With a second wave of COVID-19 cases expected to hit Minnesota hospitals in coming weeks, the state has millions of medical-grade N95 respirator masks on order for health care workers treating coronavirus patients.
So far about 337,000 of these critical masks have been delivered to the state stockpile since March, while orders for more than 5 million more are still awaiting delivery. A review of the state's purchasing shows those masks will arrive in batches over the next year and a half. Some may never arrive at all.
"This is a make-sure-we're-turning-over-every-stone approach," said Wayne Waslaski, project manager for the Minnesota Department of Public Safety's critical care supplies team. "The normal supply chain isn't working."
In a topsy-turvy global mask market, the Minnesota Department of Health warehouse in St. Paul has been able to secure just three batches of more than 100,000 medical-grade infection-preventing N95 masks since March, including two made by Maplewood-based 3M Co. These state stockpile masks serve as a backup supply for hospitals, which have about 745,000 N95s in storage today, state data show.
N95 respirators are tightfitting masks that filter out 95% of particles 0.3 microns wide, including those carrying the SARS-CoV-2 virus. They're one of the cheapest and most widely used methods to make sure doctors, nurses and lab workers can safely breathe the same air as COVID-19 patients.
Minnesota hospitals consume about 9,000 medical-grade N95 masks per day. However, nurses are wearing single-use masks for as many as five days at a time to lower their daily burn rate, going against their training. Health care workers in the state use another 67,000 nonmedical-grade masks per day, including some N95s, and also KN95 masks made under Chinese standards.
After months of vetting by the state, just two companies have been able to deliver the sought-after respirators to Minnesota: Texas-based McKesson Corp., which has filled two orders for 3M respirators, and Bloomington's Donaldson Co., which has delivered one batch of high-filtration N99 respirators and a second batch of nonmedical-grade masks.
Donaldson is still trying to get government approval to import another 500,000 N95s. The most recent delivery of medical-grade respirators to the state came last Monday, when 114,840 3M N95s arrived from McKesson. That's part of an order for 3 million, which will arrive in monthly shipments through 2021.
McKesson's masks cost no more than $1.19 each, while the masks from Donaldson have ranged in price from $1.65 to $5.50, with higher prices for better filtration.
When the traditional supply chain for N95 masks failed in March, state officials began to investigate offers from lesser-known distributors who claimed to have access to masks, including one deal that is now in limbo with a company called Supply Link Inc.
The distributor had been in touch with state officials before the pandemic to sell data-logging devices for vaccines. The two parties pivoted to masks in May, with the state agreeing to pay $4.75 per mask for 2 million 3M-made N95 respirators. State officials say the deal may never come to fruition, but Supply Link says it's still working on it.
"When we made the deal, we were confident we would get the masks," said Matthew Kaspar, president of Supply Link. "We are still confident we will get them."
Such masks are intended to prevent front-line health care workers from getting sick while treating COVID-19 patients. The state Health Department says more than 4,700 health care workers have "likely" gotten COVID-19 while working, and another 2,300 have gotten it through undetermined sources.
Minnesota added 754 new lab-confirmed cases of COVID-19 to its tally on Sunday, bringing the state's total to 65,152 since March 5. The state has seen 1,706 deaths attributed to the viral respiratory illness, including seven newly reported fatalities.
On Sunday there were 290 people in the hospital for COVID-19, including 152 getting intensive care. The average number of people in the hospital rose into the 300s Aug. 3 after hovering in the 200s since the start of July.
If a hospital runs low on masks — as happened when case counts spiked this spring — it can request a delivery of masks from the state's central stockpile at no charge.
Medical purchasing officers and distributors say the previously tame market for health care respirators turned wild at the start of the COVID-19 pandemic.
Minnesota Administration Commissioner Alice Roberts-Davis, whose department does critical care supply purchasing for the state stockpile, cautioned her staff early on to carefully evaluate offers of N95 masks.
"We've got 20 vendors saying they have a million masks, but all of those vendors have the same million masks — they're all working with the same factory to get those masks, and it's going to go to the highest bidder," she said. "So we have to be very careful that we weren't bidding against ourselves."
Minnesota's critical care supplies team will not pay for masks in advance. The state pays when the product is in hand and validated for both good fit and filtration.
"The fit is critical, and that is where we are seeing most of the masks offered on the market falling down," Roberts-Davis said.
The state has a standing order with industrial filter manufacturer Donaldson to procure as many as 1.5 million masks. Donaldson is among a group of Minnesota companies lending their employees' time to the global hunt for personal protective equipment, including N95 masks.
The company isn't profiting on the masks, instead purchasing them and passing on the cost to the state, Donaldson CEO Tod Carpenter said. "We are just trying to be a good corporate citizen."
But even with Donaldson's global connections, less than a quarter of the masks in the state's purchasing order have made their way to Minnesota.
"At one point, we felt we could have a very large quantity of masks to purchase in early March," Carpenter said. "But the rug was pulled out beneath our feet."
At this time, a sizable shipment of KN95 masks is paid for and stacked in a Donaldson warehouse in Wuxi, China, awaiting approval from the U.S. Food and Drug Administration, Carpenter said. "We have half a million masks sitting in our distribution center, ready to come to the United States, and we know they are good."
Finding quality N95 masks is an issue. Donaldson has a filtration testing lab in China, and Carpenter said the company has "tested more masks that have failed than that have passed — by an order of magnitude."
3M's N95 masks are often seen as the gold standard, and Supply Link has been trying for several months to secure 2 million of them for the state.
Supply Link executives say they had a supplier lined up when they struck the Minnesota N95 deal but had to later change sources.
Supply Link's Kaspar said many N95 sellers won't take orders for less than 5 million to 10 million masks, complicating the procurement process. Plus, the mask supply chain has been riven with demands from sellers for money down, while the number of brokers has proliferated.
"The whole mask industry has been muddled with brokers, many of them liars and thieves," Kaspar said. "This rabbit hole is a lot deeper than I thought."
Staff writer Kim Hyatt contributed to this report
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