- Distributors do not wish to purchase PPE from an open market and would rather stick to their own factories/contract sites. 
- The distributors are not willing to pay the high prices for the PPEs. 

University of Michigan - Ann Arbor

The normal PPE supply chain process is usually the sourcing teams choosing 2-3 large-scale distributors. The supplies from the distributors are delivered weekly. The distributors usually purchase directly from the manufacturer or third parties. In the U.S., PPE production is limited with more than 70% of PPE produced in China. Due to the spike of demand, distributors cannot acquire PPE to meet the demands. 
- Why aren't distributors purchasing more PPE?
- The Department of Health and Human Services' Strategic National Stockplie
- Negative consequences of PPE shortage
- What should be done?

PPE Supply Chains 

Mehrotra, P., Malani, P., & Yadav, P. (2020, May). Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies. In JAMA Health Forum (Vol. 1, No. 5, pp. e200553-e200553). American Medical Association.
https://jamanetwork.com/channels/health-forum/fullarticle/2766118

Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies

Why aren't distributors purchasing more PPE?

There should be a stockpile of at least 3.5 billion N95 respirators and 500 million surgical masks at the federal levels. A transparent system should display the stock, requests, usages, and rules. The flow from the stockpiles to hospitals should be flawless. 
- Potential short-term solutions

What should be done about the PPE shortage?

- The Department of Health and Human Services’ Strategic National Stockpile (SNS) was assembled to solve the PPE shortage problems. However, reports show that supply distributions are still below the demand level.
- Under normal circumstances, PPE requested to the SNS is fulfilled within 24-36 hrs of approval.
- With COVID-19, there is a decrease in PPE stock in the SNS. Additionally, there is a lack of transparency behind the inventory and allocation of the supplies.

The Department of Health and Human Services' Strategic National Stockplie (SNS)

With the demand for protective personal equipment constantly increasing due to COVID-19, there are compromises being made, aiming to reduce negative ramifications.
- Healthcare workers required to personally acquired their own PPE.  Often sacrifices quality of protection and increases risk of contagion.
-  Reusing of PPE presents higher risk for contracting COVID-19.  Quality degrades over time and reduces effectiveness of protection.

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