Dan Izhaky: briefs and writing

Orders, not grants.

2026-10-27T12:00:00Z

The problem

Since 2020, Washington has put more than $800 million into domestic nitrile glove capacity through Defense Production Act Title III awards. Plants got built. Demand did not follow. The United States still makes roughly one percent of the 120 billion nitrile gloves it uses each year.

A grant pays for steel and equipment. It does not pay for the next ten years of production, and no lender will finance a production line against a purchase that may never come. When the emergency faded, buyers went back to the lowest landed price, and the new capacity was left without customers.

What the numbers say

Domestic gloves cost roughly twice the imported price. Asian producers land gloves at about $13 to $15 per thousand and are still adding capacity.
A plant without offtake is a stranded asset, whatever it cost to build.

What would work

Multi-year offtake. Federal buyers commit to defined volumes over five to ten years, with price floors, so a line can be financed.
Buy what you fund. Any future capacity award comes paired with a purchase commitment from the agencies that need the product.
Rotate, don't warehouse. Inventory bought from domestic makers moves through commercial and federal channels before it expires (see Rotate the stockpile).

The ask

Stop measuring success by dollars awarded. Measure it by units ordered from American lines, year after year.

Finish the Section 232 investigation.

2026-10-27T12:00:00Z

Where it stands

On September 2, 2025, the Commerce Department opened a Section 232 national-security investigation into personal protective equipment, medical consumables and medical equipment. Its own notice names surgical masks, N95 respirators, gloves and gowns. Public comments closed in October 2025. As of this writing there has been no determination.

Why it matters

Section 232 exists for exactly this case: the national-security risk and the market outcome point in opposite directions. Left to price alone, the market keeps finished gloves in Malaysia and the raw materials in China.

A better design

Not a blanket tariff. The pharmaceutical action showed a better model: a high headline rate that drops for companies that commit to build here, and drops further for those that also commit on price.
Pair it with offtake. A tariff without a buyer is a tax on hospitals. A tariff with multi-year purchase commitments is an industrial policy.
Plan for the real objection. Hospitals run on thin margins. Phase-ins and targeted exemptions for genuine shortages keep care whole while capacity comes online.

The ask

Finish the report, and make the result a contract with a tariff as its enforcement mechanism.

Tariffs that close the market.

2026-10-27T12:00:00Z

What happened

Duties on Chinese medical gloves rose sharply, and domestic market share did not move. According to trade data cited by Charles Benoit in The American Conservative, China’s share of U.S. glove imports fell from about 40 percent to 3 percent, Malaysia’s rose from 44 percent to 68 percent, Vietnam’s tripled, and total imports grew 19 percent.

A China-only tariff does not remove Chinese supply. It routes it through third countries.

The 2026 forced-labor action

The Section 301 action effective July 24, 2026 put 10 to 12.5 percent duties on 60 economies, including the major glove sources, on top of the existing rate on Chinese gloves. That narrows the gap with domestic production. It does not close it, and no lender underwrites a line against a duty the next administration can revoke.

What would work

Origin-neutral duties. A flat per-unit duty on every country of origin at once leaves no route around it.
Enforce origin. Transshipment and minimal processing should not change a product’s country of origin.
Use the revenue. Duty receipts can fund the offtake that makes domestic supply bankable.

The ask

Tariffs are the stick. The purchase order is what builds factories. Use both.

Pay hospitals to buy American.

2026-10-27T12:00:00Z

The problem

Hospitals and their group purchasing organizations buy most of the country’s PPE, and they buy on price. Asking them to pay twice as much for domestic gloves without paying them back is asking them to lose money.

What is already moving

Medicare already has a payment adjustment that recognizes hospitals’ added cost of buying domestically made N95 respirators. In its August 28, 2026 comments to the Centers for Medicare & Medicaid Services, the American Hospital Association asked CMS to extend that adjustment to domestically made nitrile gloves, gowns, syringes, needles and other common PPE, and to define “domestic” the way the Make PPE in America Act does: made from domestic materials and components.

Why this works

It acts on the buyer, not the factory. Demand created at the hospital level is the demand that lasts.
It is cheap relative to the result. A few cents a glove, applied across Medicare volume, gives a domestic line a customer base.
It rewards real domestic content, not final assembly of imported parts.

The ask

Extend the domestic PPE payment adjustment to gloves and the other high-volume items, with a domestic-content definition that matches the Make PPE in America Act. More in “The Nickel-a-Glove Question”.

Publish the demand signal.

2026-10-27T12:00:00Z

The problem

A manufacturer deciding whether to add a line needs to know what will be bought, in what specification, in what volume and for how long. For most of the last five years, nobody could say.

A real step forward

HHS now publishes a quarterly Covered PPE Forecast under the Make PPE in America Act, giving industry a view of anticipated department-wide demand and inviting industry feedback on what would make it more useful. That is exactly the kind of signal capital needs.

What would make it bankable

Specifications and volumes by item, not just categories, so a plant can size a line.
Duration. Multi-year horizons, because equipment is financed over years, not quarters.
One signal across government. HHS, the VA, the Department of War and DHS buy many of the same items. Aggregated demand is larger and steadier than any one agency’s.
A path from forecast to order, so that a forecast line can turn into a contract.

The ask

Keep the forecast, deepen it, and extend it across every agency that buys PPE.

Rotate the stockpile.

2026-10-27T12:00:00Z

The problem

Product bought for a stockpile and left on a shelf expires. It costs money to store, protects no one when it is out of date, and does nothing for the industrial base that would have to refill it in a crisis.

The model already exists

The Defense Logistics Agency’s Warstopper program shows how: pay domestic manufacturers to maintain ready surge capacity, keep inventory moving through normal distribution channels so stock is always fresh, and back the arrangement with multi-year commitments that outlast a news cycle.

What it would look like for PPE

Warm-base contracts that pay for capacity that can be switched on, not only for units delivered.
Vendor-managed rotation, so stockpiled gloves and respirators are sold into everyday use before they expire and replaced with fresh domestic product.
Multi-year terms so the commitment survives budget cycles.

The ask

Make domestic manufacturing the core of preparedness plans, and fund it the way the warfighter supply chain already does.

The Nickel-a-Glove Question: Medicare Is Finally Asking the Right Thing About American-Made PPE

2026-07-18T12:00:00Z

CMS's new proposal would pay hospitals extra for domestic gloves, gowns, and respirators. As someone who built one of the plants this policy is meant to save, here's what it gets right — and what it still misses.

Buried on page 41985 of the July 7 Federal Register, inside a proposed rule otherwise devoted to outpatient payment rates, CMS is asking a question I've waited six years for the federal government to ask: should Medicare pay hospitals more when they buy American-made PPE and essential medicines? Not "should we fund glove factories." Not "should we stockpile." Should the largest payer in American healthcare recognize, in reimbursement, that domestic supply costs more — and pay the difference.

I founded United Safety Technology, one of the BARDA-backed ventures that tried to stand up domestic nitrile glove manufacturing after COVID. That effort is now winding down, and the press has rendered its verdict on the whole program: Bloomberg's July feature put it bluntly — almost $1 billion later, the US still can't make a medical glove at scale. Roughly $850 million in federal awards went to six companies. The US consumes about 120 billion nitrile gloves a year and still makes about 1% of them.

The postmortems mostly blame execution. Having lived it, I'll tell you what actually killed the program: we financed supply and never built demand. The plants could be engineered. What could not be engineered was a customer willing to commit to volume at a price that reflected domestic costs — roughly twice the imported price. No committed offtake means no bankable revenue; no bankable revenue means no plant survives its ramp.

That's why this obscure section of a Medicare payment rule matters more than any of the headlines. For the first time, federal policy is aimed at the demand side. It deserves serious engagement — and serious scrutiny.

From brainstorm to blueprint

In January, CMS issued an advance notice — the "Made in America PPE and Essential Medicines" ANPRM — floating three loose concepts: a "Secure American Medical Supplies" designation for hospitals, a separate Medicare payment, and a hospital quality-reporting measure tied to domestic purchasing. It was a request for ideas, with no numbers attached.

The July proposed rule (CMS-1850-P, Section XXII) shows CMS actually listened to the comments. Two of the three concepts are gone: the agency says it is "no longer exploring, at this time" the designation or the quality measure, because commenters "favored voluntary, non-budget-neutral payment approaches over quality measures or payments tied to hospital designations." What remains is one mechanism, now specified in surprising detail: a voluntary payment adjustment under the inpatient payment system — potentially funded with new money rather than redistributed from other hospital payments.

The specifics, straight from the rule text:

A defined product list with per-unit premiums. Three PPE categories qualify: N95-type filtering facepiece respirators at a $0.38 differential per item, isolation gowns at $0.82, and nitrile exam gloves at $0.05 — per glove. Eighteen essential medicines (sterile injectables and generic antibiotics with US production) carry two-tier differentials depending on whether just the finished dose, or both the finished dose and the active ingredient, are made domestically.

A workable definition of "domestic." PPE would follow the Make PPE in America Act standard — with one exception that tells you CMS did its homework: because there is effectively no domestic nitrile butadiene rubber, gloves made in the US from foreign NBR would still qualify. That is the correct call. Demanding a fully domestic input chain on day one would define the category out of existence.

An eligibility infrastructure. Manufacturers would attest annually to HHS; the government would publish a public file of qualifying products by NDC or device identifier. Only listed products get paid — a real answer to hospitals' complaint that they can't reliably identify domestic products today.

A spending cap. CMS floats a maximum annual aggregate — "$500 million or $1 billion" — allocated across hospitals by Medicare inpatient-day share.

Comments are due August 31, 2026 (docket CMS-2026-2344 on regulations.gov).

What CMS got right

Give the agency credit for three things.

First, it moved the intervention to the right end of the supply chain. The 2020–2022 approach subsidized construction and hoped purchasing would follow. It didn't. Paying for verified domestic purchases — output, not intentions — is the correct architecture.

Second, the standardized differential design is thoughtfully gaming-resistant. CMS proposes fixed, annually updated premiums rather than manufacturer-reported prices, explicitly to avoid "opportunistic price reporting" and manipulation. A new entrant knows exactly what the premium is worth before pouring concrete.

Third, CMS is candid about its own track record. The rule concedes that the existing N95 reimbursement policy — the closest precedent — has seen almost no uptake: fewer than 100 hospitals nationwide reported the data needed to claim it for FY 2024. Part of the reason is the product itself: that policy covers surgical N95 respirators, which outside a pandemic are a small, specialized purchase — nothing like the universal, everyday consumption of nitrile gloves. When the line item is that small, most hospitals conclude the extra tracking work isn't worth it and simply ignore the program. So the N95 experience is not the poster child for how this broader program will fare — but it is a warning worth heeding: participation has to be made as easy as possible for hospitals that are already overburdened, or even a well-designed premium will go unclaimed.

Where it falls short

The math only covers Medicare's slice. This is the detail most coverage has missed. The payment reimburses only the Medicare inpatient share of the premium — and CMS's own worked example shows how small that is. A hospital that buys one million respirators, 300,000 of them domestic, incurs $114,000 in domestic premiums. Under the cost-report approach, its payment is $11,400. The hospital still absorbs roughly 90% of the cost of doing the right thing. CMS acknowledges commenters told it exactly this — that the agency "would need to pay beyond the IPPS and OPPS shares of the additional costs in a non-budget neutral manner to shift purchasing," possibly requiring Congress. Unless the final design confronts that gap, uptake will look like the N95 policy: a well-intentioned adjustment nobody uses.

A reimbursement rule is not an offtake contract. Here is the manufacturer's-eye view. To finance a glove line, you need revenue a lender will underwrite. A per-unit premium that exists at the pleasure of annual rulemaking — adjustable every year, reversible by any future administration — is not that. CMS's own comment file says the quiet part: commenters emphasized that "long-term, committed contracting arrangements (for example, 2- to 3-year or longer arrangements)" are what actually expand the manufacturing base. The payment adjustment can be the fuel, but committed multi-year purchasing — by hospitals, GPOs, and federal buyers — is the engine. The rule should be explicit about how it induces contracts, not just transactions.

Is a nickel the right number? CMS's differentials are "derived from public comments, prior discussions with manufacturers, and Federal procurement data," and the January ANPRM cited ASPR's finding that domestic gloves run roughly 1.5 to 3 times the imported price. Whether $0.05 per glove truly bridges that spread depends on where import prices sit and where a domestic line's costs land at realistic utilization — numbers I spent years living with. CMS is inviting exactly this input, and manufacturers should give it with specificity, because a differential set too low delivers all of the administrative burden with none of the demand shift.

The tracking burden is real. The claims-based approach requires hospitals to bill new codes for domestic gloves, gowns, and respirators; the cost-report alternatives require allocation formulas built from cost-report worksheets. Hospitals told CMS in the ANPRM round that they struggle to identify domestic products at all. If claiming the payment costs more in administrative effort than it returns — see again: fewer than 100 hospitals on the N95 policy — the program fails quietly.

What happens next

CMS closes this comment period on August 31. The rule contains a direct solicitation that I hope every domestic manufacturer, hospital supply chain leader, and GPO answers: the agency wants data on "current domestic production capacity, manufacturers' ability to expand output, expected expansion timelines, and barriers to scaling production."

I'd summarize my own answer this way. Capacity was never the hard part — the industry demonstrated it can build lines. The barrier to scaling is, and has always been, the absence of committed demand at a price that reflects domestic cost. This proposal is the first federal mechanism aimed at that barrier. It is also, in its current form, too small a signal to finance a plant: Medicare's fractional share of a nickel a glove, capped, claimable through paperwork most hospitals won't do.

The fix isn't to abandon the mechanism — it's to finish it. Pay a share large enough to change purchasing behavior, or pair the adjustment with procurement vehicles that can sign multi-year commitments. Publish the eligibility file and keep the differentials standardized. And design the claiming process so a hospital can participate without hiring a consultant.

We already ran the experiment where America funded glove factories without funding glove customers. It cost about a billion dollars and produced a Bloomberg headline. This rule is the beginning of the second experiment — the right one. It's worth getting the details right.

Sources: CY 2027 OPPS/ASC Proposed Rule (CMS-1850-P), Section XXII, 91 FR 41985–41996 (July 7, 2026); Made in America PPE and Essential Medicines ANPRM (CMS-1516-ANPRM), 91 FR 3851 (Jan. 29, 2026); CMS Fact Sheet on the CY 2027 OPPS/ASC Proposed Rule (July 2, 2026); Bloomberg, "Why It's So Difficult to Produce 100% American-Made Medical Gloves" (July 7, 2026); Becker's Hospital Review, "$850M later, US medical glove production still lags" (July 7, 2026); public comment docket CMS-2026-2344 at regulations.gov.

Uncle Sam’s Shopping Spree: How Centralizing Purchases Could Change Your Next Doctor’s Visit

2025-03-21T12:00:00Z

Imagine the U.S. government as the world’s biggest shopper, spending billions each year on everything from computers to, yes, even the nitrile gloves your doctor wears. Recently, President Trump signed an Executive Order aiming to streamline this massive purchasing system by consolidating it under the General Services Administration (GSA) . The idea is simple: by buying in bulk, the government hopes to save taxpayer dollars and eliminate waste. But what does this mean for something as crucial as the disposable medical supplies used every day in our healthcare system? Let’s take a closer look at how this change could affect the procurement of nitrile exam gloves and syringes.

A Look at the Current System

Currently, major federal agencies like the Department of Health and Human Services (HHS), the Department of Veterans Affairs (VA), and the Department of War (DoW) largely handle their own procurement of medical supplies . HHS, for instance, uses its Procurement and Contracting Services (PCS) division and the Strategic National Stockpile (SNS) to acquire these items, especially for public health emergencies . The VA relies heavily on its Medical/Surgical Prime Vendor (MSPV) program , while the DoW utilizes the Medical Electronic Catalog (ECAT) . Each system has its own established processes, contracts, and supplier relationships.

The Proposed Shift: All Under One Roof?

The new Executive Order could change this significantly. Agencies will need to propose how their procurement of common goods, which likely includes medical supplies, can be consolidated under the GSA . This means the GSA, traditionally focused on things like office buildings and IT, could become the central buyer for nitrile gloves and syringes for the entire federal government .

Potential Perks: Savings and Efficiency

This centralization could bring some notable benefits . By pooling the purchasing power of multiple agencies, the GSA might be able to negotiate lower prices from suppliers . Think of it like buying in bulk at a warehouse store — the more you buy, the cheaper each unit becomes. This could lead to significant cost savings for taxpayers, especially considering the vast quantities of medical supplies the government purchases annually .

Beyond cost, a unified system could streamline the supply chain, reduce administrative redundancies, and potentially improve inventory management across different agencies . Standardizing the types and specifications of gloves and syringes could further simplify the process and ensure consistent quality .

Possible Pitfalls: Responsiveness and Supply Chain Stability

However, this consolidation isn’t without potential challenges . Agencies like the VA, which directly provides healthcare, might have very specific needs that a one-size-fits-all GSA approach might not fully address . A centralized system might also be slower to respond to the urgent or changing needs of individual agencies . Imagine a sudden surge in demand due to a health crisis — a centralized system might face bottlenecks in quickly fulfilling those needs.

Furthermore, disrupting established supply chains could lead to temporary hiccups in the availability of these critical supplies . Agencies have built relationships with specific suppliers based on factors like reliability and quality. Shifting these relationships to the GSA could create uncertainty and potential disruptions.

Learning from the Past:

This isn’t the first time the federal government has considered consolidating procurement . Past efforts, like attempts to combine medical supply procurement between the DoW and VA, have faced complexities and haven’t always achieved their intended goals . These experiences highlight the importance of careful planning and understanding the unique needs of different agencies when implementing such a significant change .

The Road Ahead

The impact of this procurement consolidation on disposable medical supplies remains to be seen. While the potential for cost savings and increased efficiency is appealing, it’s crucial to carefully navigate the potential challenges to ensure that agencies can still readily access the supplies they need to provide essential services. The coming months will be critical as the GSA works with other agencies to develop and implement this new centralized system. How smoothly this transition occurs could ultimately affect the efficiency and cost-effectiveness of healthcare delivery across the federal government.

https://www.whitehouse.gov/fact-sheets/2025/03/fact-sheet-president-donald-j-trump-eliminates-waste-and-saves-taxpayer-dollars-by-consolidating-procurement/

The Case for an American Sovereign Wealth Fund: A Public-Private Partnership That Benefits All

2025-02-04T12:00:00Z

As an entrepreneur and government contractor, I’ve witnessed firsthand how public funding catalyzes private-sector innovation and growth. President Trump’s executive order to establish America’s first federal sovereign wealth fund (SWF) represents a transformative opportunity to maximize returns on public investments for all Americans[1].

Why America Needs a Sovereign Wealth Fund

The United States government holds $5.7 trillion in assets, with far more value in natural resources and other holdings[1]. Currently, these assets generate limited returns for taxpayers. An adequately structured SWF would allow the American people to benefit from professional management of these assets, potentially funding critical services and reducing tax burdens over time[4].

Key Benefits of the Proposed Fund

Economic Growth and Stability
A U.S. sovereign wealth fund could stabilize economic downturns by providing capital for job creation and infrastructure projects when private investment slows[4]. The fund could also help reduce inflation and provide steady funding for essential public services[8].

Infrastructure Development
The fund could invest in critical infrastructure projects that benefit the public while generating returns. Rather than simply spending tax dollars, the government could take equity positions in projects, creating long-term value for citizens[4].

Reduced Tax Burden
Returns from the fund could help finance public services without raising taxes. Norway’s model demonstrates how investment returns can sustainably fund government operations while building wealth for future generations[7].

Essential Safeguards

Independent Governance
The fund must operate with strict governance controls and professional management, following established best practices from successful SWFs worldwide[62]. Clear separation from political influence is essential.

Transparency and Accountability
Regular public reporting, independent audits, and transparent investment criteria will be crucial for maintaining public trust and ensuring responsible management[61].

Strategic Investment Focus
The fund should focus on investments that serve both financial and strategic national interests, such as critical infrastructure, technology, and industries vital to supply chain resilience[5].

Looking Forward

While establishing an American sovereign wealth fund presents challenges, the potential benefits far outweigh the complexities. With proper structure and oversight, this fund could become a powerful tool for building long-term national wealth while delivering tangible benefits to American taxpayers[59].

The 90-day planning period directed by the executive order provides an opportunity to design a world-class institution that serves American interests for generations to come[1]. As business leaders and citizens, we should engage constructively in this process to ensure its success.

The Two-Call Rule: Unlocking Abundance Through Connection

2025-01-24T12:00:00Z

In our hyperconnected world, we’re often blind to the incredible wealth of resources and opportunities that surround us. There’s a powerful concept I recently encountered that’s transformed my perspective on abundance: you’re only two phone calls away from virtually anything you need in life.

The Power of Network Dynamics

Think about it for a moment. Your immediate network — friends, family, colleagues — represents your first-degree connections. Each of these people has their own network, exponentially expanding your reach. When you embrace this reality, the world begins to look less like a place of scarcity and more like an ocean of possibilities.

Breaking Down the Two-Call Rule

Here’s how it works: Let’s say you’re dreaming of starting a sustainable fashion brand. You don’t know anything about textile manufacturing or retail distribution. But:

Your college roommate (first call) works at a marketing firm
2. They know a sustainability consultant (second call) who has deep connections in eco-friendly textile manufacturing

Just like that, you’re connected to exactly the expertise you need. The beauty of this principle isn’t just in its practicality — it’s in the mindset shift it creates.

Abundance as a State of Mind

When you truly internalize that you’re just two connections away from any resource, knowledge, or opportunity you need, something remarkable happens. The mental barriers of “I can’t” or “It’s not possible” begin to dissolve. They’re replaced by more empowering questions:

“Who do I know who might know someone who could help?”

“What connections haven’t I explored yet?”

“How can I approach this challenge differently?”

Cultivating Connection Consciousness

To leverage this principle effectively, we need to:

Maintain genuine relationships, not just transactional ones
2. Stay curious about people’s backgrounds and experiences
3. Be willing to both give and receive help
4. Keep an open mind about unexpected connections

The Ripple Effect of Abundance Thinking

When you operate from a place of abundance, you’re more likely to:

Share opportunities with others
- Collaborate rather than compete
- Take calculated risks
- Approach challenges with creativity
- Maintain resilience in the face of setbacks

From Mindset to Action

Here’s how to put this principle into practice:

Before declaring something impossible, pause and ask yourself: “Who in my network might know someone who could help?”
2. Keep a running list of your contacts’ unique skills and experiences
3. Regular check-ins with your network shouldn’t feel like networking — they should be authentic connections
4. Be the connector for others whenever possible

The Responsibility of Abundance

With this powerful perspective comes responsibility. As you recognize the abundance available through your network, consider:

How can you be a valuable resource for others?
- What unique connections can you offer?
- How can you help expand others’ vision of what’s possible?

Conclusion

The two-call rule isn’t just about accessing resources — it’s about recognizing that we live in a world of abundance, not scarcity. Every person you know is a gateway to new possibilities, knowledge, and opportunities. When you embrace this truth, you’ll find that your limiting beliefs begin to fade, replaced by an exciting question: “What else is possible?”

Remember, the next time you face a challenge or dream of a new possibility, you’re probably just two phone calls away from someone who can help make it happen. The only question is: are you ready to pick up the phone?

How Tariffs on Critical Imports Strengthen National Security

2025-01-23T12:00:00Z

In a recent interview with CNBC, Jamie Dimon, CEO of JPMorgan Chase, addressed the lingering controversy over tariffs enacted during President Trump’s administration by bluntly advising everyone to “get over it.” While Dimon’s remark might seem dismissive, it brings forward a meaningful conversation about tariffs’ enduring impact on national security — especially regarding critical imports. This discussion goes beyond politics and centers on ensuring stability, preparedness, and resilience for any nation in a rapidly shifting global landscape.

1. Defining “Critical Imports”

Critical imports are resources, components, or technologies essential to a nation’s infrastructure, defense, healthcare, and broader economic vitality. Think of rare earth minerals crucial for defense systems, healthcare supplies like personal protective equipment (PPE), or semiconductors powering virtually every modern electronic device. When these goods are predominantly sourced from abroad, any disruption — whether caused by political instability, trade disputes, or global crises — can compromise national security.

2. Tariffs as a Tool for Domestic Readiness

Tariffs are, in essence, taxes on imported goods. When placed on critical imports, they can serve as an incentive for:

1. Domestic Production: Tariffs can encourage manufacturers to invest in local production by making some imported goods more expensive and reducing dependency on foreign suppliers.

2. Supply Chain Diversification: When costs increase, companies may seek alternative partners, spurring a more robust and geographically diverse supply chain.

3. Strategic Reserves and Reshoring: Governments and industries may benefit from stockpiling essential resources or bringing production facilities home to prevent supply shocks.

From a national security standpoint, control—or at least improved oversight—of these assets and products is crucial. Tariffs, though imperfect, are one policy option to incentivize that movement toward domestic and allied production.

3. The Jamie Dimon Perspective: “Get Over It”

Jamie Dimon’s perspective, as reported by CNBC, underscores a practicality: tariffs are likely to remain part of the trade landscape for the foreseeable future. Instead of fighting the reality of tariffs, he suggests companies should adapt their strategies and operations to stay competitive.

However, “getting over it” does not mean ignoring potential downsides or overlooking how tariffs fit into broader strategic objectives. Tariffs can increase consumer costs, sparking retaliatory measures from trade partners and occasionally strain diplomatic relationships. Yet when it comes to critical materials or technologies that directly affect national security, the benefits of partial self-reliance and assured supply often outweigh short-term financial downsides.

4. Balancing Security and Economic Growth

To effectively use tariffs as a safeguard for national security, policymakers and industry leaders must strike a balance:

• Selectivity in Application: Tariffs on all goods can unnecessarily harm economic growth and escalate trade disputes. Focusing on critical imports that truly affect national security and industrial resilience is more prudent.

• Supporting Domestic Investment: Tariffs alone won’t build new factories or infrastructure. Governments can bolster the effects of tariffs by offering incentives, tax breaks, or grants to companies that invest in the domestic production capacity of essential materials.

• Ensuring Global Competitiveness: Even as local production is strengthened, policymakers must ensure that U.S. industries remain competitive internationally. That means fostering innovation, streamlining regulation, and investing in workforce development.

• Multi-Partner Cooperation: The U.S. can cooperate with reliable allies if specific critical resources are more readily available or more efficiently produced abroad. Tariffs can be designed to exclude or lower rates for allied nations, maintaining secure supply chains without fueling unnecessary trade wars.

5. Preparedness in a Volatile World

Recent global events — from pandemics to geopolitical tensions — have highlighted the fragility of supply chains and the risks of over-reliance on distant suppliers for life-saving or defense-related items. While tariffs are not a cure-all, they represent one way a country can shape supply chain decisions and encourage more robust domestic production. In conjunction with other measures — like stockpiling, bilateral trade agreements, and investment in research and development — tariffs can be a calculated part of a national security strategy.

6. Conclusion: Looking Beyond the Politics

Whether you side with Jamie Dimon’s “get over it” approach or have concerns about the broader economic repercussions, tariffs on critical imports undeniably intersect with national security issues. They serve as a policy instrument that can reduce external dependencies, spur domestic innovation, and protect key industries from external shocks.

Ultimately, the conversation about tariffs should transcend partisan lines and focus on a central question: How do we ensure our nation can secure the resources, technologies, and capabilities needed to protect our citizens and remain globally competitive? That is the core of national security — and tariffs on critical imports are one piece of that ever-evolving puzzle.

A Fond Farewell and a Warm Welcome: Looking Back and Moving Forward

2025-01-20T12:00:00Z

As one era comes to a close and another begins, it’s time to reflect on the impressive achievements of the outgoing ASPR (Assistant Secretary for Preparedness and Response) and their dedicated team over the past four years. Together, they have steered the ship through some of the most challenging waters in recent history, strengthening our nation’s public health emergency preparedness and response capabilities.

Under their leadership, we’ve witnessed significant strides in building the Strategic National Stockpile, expanding medical countermeasure development, and improving our ability to respond swiftly to a wide range of emergencies. Whether it was bolstering hospital readiness, managing pandemic-related supply chain challenges, or advancing innovation in medical response strategies, their efforts have undoubtedly made our nation safer and more resilient.

As we extend our heartfelt congratulations and gratitude to the outgoing team, we also look ahead with anticipation to the work that remains. The next ASPR inherits both an improved foundation and a formidable set of challenges that require urgent action:

• Pandemic Preparedness: The experience of the last pandemic underscored the critical importance of readiness. While progress has been made, we must continue to refine our response frameworks, enhance early warning systems, and ensure that the lessons learned translate into concrete improvements for the future.

• Domestic Manufacturing Base: The recent public health crises highlighted vulnerabilities in the global supply chain. It’s essential that we accelerate efforts to establish and sustain a robust domestic manufacturing base for personal protective equipment (PPE), diagnostic supplies, and essential pharmaceuticals. Building this capacity will not only prepare us for future emergencies but also create jobs and strengthen the economy.

• Strategic National Stockpile Enhancements: While the stockpile has grown, maintaining and replenishing it with domestically sourced materials and cutting-edge products remains an ongoing priority.

• Healthcare System Resilience: Ensuring that our hospitals and healthcare providers have the resources, training, and infrastructure needed to face any emergency must remain a top focus.

• Equity and Inclusion in Emergency Response: Ensuring that every community — particularly those historically underserved — has equitable access to lifesaving interventions and timely information is paramount.

As we thank the outgoing ASPR for their tireless service, we also welcome the incoming leader with high hopes and a clear vision. The path forward is not without its hurdles, but with determination, collaboration, and a focus on continuous improvement, we can rise to the occasion. By building on past successes and tackling these critical issues head-on, we can leave our nation better prepared, more secure, and stronger for generations to come.

Strengthening Manufacturing Through Disability-Inclusive Employment: A Win-Win for Business and Soc

2024-12-28T12:00:00Z

In an era of domestic manufacturing opportunities and challenges, one robust solution remains surprisingly under-tapped: the talent pool of workers with disabilities. As a manufacturing business leader, I’ve witnessed firsthand how disability-inclusive hiring practices strengthen our workforce and drive innovation, productivity, and bottom-line results.

The Business Case for Inclusive Hiring

The numbers tell a compelling story. According to the U.S. Department of Labor, workers with disabilities demonstrate higher retention rates, lower absenteeism, and comparable or superior safety records compared to their peers. These statistics translate into reduced training and recruitment costs, enhanced workplace stability, and improved operational efficiency.

Manufacturing environments, with their emphasis on process optimization and adaptable workstations, are particularly well-suited for inclusive employment. Modern manufacturing often involves tasks that can be effectively performed by individuals with various abilities, especially when paired with today’s advanced adaptive technologies.

Innovation Through Inclusion

Workers with disabilities bring unique perspectives to manufacturing challenges. Their lived experiences often lead to innovative solutions for workplace efficiency and accessibility. For instance, modifications made to accommodate employees with disabilities frequently result in improvements that benefit all workers, from ergonomic workstation designs to more intuitive process flows.

Breaking Down Barriers

Common misconceptions about employing people with disabilities in manufacturing settings often center around concerns about safety, productivity, and accommodation costs. However, research shows these concerns are largely unfounded:

The average cost of accommodations is typically less than $500, while many cost nothing at all
- Modern manufacturing facilities already emphasize safety and ergonomics
- Technological advances have made most manufacturing roles adaptable for various abilities
- Tax incentives and support programs can offset any associated costs

Best Practices for Implementation

Creating an inclusive manufacturing workplace requires thoughtful planning and execution:

Partner with disability employment organizations for recruitment and training support
Invest in universal design principles that benefit all employees
Provide disability awareness training to existing staff
Establish clear communication channels for accommodation requests
Create mentorship programs to support career development

Success Stories That Changed the Industry

The transformative power of inclusive employment in manufacturing and distribution is perhaps best illustrated by Randy Lewis’s revolutionary work at Walgreens. As the former Senior Vice President of Supply Chain and Logistics, Lewis spearheaded an initiative that became the gold standard for disability employment in distribution centers.

When Walgreens opened its Anderson, South Carolina distribution center in 2007, Lewis set an ambitious goal: more than 30% of the workforce would be people with disabilities, working alongside other employees, earning the same pay, and meeting the same productivity standards. The results were extraordinary:

The Anderson facility became the company’s most efficient distribution center
- Employee turnover rates dropped significantly
- Safety metrics improved across the board
- The success led Walgreens to expand the model to other facilities, with some reaching 40% of employees with disabilities

Lewis’s initiative proved that inclusive employment wasn’t just about social responsibility — it was about building a more effective, stable, and productive workforce. His work has inspired numerous other companies to follow suit.

Real Impact on Communities

Beyond these business success stories, inclusive hiring strengthens local communities. Manufacturing jobs typically offer competitive wages and benefits, providing economic independence for workers with disabilities. This economic empowerment creates a ripple effect, supporting local economies and reducing dependence on social services.

Looking Forward

As domestic manufacturing continues to evolve, disability-inclusive employment represents not just a social responsibility but a strategic advantage. Companies that embrace this opportunity position themselves as industry leaders while building more resilient, innovative, and productive workforces.

The path to inclusive employment in manufacturing may require some initial adjustments, but the long-term benefits — from improved operational efficiency to enhanced company reputation — make it a worthwhile investment. More importantly, it’s an opportunity to tap into an underutilized talent pool while creating meaningful career opportunities for all members of our communities.

Remember: Disability inclusion in manufacturing isn’t just about doing good — it’s about doing good business.

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What actions will you take to make your manufacturing workplace more inclusive? The time to act is now.

The Not-So-Secret Way Around U.S. Tariffs: A Comprehensive Look

2024-12-22T12:00:00Z

Trade policies shape the global economy in profound ways, and U.S. tariffs, particularly those imposed on Chinese imports, have dramatically altered the landscape of international trade. While these tariffs aim to protect domestic industries and address trade imbalances, companies have developed sophisticated methods to navigate around them. Let’s explore these circumvention strategies, their implications, and the ongoing efforts to maintain trade policy integrity.

Understanding Tariff Evasion Strategies

The complexity of global supply chains has given rise to several methods companies use to avoid tariffs. These strategies, while potentially offering short-term financial benefits, raise significant concerns about fair trade practices and economic stability.

Transshipment: The Route Less Traveled

Transshipment has emerged as one of the most prevalent tariff avoidance methods. In this practice, companies route their goods through intermediate countries not subject to tariffs, effectively masking the products’ true origin. For example, Chinese-manufactured electronics might arrive in the United States bearing “Made in Vietnam” or “Made in Mexico” labels, circumventing the tariffs specifically targeting Chinese imports.

Misclassification: A Game of Categories

Product misclassification represents another sophisticated evasion strategy. Companies might make subtle modifications to their products or packaging to qualify for different tariff classifications with lower duty rates. This practice often involves creative product descriptions or minor component alterations that can significantly impact tariff obligations.

Undervaluation: The Hidden Discount

Perhaps the most straightforward yet challenging-to-detect method is undervaluation. Companies deliberately declare lower values for their goods, reducing their tariff burden since duties are typically calculated as a percentage of declared value. This practice particularly challenges customs authorities, requiring extensive auditing and verification processes.

The Ripple Effect on U.S. Business

These evasion strategies create complex challenges for the American economy. While some importers benefit from reduced costs, domestic manufacturers face an increasingly uneven playing field. The impact extends beyond immediate financial consequences, affecting various aspects of the U.S. economy:

The manufacturing sector often bears the heaviest burden, with some domestic producers struggling to maintain competitive pricing against imports that have circumvented tariffs. This disadvantage can lead to reduced production, job losses, and, in some cases, facility closures.

Market distortions emerge as companies operating within tariff regulations compete against those employing evasion strategies. This creates artificial price advantages that can destabilize entire industry sectors.

Government Oversight and Enforcement

The U.S. Customs and Border Protection (CBP) has intensified its efforts to combat tariff evasion through various measures. They employ sophisticated data analytics, conduct thorough audits, and perform regular physical inspections. However, the sheer volume of international trade and the complexity of global supply chains make comprehensive enforcement challenging.

Legal and Ethical Implications

Companies considering tariff evasion strategies face significant risks. Beyond substantial fines and penalties, violators may face criminal charges and lasting damage to their reputation. The ethical implications extend beyond legal considerations, raising questions about corporate responsibility and fair competition in global markets.

Looking Ahead: The Future of Trade Policy

As global trade continues to evolve, several potential developments could reshape the tariff landscape:

The effectiveness of current tariff policies is under increasing scrutiny, with some experts advocating for more nuanced approaches that better reflect the complexities of modern supply chains. Technological advances may also provide new tools for tracking and verifying product origins, potentially making tariff evasion more difficult.

Conclusion

The challenge of tariff evasion through various methods highlights the intricate balance between protectionist policies and the realities of global trade. While these practices might offer temporary advantages to some businesses, they ultimately undermine fair trade principles and economic stability. As the United States continues to refine its trade policies, particularly regarding China, finding effective ways to enforce tariffs while maintaining competitive markets remains crucial.

The solution likely lies in a combination of enhanced enforcement mechanisms, technological innovation, and potentially revised trade policies that better reflect the complexities of modern global commerce. Understanding these challenges and their implications is essential for businesses, policymakers, and anyone interested in the future of international trade.

This article explores common tariff evasion strategies, their impact on U.S. businesses, and the ongoing efforts to maintain fair trade practices. For the latest updates on trade policies and enforcement measures, consult official government resources and reputable trade publications.

Strengthening Our Domestic Medical Manufacturing for a Resilient Future

2024-10-10T12:00:00Z

The American Medical Manufacturers Association (AMMA) recognizes the critical importance of our domestic medical manufacturing sector in ensuring public health and the resilience of our healthcare system. Recent global challenges have highlighted the need for a robust and strategically analyzed manufacturing base, especially regarding the concentration of sources for essential medical supplies.

Why Strategic Analysis Matters

Identify Concentration Points: Understanding where critical supplies are produced helps us pinpoint potential vulnerabilities and prevent bottlenecks.

Enhance Supply Chain Resilience: Diversifying manufacturing sources ensures continuity during disruptions, whether from natural disasters, geopolitical tensions, or pandemics.

Promote Innovation and Capacity Building: Investing in advanced technologies and expanding production capacities prepares us to meet both current and future healthcare needs.

Maintain Quality and Compliance: Upholding stringent quality standards ensures the safety and efficacy of medical supplies.

AMMA’s Commitment

At AMMA, we are dedicated to:

• Collaborative Partnerships: Working with government, healthcare providers, and industry stakeholders to enhance manufacturing resilience.
• Data-Driven Insights: Utilizing analytics to map manufacturing concentrations and predict potential disruptions.
• Policy Advocacy: Championing policies that support domestic growth, innovation, and fair trade practices.
• Workforce Development: Investing in training programs to build a skilled workforce for the future of medical manufacturing.

A Call to Action

The strength of our healthcare system relies on a resilient domestic manufacturing base. I urge policymakers, industry leaders, and all stakeholders to join us in strategically analyzing and strengthening our medical manufacturing landscape. Together, we can ensure that critical medical supplies remain accessible, affordable, and of the highest quality, safeguarding the health and well-being of all Americans.

Let’s build a more secure and innovative future for medical manufacturing in the United States.

New USTR Tariffs on Medical Gloves: Securing America’s Medical Supply Chain

2024-09-18T12:00:00Z

The U.S. Trade Representative (USTR) has announced substantial tariff increases on medical gloves imported from China, reflecting a broader effort to strengthen America’s domestic medical manufacturing base. These new tariffs are a critical component of the government’s strategy to reduce dependence on foreign suppliers for essential medical supplies and to encourage investment in U.S. production.

Strengthening the U.S. Medical Industrial Base

Starting in 2025, the import duty on medical gloves will increase to 50%; by 2026, this rate will rise to 100%. These measures are intended to safeguard recent U.S. investments in domestic glove production, ensuring the nation is better prepared for future healthcare crises like the COVID-19 pandemic. The tariffs are designed to encourage a shift away from reliance on Chinese imports, which currently dominate the market, and create a more resilient, diversified, and secure domestic supply chain for medical gloves(Section 301 Modification…).

Circumvention Tactics: Beating the Deadline

As with any significant trade measure, foreign manufacturers must seek ways to evade these new tariffs. A likely short-term strategy is to expedite shipments of gloves to the U.S. before the new tariffs take effect. We anticipate a surge in container shipments from China in the months of September, October, and November 2024 as companies try to avoid the 50% tariff hike by ensuring their goods reach U.S. ports before Christmas. This rush to beat the deadline is expected to increase container volumes, requiring U.S. Customs and Border Protection (CBP) vigilance to ensure that these shipments comply with trade regulations.

Exploiting ASEAN Trade Loopholes

More troubling is the long-term strategy Chinese manufacturers may adopt to circumvent these tariffs. Starting in December 2024, Chinese glove producers are expected to shift production capacity to manufacturers in ASEAN (Association of Southeast Asian Nations) countries, using these countries as transit points to export gloves to the U.S. By altering the country of origin and masking the true origin of the goods, these producers hope to avoid the 50% tariff on Chinese products.

This transshipment tactic is familiar and seriously threatens U.S. efforts to rebuild its medical-industrial base. ASEAN traders will likely take advantage of this opportunity to export Chinese-made gloves and other personal protective equipment (PPE) as “Made in ASEAN” products, thus evading the steep import duties. This practice undermines the intent of USTR’s tariff policy, which aims to foster a robust domestic supply chain while reducing dependence on foreign, mainly Chinese, manufacturing.

AMMA’s Call to Action

At the American Medical Manufacturers Association (AMMA), addressing these circumvention tactics head-on is crucial. We urge U.S. policymakers and the CBP to closely monitor these developments and take strong enforcement measures to prevent transshipment fraud. We must close any loopholes that allow Chinese manufacturers to sidestep the tariffs, as doing so would weaken U.S. manufacturing and prolong our dependence on foreign PPE.

The USTR’s decision to impose significant tariffs on medical gloves is a step in the right direction, but its success will depend on robust enforcement. The AMMA stands ready to work with government agencies to ensure that tariff policies are upheld and that U.S. manufacturers have a level playing field to compete and grow.

Conclusion

The USTR’s new tariffs on Chinese medical gloves represent a vital opportunity to strengthen the U.S. medical-industrial base. However, without diligent enforcement, circumvention tactics from Chinese manufacturers could render these tariffs ineffective. AMMA will continue to advocate for strong policies that support U.S. manufacturing and supply chain security. Together, we can reduce reliance on foreign manufacturers and ensure the U.S. is prepared for future healthcare challenges.

Pandemic Preparedness: A Crucial Step Forward

2024-01-24T12:00:00Z

As the COVID-19 pandemic continues to evolve, a recent Washington Post editorial highlights a critical issue that deserves our immediate attention: pandemic preparedness.

The editorial underscores the harsh reality — despite years into the pandemic, the U.S. remains unprepared for future health crises. Only 21% of adults have received the latest booster, indicating a gap in vaccine uptake. But it’s not just about vaccines; it’s about a comprehensive strategy.

The call for action

Developing pan-coronavirus vaccines. Research efforts, including the ambitious Project NextGen, aim to create vaccines effective against all variants. This is not just a scientific challenge but a global imperative.
Addressing long COVID. With the debilitating effects of long COVID becoming increasingly evident, it’s crucial to understand and mitigate its impact.
Political will and public support. Overcoming vaccine hesitancy and political resistance is essential to build community immunity and safeguard public health.
Legislative backbone. We need strong, bipartisan support for laws like the Pandemic and All-Hazards Preparedness Act. Political commitment is key to turning plans into actions.

Why it matters

The lessons from the past few years are clear. Preparedness is not just a policy matter; it’s about safeguarding our future. It’s about ensuring that businesses, communities, and health systems are resilient in the face of health crises.

Your role

Each one of us has a role to play — from advocating for stronger policies to supporting scientific research and staying informed about health measures. Let’s join forces to advocate for and contribute to a future where pandemic preparedness is not an afterthought but a priority.

As we navigate these challenging times, let’s remember: preparedness is not just about responding to the crisis at hand but about being ready for what the future holds.

Urgent Call to Action: Navigating the Tides of Global Trade in Medical Products

2024-01-21T12:00:00Z

As a professional deeply involved in the medical products industry, I’ve been closely following the trends and challenges similar industries face, especially as illustrated in a recent comprehensive analysis of the clean energy and high-tech sectors. The core message? We must act now to safeguard our industry.

Global market forces. The New York Times article vividly portrays how the influx of low-priced products, particularly from China, reshapes industries. This is not just about solar panels or semiconductors — the medical products sector is on the brink of a similar upheaval. We are witnessing an increasing flood of medical products from markets with significant cost advantages and government support. If this trend continues unchecked, it could profoundly impact our industry’s competitiveness and innovation.

Manufacturing and supply chain risks. The U.S. investment in manufacturing infrastructure to enhance domestic capabilities mirrors our efforts in the medical field. However, these efforts are at risk if we don’t address the surge of imported medical products that could overshadow our advancements. This scenario is not hypothetical — it’s a looming reality that demands immediate attention.

Economic and strategic implications. The article highlights the importance of maintaining a competitive edge in critical industries. In the medical sector, this translates to sustaining innovation, quality, and accessibility in our products. Failing to do so could lead to a dependency on imports for essential medical supplies, a situation fraught with risks, especially in global crises.

Collaboration and policy response. Just as the analysis calls for new protective measures and tariff considerations in other sectors, we need a similar concerted effort in the medical products industry. It’s time for industry leaders, policymakers, and stakeholders to collaborate on strategies that bolster our domestic manufacturing capabilities and implement fair trade practices. This includes exploring tariffs, subsidies, and partnerships aligned with our long-term objectives.

A call to action. The alarm has been sounded, and we must respond with urgency and resolve. Let’s come together to ensure that our industry remains vibrant, competitive, and capable of meeting the healthcare needs of our nation and the world.

Understanding Disease X: A Wake-Up Call for U.S. Healthcare Resilience

2024-01-19T12:00:00Z

As the world grapples with the concept of Disease X, a hypothetical pathogen warned by the World Health Organization, it’s time to reflect on our preparedness for future pandemics. Disease X represents an unknown threat that could lead to a global health crisis. The COVID-19 pandemic, an unforeseen Disease X scenario, has already shown us how rapidly a new pathogen can spread and the devastation it can cause.

However, there’s another critical aspect we must address: the U.S. healthcare system’s reliance on Southeast Asia for medical supplies. Currently, a significant portion of essential medical supplies and pharmaceutical ingredients are sourced from this region. This dependency poses a severe risk in the event of a geopolitical crisis, potentially leaving the U.S. vulnerable during a simultaneous pandemic.

The call to action: strengthening the U.S. industrial base

It’s crucial to consider the implications of this dependency. A combined threat of geopolitical instability and a pandemic similar to Disease X could have catastrophic effects on the U.S. healthcare system. Therefore, it’s imperative that we take proactive steps to:

Expand the U.S. industrial base. Investing in domestic production facilities for critical medical supplies and pharmaceuticals is vital. This move will not only reduce dependence on external sources but also ensure a quicker and more reliable supply chain during health emergencies.
Focus on sustainability. As we expand our industrial base, incorporating sustainable practices is key. This includes eco-friendly manufacturing processes and the use of renewable resources, ensuring that our healthcare system’s growth doesn’t come at the environment’s expense.
Encourage innovation. Supporting research and development in the healthcare sector will lead to advanced medical technologies and supply chain solutions, further bolstering our preparedness for future health crises.

The time to act is now

As leaders, policymakers, and citizens, the responsibility to build a robust and self-reliant healthcare system lies with us. The threat of Disease X is a reminder that we must be prepared for the unknown. By investing in and expanding our domestic industrial base, with a focus on sustainability, we can create a healthcare system that’s not only resilient but also ready to face future challenges.

Further reading: New Scientist, “What is Disease X and why is it in the news?”; University of Nebraska Medical Center, “What Is Disease X?”; Wikipedia, “Disease X”.

5 Benefits of Adding Domestic Manufacturers to Your Purchasing Strategy

2023-12-06T12:00:00Z

“Made in America” is not only patriotic. Procuring a portion of supplies from domestic manufacturers offers numerous advantages. The approach of shifting certain purchases to domestic and “near-shore” suppliers has gained traction among companies looking to bolster their supply chain strategies. Here are five reasons why organizations should consider sourcing from domestic suppliers for a portion of their overall supply needs:

Reduce your lead times

Long shipping times from overseas suppliers can result in prolonged lead times, making it challenging to quickly respond to changing market demands. Sourcing from domestic suppliers shortens the distance between production facilities and end markets, resulting in shorter lead times. This agility enables your company to adapt swiftly to market changes.

Impact your local community positively

Reshoring efforts help to create jobs in your home country, contributing to economic growth and stability here in the US. This can also lead to a stronger public image and goodwill, as your company is seen as a supporter of the local community and workforce.

Enhance your resilience

The COVID-19 pandemic exposed the vulnerabilities associated with heavily relying on distant suppliers. Disruptions in global supply chains made accessing critical components and materials challenging, resulting in delays and increased costs. By shifting even a portion of your supply chain to domestic suppliers, you can reduce the risk of supply chain disruptions, ensuring a more stable and reliable source of essential goods and materials.

Increase your sustainability

Reducing the distance that products travel can significantly reduce your carbon footprint. The US also often has higher environmental standards than countries we import from. Domestic suppliers can be part of your company’s sustainability strategy, aligning with the growing demand for eco-friendly practices and reducing environmental impact.

Strengthen your relationships

Proximity fosters stronger relationships between companies and suppliers. When suppliers are local or domestic, it’s easier to collaborate, exchange ideas, and build mutually beneficial partnerships. This enhanced communication and collaboration can lead to innovations, cost reductions, and improved problem-solving.

Diversifying your supplier base can be a strategic move that benefits your company by enhancing supply chain resilience and sustainability while fostering stronger relationships and supporting local economies. When done right, this hybrid approach to the supply chain can create a competitive advantage, driving your company’s success in an increasingly interconnected global marketplace.

N95s, Elastomeric Respirators and the Future of PPE during Pandemics

2020-10-29T12:00:00Z

As Americans are struggling to prevent the spread of infections across the country, there are numerous PPE options available to keep them safe from hours to years. Most Americans are familiar with N95 disposable masks, which continue to be the most requested PPE by health care workers since the start of the pandemic. N95 respirators have been used since the 1970s to help miners avoid black lung.

N95s were initially used to protect health care workers from deadly viruses in the 1990s when drug-resistant tuberculosis started infecting health care workers. N95 standards were updated for health care workers, and doctors began wearing them when helping tuberculosis patients. N95 masks work better than a surgical mask because they can filter out large and small particles when they inhale. N95s also have electrostatic charges that can attract virus particles and trap them in the mask's fibers. In comparison to standard surgical masks, N95 masks seal better to one's face; therefore, making it significantly less likely to let contaminated air in or out of the mask. It is also important to note that health care workers need to be fit tested to know which size N95 they should wear to have a proper seal.

Historically, N95s were used to successfully protect health care workers during the SARS and H1N1 pandemics and have been in widespread use for Covid-19. N95s are made to be disposed of after each use to prevent contamination and infection of health care workers. Up until 2020 and the Covid-19 pandemic, N95s were not considered a reusable form of PPE; however, due to severe PPE shortages, reusing N95s for days to weeks has become a prevalent and dangerous practice among health care workers. The CDC, NIOSH, OSHA, and other top health agencies researched ways to prevent needing to reuse N95s, and they are recommending health care workers use elastomeric respirators to extend the stockpile of N95s and prevent the need to reuse disposable PPE. Additionally, in 2018, the CDC recommended that elastomeric respirators be stockpiled in the National PPE stockpile for health care workers to use in case of an eventual pandemic.

Like N95s, elastomeric respirators were created and used in mining and other industries before being used in health care settings. Elastomeric respirators were first used by health care workers in 1996 at the Texas Center for Infectious Diseases (TCID) to protect doctors against drug-resistant tuberculosis and other deadly viruses. Health care workers used elastomeric respirators during SARS and H1N1, but it wasn't until Covid-19 that these respirators started being put into widespread use during pandemics.

Similar to an N95, health care workers need to be fit tested to find the right size of the elastomeric respirator to ensure a proper seal. Elastomeric respirators can filter out more airborne particles than an N95. Because they are made of a rubber-like material, they can also be exposed to liquids without losing their seal, making them ideal for droplet and airborne protection. Elastomeric respirators will soon become the gold standard of respiratory protection because they can protect equally or better than an N95 depending on the filter used, but unlike an N95, elastomeric respirators are not disposable and can be safely reused for years.

Elastomeric respirators can use N95/P95 filters, which filter over 95% of airborne particles similar to an N95 mask, or they can use N100/P100 filters, which can filter out 99.97% of airborne particles. Some elastomeric respirators have one-way valves which only filter the air going in but not the air going out, so for health care workers that use elastomeric respirators with one-way valves, the CDC recommends they place a surgical mask, cloth mask, or procedural mask over the valve so it can be used as source control. Another way to use elastomeric respirators with one-way valves as source control is to give the patient a cloth, procedural or surgical mask, which has the same effect.

While N95s continue to be in short supply, elastomeric respirators are readily available and make a sustainable option for any hospital or long-term care home. By combining elastomeric respirators with N95s, health care workers would no longer need to reuse N95s and can dispose of them after a single use, as recommended. Not all elastomeric respirators are created equal, and some elastomeric respirators have features built into the respirator that can help with communication and comfort. Depending on a healthcare worker's situation, they should choose an elastomeric respirator that works best for their work environment.

While widespread use of elastomeric respirators can prevent outbreaks at long-term care homes and hospitals, they can also be used to protect workers in places where outbreaks occur, such as food plants, which would also prevent the community spread that follow those outbreaks. With proper training and increased use of elastomeric respirators in areas where attacks or large clusters occur, the need to shut down the economy to contain the virus's spread would be significantly reduced. Therefore, hospitals like those in Utah would not have to choose between whom they can save with the limited supply of medical equipment and those who may not survive due to this tragic shortage of equipment.

Due to the sustainability of elastomeric respirators, they could not only help our front-line workers during the current pandemic, but they could also be stored and used the next time a deadly virus should surface. They are thereby stopping the spread of these viruses early and eliminating the threat of another fatal pandemic.