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A Michigan congresswoman, a guy in line in China and a global scramble to find N95 masks

April 6, 2020

HOLLY, Mich. — Rep. Elissa Slotkin was trying the governor, the head of a major auto parts supplier and the CEO of a Detroit bicycle company that imports parts from China in a frantic search for someone who might be able to help her find N95 masks for hospital workers in her district.

But it was the owner of a Michigan-based sex toy company who knew a guy who knew a guy who was pretty sure he could get several hundred thousand Food and Drug Administration-certified masks. His connection was standing in a line somewhere in Shandong province.

"I just got off the phone with my guy in China," Steve Craig, the chief executive of Nalpac, a 40-year-old firm based in the Detroit suburbs, told Slotkin (D) in a call late last week. "He's literally at the factory and hasn't left for three days. He's telling me that there are 110 people in line waiting for their orders. I told him to take pictures because no one is going to believe this."

The race for masks and gowns to protect doctors, nurses and paramedics from the novel coronavirus pandemic has consumed governors, presidents, prime ministers and other politicians around the world. Slotkin, the governor's office and the rest of the Michigan congressional delegation had been working closely with the Big Three auto manufacturers, which have long-standing relationships in China, to secure masks.

But even with their help, the demand was far outpacing supply, leaving Slotkin to improvise as best she could as her office was being overwhelmed by increasingly desperate pleas from doctors and nurses begging for help.

"The conditions we're being forced to work in are deplorable," wrote a nurse in Flint who is staffing a wing filled with coronavirus patients.

"How is this possible in a prosperous country?" demanded a doctor in Rochester.

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"Lives depend on you," urged a pediatric nurse in Brighton. "My life. . . . My husband's life."

One of Slotkin's best hopes at the moment was Craig. In late March, as the pandemic was spreading across the world and deaths began to spike in Michigan, a high school friend introduced Slotkin to Craig. His company buys its products from a Chinese firm with a connection to two major N95 mask and medical equipment factories.

Within days, Craig was texting her pictures of his Chinese representative standing in front of the Sanqi Medical factory in Shandong. Slotkin, in turn, matched him with a hospital in her district that was desperate for N95s.

"Do you have any idea who's in line around you?" Slotkin asked.

"Texas, California and Georgia," Craig relayed from his representative.

"What can I do to help?" she asked. "What's your shipping method?"

Craig said he was looking at flying the N95s out in small parcel shipments, even though he would have to pay a significant premium. He asked for help speeding the masks through customs once they reached the United States.

Slotkin offered to check with contacts at the Department of Homeland Security.

She hung up the phone and stared out the window of her family farmhouse in Holly, about an hour outside of Detroit. A skein of Canada geese, migrating north for the summer, honked in the distance. Her aging dogs loped across her front yard. A few hours earlier Michigan had announced 80 new deaths, driving the state total to 417, the third-highest in the nation.

"This is insane," she said. "Just insane."

Reminded of being in Iraq

Slotkin, a former senior Pentagon official and CIA analyst who served in Iraq, flipped a district that President Trump carried by seven points in 2016. Last fall she was part of a group of moderate freshman Democrats who called for impeachment hearings following a whistleblower complaint alleging Trump used the threat of withholding military aid to extract political favors from Ukraine.

In December, when Slotkin voted to impeach, her office was so overwhelmed by calls from angry Republicans that she had to install extra phone lines. Now those same phones were being flooded by people who were scared and wanted help.

A woman from Lansing worried about her daughter, a grocery clerk without any health insurance. An elderly woman from Lake Orion asked if it was safe to go outside. The most anguished calls came from doctors and nurses.

"This virus is so cruel. Our patients come in sick, but conscious and talking and stay that way long enough for us to learn their families' names and to see their grandkids on FaceTime," wrote a nurse from Howell. Soon their "eyes are filling with the terror of people who are drowning," the nurse wrote. "I hate this for them. I hate this for us. I want this to be over."

Many of the health-care workers were furious with their hospitals and their government. "I come from a former communist country and am sad to say this reminds me of the times there 30 years ago," a doctor from Slotkin's district told her. "We get a lot of talk and excuses and justifications. . . . Mask production is not rocket science!"

Early on, Slotkin hoped that the national stockpile of emergency medical equipment would come to Michigan's rescue. When that failed, she began turning to manufacturers in her district with ties to China. A major auto parts supplier in her district had success buying several hundred thousand masks but reported the competition in China was getting more and more "chaotic." The CEO of a Detroit bicycle company told her that he had a half-empty plane leaving Shanghai in 24 hours and was willing to load it with medical equipment. But Slotkin couldn't find the product in time.

An order of masks landed in Lansing, but airport officials there were told to redirect through customs in Atlanta before letting it into the United States. The plane eventually made it back to Michigan, but precious days were lost.

Meanwhile, the virus continued to spread. The number of deaths continued to surge. The stress, anxiety and feeling of helplessness reminded her of being in Iraq when her Iraqi colleagues and friends were being threatened and assassinated. "It just never ends. You never feel like you are doing enough," she said. "You feel like you're constantly underperforming."

'Please keep heart'

Slotkin's phone was buzzing again. She cut short a call with her staff to talk to Craig, who had more news from China. His guy outside the factory in Shandong was number 10 in line, but because Craig's order was relatively small he worried that the factory might decide it wasn't worth doing business with him.

"Every day the price changes and the lead time for delivery changes," Craig told her. His team at the factory was telling him that the Chinese were only interested in working with buyers who were willing to sign contracts for 10 million or more masks, but Craig didn't have that kind of money.

Craig got involved in the search for masks after his child's pediatrician shut down because the office had run out of protective gear. He hoped to make money selling the masks, but like so many Americans feeling overwhelmed by the pandemic, he also wanted to help his state.

"They want 100 percent prepayment," he was telling Slotkin. "I'm worried we're going to lose our place in line." He asked for the congresswoman's help bundling his order with others from Michigan and surrounding states, like Illinois and Ohio, so that they would have more clout with the factory.

Slotkin said she would try.

"I don't want to give you false hope," Slotkin told him, "but I also don't want you to get out of line."

A week earlier, Slotkin and other Michigan officials had decided that the best strategy was to place bets on as many companies as possible in the hopes that a few of them would be able to deliver masks and protective gowns. Now it seemed like they should be consolidating their orders so that they could better compete with other big buyers from around the world.

She called a hospital executive from her district who told her that his hospital had just lost its order to another buyer who had shown up at the Chinese factory with "bags of cash."

Slotkin was also working closely with Michigan Gov. Gretchen Whitmer (D), who had made securing protective gear the state's top priority. A senior official at Whitmer's office told Slotkin that nothing was getting out at all, including the state's order for some 13 million masks. The official speculated that the Chinese were holding on to the gear to ensure they were prepared for a second wave of possible outbreaks.

"I need you to commandeer a plane with troops and guns and Bruce Willis and go get our stuff," the state official joked darkly in a text.

"If I could, I would," Slotkin said under her breath.

Slotkin's long-term answer to the problem was to make sure the United States never found itself at the mercy of the Chinese government apparatchiks for emergency medical equipment. She was working on "buy American" legislation that would shift manufacturing of protective masks, gowns and pharmaceuticals back home from overseas.

"It's not right that the United States has to queue in line with state-controlled Chinese middlemen who set the price for goods and decide who can place orders," she said. "We need to think of the medical supply chain as a national security issue. We've outsourced too much."

But new laws weren't going to get doctors and nurses protective gear to keep them alive through this crisis. A week earlier she had learned about a joint effort involving Michigan State University, a biomedical company in her district and a hospital to decontaminate masks using heat or a hydrogen peroxide mist.

The procedure hadn't been certified by the FDA, but university officials told the Lansing State Journal it showed promise.

Slotkin called the university's president. "What do I need to do to help you get this certified and scale it up?" she asked. "I am ready to move heaven and earth to get the approvals you need from the FDA."

The program was still in the testing phase, but the university hoped that it could prove it worked within a few days or a week. "This program is way more important today than it was 36 hours ago," she told the Michigan State president.

Slotkin takes notes as she works at her family's farm house in Holly, Mich. "It's not right that the United States has to queue in line with state-controlled Chinese middlemen who set the price for goods and decide who can place orders," she said. "We need to think of the medical supply chain as a national security issue. We've outsourced too much."

Her next call was to Rep. Fred Upton (R-Mich.), a senior Republican on the Energy and Commerce Committee, which provides oversight of the FDA. "Getting stuff out of China is going to get worse and worse," she told him. "Decontamination is the way to deal with the problem." Upton promised to help in any way possible.

She checked her phone, which was filling with more text messages. State senators were worried about how they were going to close a budget shortfall, caused by the pandemic, of more than $1 billion. Local nonprofits, which had seen donations dry up, were looking for help to access federal aid.

She called the owner of the Lansing Lugnuts minor league baseball team, who told her his team was fighting to stay financially afloat. Slotkin promised to advocate on his behalf with the Small Business Administration and urged him to team up with the other minor league owners around the country on a letter asking for federal help.

"The louder we yell, the more likely we'll get something," she told him.

The sun was setting outside her window. Slotkin had barely budged from her desk all day. She popped two Advils to ward off a headache.

"This is insane," she repeated.

Meanwhile, the calls and messages from front-line health-care workers kept coming, including a message from a nurse in Flint who had first emailed on March 24 to tell Slotkin that his hospital was running dangerously short of masks and protective gowns.

"We are using our one disposable mask the entire night, and are given one gown per room (not one gown per RN, one gown per ROOM)," he wrote. "So you have multiple people using one (contaminated) gown all night. It hangs in the hallway outside the room where it has the potential to pass the virus to anyone who passes by. . . . Please, I'm begging you. We need your help."

A week later he texted Slotkin again: "Things are pretty grim (and getting worse)," he wrote. "Sometimes it feels like we're fighting the battle alone. . . . As of last night three of my fellow RNs have tested positive for covid. We're contracting the very disease we're trying to fight."

Slotkin paused over her phone, searching for some words of encouragement. She texted that she had been talking to anyone she could find with connections to factories that make protective gear.

"It's a mess but we are trying to fight our way through it," Slotkin wrote. "Please keep heart. Your country has drafted you into service and I know how critical you are to all of us getting through this."

Included with the Flint nurse's last text was a photograph of him and six of his colleagues from the covid-19 ward. Some wore N95s. Others had doubled up surgical and cloth masks. They were all staring grimly at the camera.

"This is a f---ing/ first-world country," Slotkin said in disbelief.

The only hope was to keep pressing on all fronts. The Michigan State University officials told her that they were ramping up trials of their decontamination process over the weekend and planned to have an application in to the FDA in the coming week.

Michigan hospitals were now bundling their orders in the hope that they might be able to secure a massive shipment soon.

Craig's guy was no longer in line on the other side of the world. He had left the factory and returned to his hotel room to shower and get some sleep. Factory officials told him that because of high demand from the Chinese government for masks, his order had been delayed two more weeks.