David Dobrzykowski, an associate professor of supply chain management and director of the Master of Science in supply chain management program at the University of Arkansas, said the pandemic “created a sea change of disruption in the supply chain” that hadn’t been seen before. Past major disasters were geographically isolated and had a limited duration, unlike the current pandemic, he said.

“This is a 100-year pandemic,” Dobrzykowski said. “While the existing supply chain did everything that was reasonable to do, there was no way around bringing in new sources of supply. The whole world was in the same situation.”

For example, while 3M committed in March to doubling its annual production of N95 masks to more than 1.1 billion, that was “still a drop in the bucket” when it came to overall demand, Dobrzykowski said.

Premier, a consulting and group purchasing organization, estimates the surge demand for N95 masks is 17 times higher than usual, according to a survey of more than 1,500 U.S. hospitals. And the problem is exacerbated by the supply chain’s dependence on low-cost products from Asia, those in the industry say. Shawn Osborne, vice president of pharmacy and supply chain services at University Hospitals, Cleveland, said there had been a “multidecade journey of wringing out costs,” especially as the market has consolidated.

“The resilience on a global scale has kind of faded away. As we’ve gotten better price points, we’ve lost resilience,” he said.

So healthcare providers turned to novel manufacturers. Across the country, plants that typically offered print finishing services like lamination started producing parts for face shields; facilities that made uniforms started sewing gowns and cloth masks.

“There was no infrastructure in the early days of the pandemic for getting PPE to the hospitals that needed it the most,” said Andy Shin, chief operating officer at the AHA Center for Health Innovation.

The AHA, through the 100 Million Mask Challenge and HealthEquip, a PPE sharing initiative, started vetting manufacturers and pairing their goods—as well as donated items—with healthcare providers in need, an effort that is still ongoing.

State and regional efforts also took hold. Ohio in late March created the Ohio Manufacturing Alliance, a public-private partnership among manufacturing and economic development groups, the state hospital association and the government, to create PPE locally. Just days after Gov. Mike DeWine announced the alliance, 2,000 manufacturers had signed on, said Ethan Karp, CEO of Magnet, a not-for-profit consultancy for Northeast Ohio manufacturers and one of the alliance’s leaders.