Still rising why wasnt the United States more prepared . You cant be prepared if youre not funded to be prepared. Narrator who is accountable . Do you think that this administration has done what it needs to do to protect healthcare workers . I think a lot more could be done. Narrator and what will happen when a vaccine is ready . Given the abject failure, of the administraon we do worry. Narrator now on frontline americas medical supply crisis. Frontline is made possible by contributions to your pbs station from viewers like you. Thank you. And by the corporation for puic broadcasting. Major support is provided by the john d. And catherine t. Macarthur foundation, committed to building a more just, verdant and peaceful world. More information at macfound. Org. The Ford Foundation working with visionaries on the frontlines of soal change worldwide. At fordfoundation. Org. Additional support is provided by the abrams foundation, committed to excellence in journalism. The park foundation, dedicated to heightening Public Awareness of critical issues. And by the frontline journalism fund, with major support from jon and jo ann hagler. It hit the whole hospital hard. Everybody knew sandyvery lab, xray, the respiratory therapists. You know, she always had a smile for them, or a kind word for them. Were a family, and it w devastating. My sister was a nurse. voice breaking she would tell us that she was going to go to work with no fear, that she knew that god was with her and he was going to protect her. Narrator it was the start of the corovirus pandemic in california, and nurs Sandy Oldfield were short on masks and gowns and gles. It was hard. Our morale was pretty low. We still weren getting the ppe on our floor, on our unit. It was tough. She didnt feel safe. I even had made a comment to her. I said, just dont go to work. She was, like, we have to. Weve already, i mean, you dont just not show up, you know . But she said everybody felt the same. I mean, they felt that they just were not being protected. She cared for a patient that was asymptomatic. He showed no signs of the virus or anything. And my sister, unfortunately, was exposed. She called me in the morning and said that she was positive. Narrator after nine other nurses in the same hospital came down with covid19, the nursing staff started protesting. What do we want . Ppe were all saying the same thing. Give us our ppe. The hospital says safety is the ghest priority. We are seeing a l of our healthcare workers come down with this illness. Narrator inside the hospital, sandy oldfie getting sicker. She told me, the doctors are going to put me on a ventilator. And i said, were going to be right here when you open your eyes. I told her i loved her, and that was the last time i spoke to her. A somber night in fresno as nurses mourn the loss of one of their own to covid19. Sandy oldfield died on moay after battling the virus for two months. She was very wellliked and had many friends, many of which gathered here. We welcome all of our sisters and brothers here tonight, to honor the tragic loss of our first nurse to the coronavirus pandemic here in fresno county. It just really hurt my het just to know that my sister wasnt protected. All of ts could have been avoided. In a plane crash situation, you put your mask on first. You need to put your ppe on so that you could take care of them. Ifou get sick, you cant help them. You cant help anybody. I feel if she wouldve had the proper ppe, she would be alive today. What do we need . Ppe. What do we want . What do we need . Ppe we are demanding ppe so that we can protect ourselves and our families. Narrator Sandy Oldfield was one of the countless americans left unprotected when the coronavirus hit. Left without essentials like gloves, gowns, masks. A major problem amid this crisis a National Shortage of personal protective equipment, or ppe. Narrator forced to reuse personal protective equipment or make their own even healthcare workers, around a thousand of whom have died from the virus. This is deplorable. You know, when yand think that we send soldiers into battle with the equipment that they need, yet we were asking nurses to do the exact same thing, but without the equipment that they needed. Theres a failure in the system. I think those who are in position to ensure that the supply chain was being maintained, they failed us, big time. Narrator for the past seven months, frontline and Associated Press reporters Juliet Linderman and Martha Mendoza have been examining that failure and the unheeded warnings, interviewing manufacturers and government officials, analyzing records, and tracing key medical supplies along a fragile global chain. Mendoza i did a run of n95 masks. Narrator from the earliest days, they were tracking a database of medical supply imports. Mendoza most all coming from china. Narrator within the numbers, one detail stood out. Mendoza you see this graph . Linderman yeah, yeah. Narrator beginning in march, the usual flow of tons of ppe from china to the u. S. Had plummeted. Linderman what were seeing here is, like, pretty consistent. 25 shipments. 22 shipments. 23 shipments. And then, just, whoosh. Drops to three shipments in all of march. Complete dropoff. Narrator china was dealing with its own outbreak. China has identified a previously unknown coronirus. Narrator . And the u. S. Was left desperately short. Its thought to have originated in the ci of wuhan. Narrator u. S. Officials began urging the public to conserve supplies. Right now in the United States, people should not be Walking Around with masks. It can lead to a shortage of masks . Exactly, thats the point. It could ld to a shortage of masks for the people who really need it. Narrator but then, in la march, there was a sign of relief. Import records showed ppe shipments were slowly starting up again. One of the first was a planeload of n95 masks destined for this warehouse in santa barbara, california. This is the first shipment that weve got in from china in the past two months. These are the n95 masks that are in such high demand right now. Narrator the charity direct relief, which normally helps with disasters around the world, had turned its focus on e u. S. To help fill the gap in the mask supply. Its just such a scramble because of the huge demand and the scary time were in. So what youre seeing now is a Global Demand spike. Because of the outbreak in china itself, i think the demand was all gobbled up. That is now just starting to loosen up. Narrator direct relief planne planned to distribute these chinesemade masks to healthcare workers across the country. Looking at the footage wed shot, the Associated Press reporters made a surprising discovery. Linderman looks like hes inspecting them, right . Mendoza those, those are ear loops, not a head strap. Narrator the straps on the masks looked different than normal. Mendoza i dont think theyre supposed to have an ear loop lderman no, theyre definitely not. Narrator we sent some of the masks to be tested at an environmental medicine lab at the university of north carolina. All of these products that arrived, even though theyre labeled clearly n95, and they show the lady in the picture is wearing a mask with head straps, it has ear loops, so thats a dead giveaway that its a counterfeit product. These were all counterfeit that we tested. Narrator his tests showed that the counterfeit masks did not meet requirements to filter at least 95 percent of harmful particles. Direct relief never sent out the masks, but around the country as more shipments began to arrive from china, more counterfeits began turning up. And now federal agents say that they are seeing criminals preying on people during the coronavirus pandemic. Narrator . Just as Health Officials were reversing course and urging everyone to wear masks. Counterfeit masks, hand sanitizers, fake covid19 testing kits. Customs inspectors have been seizing fake medical supplies as scammers try to take advantage e of the crisis. Narrator we wanted to talk to the fbi about the rash of counterfeits. They were part of a task force investigating the problem. Linderman my colleagues and i were working on a story about a nonprofit organization. They were getting one of the first shipments of medicalgrade n95 masks. They opened it up and it turned out that they were all counterfeit masks. How does Something Like this happen . Under the covid circumstances, supply and demand changed rapidly, and the demand became so great that it overtook what we really had in our stock. So that didnt change that, the fact that the medical professionals and First Responders really needed that. Theres a lot of money out there and, you know, working for the fbi, it becomes clear on your first day here that when there is an opportunity for a criminal to make money, they will explore that. Linderman what is the risk of having counterfeit or substandard masks actually make it to frontline medical workers . If, when you put on a set of ppe, you assume that its going to protect you. Thats what its for. And if its not dog that job, it really is putting the most Vulnerable People at risk. So that is something that should scare every one of us. Narrator as we continued investigating medical supply shortages, we followed a trail leading back more than a decade, to the story of a maskmaker in texas. The mask capital of the world was fort worth, texas. I was with some Amazing Companies that did se incredible things. Great products, great company, very innovative, very efficient. We ruled the world on face masks. Narrator dan reese is one of the last domestic mask manufacturers. He told us a turning point for the industry ce in 2001. China was vo the World Trade Organization today narrator . When the wor trade organization welcomed its newest member. The peoples republic of china. That was the beginning of the end. Theres nothing to stop them, so were left competing agnst china. Narrator by the late 2000s, most of the masks used in the United States were produced outside the country. This is a huge security issue for this country. They can stop it, saying, were not going to ship to you because we need it. R reese had officials from the department of health and Human Services visit his factory in 2007, and warned them the u. S. Risked losing control of its mask supply. The ppe, the things tt we have to have in an emergency, we, as a country, cannot hand this control over to a foreign government, say, okay, if youre okay with it, send it to us. And thats what we did. Thats the security issue. Narrator it wasnt long before his fears were aying out. The world is now at the start of the 2009 influenza pandemic. H1n1 has spread to 46 states. More than 1,000 americans have died, and more than 20,000 have been hospitalized. Narrator amid the h1n1 pandemic, officials believed the u. S. Might need as many as five billion n95 masks nearly 50 times what the country had on hand. Public Health Experts are expressing concern about whether hospitals could handle the onslaught. We received a call from the government that says, prestige, we have a situation. So they ask us to ramp up, ramp up hard, do everything we could do. Save the cntry. And ouresponse was, were small. Were t that big, you know . We dont have huge market share. But what we did, with our own money, our own investment, we went round the clock. We built machines as fast as we could possibly build them. We went from having probably 60 employees to having 260. And we respond as much as we possibly can for the country. Narrator with much fanfare, reese cut the ribbon on a new facility that they called the Global Pandemic preparedness and Response Center. Its kind of a dream to be this Pandemic Response center. 15 years ago, nine out of ten masks were made right here in the United States of america. In less than a decade, that flipped, where one out of ten masks is now made in this country. But this company, this company made the commitment to turn that around. Narrato texas congressman michael burgess, whos also a physician, understood the importance of what was happening. It is important that those masks function as required, and the only way to ensure that is to have those masks made by you in the United States of america. Are we willing to spend a few pennies more for a mask, but have a reliable mask availle, and the supply of masks that we need . I think thats the question that has to be answered. Linderman so what happened to that Response Center . sighs the amount of product that was purchased diminished. The pandemic w over, everyones attention got diverted to something else, then the monies dried up. One day, america realizes, were not going to die from h1n1. It looks like swine flu is history. The World Health Organization just declared an end to the h1n1 pandemic alert. Narrator with the outbreak under control, prestige ameritechs orders werent renewed. Hospitals went back to buying cheaper masks from their overseas suppliers. Reeses business nearly went bankrupt. The people that wed hired, these people thastepped in to save america, they were rewarded by getting in an unemployment line. Mendoza when they asked you to ramp up, didnt the government guarantee anything to help support you . No. Mendoza nothing. No. Narrator reese showed us letters he and his colleues wrote to the Obama Administration insisting that america must resecurits mask supply chain. They said h1n1 was a wakeup call, and warned that in a major pandemic, china could stop shipping maskso the u. S. But in washington, officials had moved on. Their fallback would be an emergency stockpile meatockpt to cover medical needs in such a crisis. The stockpile fills a gap. If the Strategic National stockpile did not exist, we would have very limited or no capability to respond to these types of events. Narrator greg burel ran the Strategic National stockpile, thsns, a series of governmentrun warehouses filled with medical supplies like ventilators and masks, which were critically important during the h1n1 pandemic. Linderman the sns response to h1n1 was the rgest deployment of the stockpile. What was your focus during that tim during h1n1, we sent out personal protective equipment that we had stocked for a pandemic influenza event ahead of a great deal of disease spread, so it was already in place. We showed we could get that material out rapidly, and it could be made available. Narrator the problem was, h1n1 ended up depleting the stockpile. And in the ensuing years, Neither Congress nor the white house moved to substantially refill it. One government report found that many of the n95 masks in the stockpile were past their Expiration Date some broken, gathering dust and mold. We bought the n95 masks that are in the stockpile with funds that were appropriated in the early 2000s. Theyve passed their expiry date, but we didnt have additional funds to buy more, so weade the difficult decision to hold on to those. You cant be prepared if youre not funded to be prepared. Linderman why do you think you didnt receive those appropriations . Youd really have to ask the congress. Well, yeah, congress does bear a significant amount of responsibility. There are always going to be competing budgetary priorities. Its difficult when you talk to the people in the Budget Committee to say, these are the dollars were going to need to purchase n95 masks. I think if wed had that discussion a year and a half ago, youd have got a lot of blank stares. Narrator but, in fact, in those precovid years, we found repeated warnings from inside and outside the government that the country was being left without a safety net. That the government needed to strengthen the supply of ppe. And it wasnt just masks. It was ventilators, too. At that time, the ventilators in the stockpile were pretty old. And we really wanted to set out to modernize the stockpile. Narrator nicole lurie was in charge of preparedness and response at the department of health and Human Services. In the wake of h1n1, she tried to do something about the dire situation. How can we make a better ventilator . How can we make it cheaper . And how, then how can we have enough . And so we contracted with a couple of Different Companies to make those ventilators. Narrator the final contract in 2014 went to a Company Called philips respironics. The plan at the time washey cou0 machines to the stockpile by mid 2019. Ultimately, that ventilator t approved for use by the fda. It was small. It was nimble. It was notve. And there was a contract to procure those for the strategic nation stockpile. Linderman so philips delivered on their contract . No. Narrator hhs didnt actually order the ventilators until september 2019, and thenave philips more time to deliver. The delays have sparked questions in light of the coronavirus pandemic. When we spoke to congressman Raja Krishnamoorthi this past summer, he was leading an investigation into the philips deal. Although philips had been contracted to deliver them by this time, theyre nowhere to be seen. Linderman is that surprising . It is surprising, given how much money that the federal government and the taxpayers have put into this project of developing these ventilators. The fact that i dont believe we have even one of these is not only surprising, its shocking. Thats all the more an indication of failure on the part of the government. Narrator philips would not agree to an interview, but in aners to our written questions, said it had recently delivered 1,700 ventilators. The company said the delays were due to Software Develop