As Americans rushed to buy face masks amid the early but growing threat of coronavirus, U.S. February imports of the product from its biggest supplier - China - plummeted to its lowest level in years, a USA TODAY analysis of trade data found.
Combined with a sky-high increase in U.S. mask exports to China the same month, the trade data suggest a double whammy: fewer masks coming in and more masks going out, just as U.S. medical workers were about to need as many as they could get.
The U.S. imported $203.1 million in protective masks from China in February, a more than 20% drop from the $261 million worth of masks in the same month last year, according to a USA TODAY analysis on Census trade data.
It was the lowest February import of Chinese masks since 2015.
At the same time, U.S. exports of masks to China surged to $15.8 million, their highest February levels in a decade, the data show.
The analysis examines a trade category that includes the tight-fitting N95 respirator masks, as well as the looser-fitting, disposable surgical masks and other textile-based masks. The World Customs Organization identifies the code group as one of several different medical supply categories needed for handling COVID-19.
China is the world's biggest exporter of medical face masks. It produced about half of the world's $11.7 billion supply in 2018 alone, the United Nations' latest trade data shows. And the U.S. has long been its biggest customer.
The import drop happened as COVID-19 raged through China, and the country implemented export restrictions on its masks and other medical equipment to treat tens of thousands of infected residents. It also shut down much of its economy, including mask manufacturing plants, to stop the spread of the virus.
"Suppliers may not have been able to supply as much as was demanded because they needed to provide it to the local economy, and the Chinese factories were simply not operating," said Mary Lovely, an economics professor at Syracuse University. "Workers were not at work. They were at home. They were quarantined."
Meanwhile, the U.S. was still imposing 15% tariffs on imports of personal protective equipment from China through March 17 as part of the trade war.
"Not surprisingly, we got less of those things. Imports fell," said Chad Bown, a senior researcher with the Peterson Institute for International Economics.
Downplaying the risks
Even though U.S. intelligence agencies and people within his own administration warned the coronavirus would soon wreak havoc on American soil, U.S. President Donald Trump was still downplaying its risk to the public.
"We think we have it very well under control," Trump said on Jan. 30. "We have very little problem in this country at this moment - five. And those people are all recuperating successfully."
The flawed assurances - along with the U.S. Centers for Disease Control's recommendation that healthy people not wear masks - lessened the demand for masks when the country should have been trying to obtain them, experts said.
Even U.S. Surgeon General Dr. Jerome Adams weighed in.
"Seriously people- STOP BUYING MASKS!" Adams tweeted from the office's official Twitter account in February. "They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"
As a result, Lovely said, the U.S. demand for masks was "not really coming on strong until the beginning of March." She predicted that when the March trade data is released, it will show an increase.
The CDC revised its position in April and now recommends all people wear face masks when in public. Adams even posted a video showing how to make a face mask with common household items.
But many frightened Americans didn't listen to the government in January and February and stocked up on masks anyway.
U.S. retailers began selling out in late January. Two of the nation's largest drugstore chains - Walgreens and CVS - saw depletions of their stock in stores across the country within days of the first reported U.S. coronavirus case. People reported shortages in New York, Los Angeles and Phoenix, among other cities.
Online retailers like Amazon also reported a rush of sales and delivery delays.
Even the makers of face masks for pet dogs struggled to keep up with demand. Kirby Holmes, the owner of the Austin-based company K9 Mask, said sales skyrocketed as much as 400% by early February.
The CDC reported its first case in the United States on Jan. 20. Within the next two weeks, the World Health Organization and the U.S. Department of Health and Human Services had declared the disease a public health emergency.
By March, hospitals across the county were struggling to purchase surgical and N95 masks, encountering ordering delays of up to six months, according to a survey released Monday by the watchdog of the U.S. Department of Health and Human Services.
One hospital administrator said masks that once cost 50 cents each now exceed $6, according to the report.
More than 374,000 Americans have tested positive for coronavirus and more than 12,000 have died, according to the CDC.
"My guess is that the CDC's initial guidance on face masks did help reduce domestic demand," said Michelle P. Connolly, a Duke University economist. "With their recent change, they are now recommending cloth face coverings, but they are also being very clear that those aren't surgical masks or N-95 respirators."
While drug stores, states and hospitals were scrambling to stock up, officials at Health and Human Services, which oversees the Strategic National Stockpile, didn't place the first order for N95 respirators until mid-March, according to The Associated Press, citing federal contracting records.
It had about 13 million such face masks at the start of the pandemic, but demand from states hard hit by the pandemic quickly drained the stock.
"We had a stockpile of medical equipment," Lovely, the Syracuse University economist, said. "It just wasn't adequately maintained."
The agency placed its initial order for $4.8 million in N95 masks with 3M on March 12, according to AP. It placed a larger order for $173 million on March 21, but the company wasn't expected to start delivering the supplies until the end of April.
The White House began sparring with 3M late last week over the company's production of N95s here and abroad. Trump asked the company to increase its import of the masks from its overseas factories and decrease exports, and signed an order authorizing FEMA to use its authority to acquire the masks from 3M if necessary.
The company had resisted reducing its exports to Canada and Latin America, saying it would have "significant humanitarian implications," and could reduce the net number of respirators available to the U.S.
Experts disagree over whether the U.S. should use its authority to interfere in free trade. Many support reducing restrictions, such as lowering tariffs and making sure that countries can share what they produce.
But Cameron Kerry, a visiting fellow with the Brookings Institution, said the acute shortage of personal protective equipment creates a strong argument for temporary government intervention.
The Federal Emergency Management Agency this week unveiled regulations restricting the export of five types of personal protective equipment, saying the items could no longer be exported without explicit FEMA approval. The list includes N95 respirators; other filtering facepiece respirators; reusable elastomeric air-purifying respirators and cartridges; surgical masks and surgical gloves.
Scheduled to take effect April 10, the rule would last four months. Trump signaled he would ban the export of the medical gear earlier this week, but the regulations offer new detail about specifically how the prohibition will work.
'Ray of hope'
The actual value of imports from China is likely more than what's reported in the trade data, said Gary Hufbauer, a nonresident senior fellow at the Peterson Institute. That's because small personal shipments usually aren't included.
For example, Hufbauer said, one of his colleagues in China sent him protective masks via FedEx in recent weeks, much like how many Chinese Americans sent masks back to their families in the mainland during the early parts of the pandemic.
While Chinese exports of personal protective equipment decreased by 19% in January and February compared to the same months last year, it was a smaller decline than that of Chinese exports overall, which fell by 28% during the same period, according to an analysis by Chad Bown, the Peterson Institute researcher.
And U.S. imports of nose and face coverings from China declined less than for the European Union compared to previous years - 19% for the U.S. versus 21% for the E.U. However, when taken as a whole, the U.S. saw a greater decrease in personal protective equipment from China than the E.U. - 19% versus 17%.
Bown called the findings a "ray of hope."
"The U.S. fared only a little worse than Europe," Bown said. "That's what we would have expected.The E.U. is not doing a trade war with China. They didn't put extra special tariffs on China like we did."
Dian Zhang is a data journalist for USA TODAY. Contact her at firstname.lastname@example.org or @dian_zhang_. Erin Mansfield and Dinah Voyles Pulver are investigative reporters for the USA TODAY Network. Contact Erin at email@example.com and Dinah at firstname.lastname@example.org.
This article originally appeared on USA TODAY: Coronavirus: How the face mask supply in the U.S. dropped