Interview with Danielle Baskin, Founder of Mask Force
During times of global turbulence, new supply chains emerge rapidly to respond to urgent demands. In the US, the COVID-19 pandemic has created a massive new demand and subsequent shortage for personal protective equipment (PPE), a shortage which puts healthcare workers at risk. A recent editorial in the respected medical journal JAMA titled “Sourcing Personal Protective Equipment During the COVID-19 Pandemic” notes that “PPE, formerly ubiquitous and disposable in the hospital environment, is now a scarce and precious commodity in many locations when it is needed most to care for highly infectious patients. An increase in PPE supply in response to this new demand will require a large increase in PPE manufacturing, a process that will take time many health care systems do not have, given the rapid increase in ill COVID-19 patients.” The article notes that the need for PPE in many hospitals dealing with COVID patience is now so acute that hospitals are being advised to conserve PPE using the following approaches: Reclaim (masks from any non-hospital laboratory or clean room), Reuse (same mask over and over), Repurpose (the article mentions “snorkel and scuba, 3D printed, welder’s, civilian military grade gas masks, ski buffs”), Create Supply (by sewing or leveraging coffee filters and HVAC masks), and Extend Supply (supplementing N95 masks with plastic face shields, Ziploc bags and other barriers).
As of April 3rd, the CDC has recommended that all Americans wear a mask, despite the impact that this will have on the supply of PPE available to healthcare workers. This has created an ethical conundrum — should we wear or not wear a mask? Suzanne Rivera, associate professor of bioethics and vice president for research and technology management at Case Western, quoted in TIME magazine’s essay on this topic summed up the important role for DIY masks in creating additional supply of medical grade masks for hospitals: “The ethical issue is that healthcare workers and other first responders really need medical-grade masks to protect themselves, but these kinds of masks are in short supply.” However, as we have seen it is still likely that sourcing medical grade masks will become more challenging. Rivera’s advice for us: “Those of us who don’t work in healthcare settings should stick to fabric masks, like the kind many people are sewing at home.”
In this interview, Arkestro CEO Edmund Zagorin sits down with Danielle Baskin, Founder of Mask Force. Coining itself as a resource for manufacturing DIY emergency PPE supplies, Mask Force focuses on connecting members of the maker-made PPE community with hospitals and organizations in need of PPE across the United States, and shows some of the challenges in executing strategic communication in a rapidly emerging supply chain that is barely a month old and is changing every single day.
Edmund Danielle, thanks so much for chatting with me. We had been catching up, and now I want to rewind and start at the beginning. How did you get into doing Mask Force in the first place?
Danielle Well, it originally started because I was making masks with people’s unique faces on them so that you could unlock your iPhone without taking your mask off. This was back in January when the coronavirus was first being reported in the US – it was before we knew how serious it was, and at the time, we thought the idea of putting people’s face on a mask was fun. Then after that, there was someone who texted me asking if I could create a mask factory in the US. Based on my knowing about masks right now and having done assembly lines here [00:01:14]and doing Branded Fruit and dealing with the Pokeball batteries and other stuff. [6.1s] And I felt like it’s totally possible to make masks here. Of course, it has to be okay with the hospitals, and at that point, this is like last week of February, hospitals were still not accepting masks just made by random people because they were still able to source N95s and other medical-grade materials like booties, gloves, and gowns. The first cases of the coronavirus started hitting the US in the first week of March, and there were articles about hospitals not having enough PPE, and then there was this one hospital in Providence that created a project called the Million Mask Project.
They got materials from a factory that were surgical-grade materials that people could just sew and turn into masks, and they sold out of all their kits immediately. Then, I started searching to find out who were the crafters working on these and found all of these Facebook groups of people making masks. They were sharing tutorials and discussing materials. This is thousands of people researching, but there’s no organizational system. I thought that by developing Mask Force, this would be a place to list that you are down to sew, and it would connect you to tutorials that are through certain hospitals. It also collects a list of hospitals and organizations that are willing to accept maker-made masks that are up to certain specs, in the case that their medical-grade supply is depleted, which happened pretty quickly. A lot of hospitals need masks and PPE now. While waiting for factories to ramp up, the best solution is to have crafters all over the nation, making things.
Edmund: Wow, that sounds like quite a complex effort and undertaking.
Danielle: Yeah, and what we saw was within a few days, 1300 volunteers joined our Mask Force group, and then we got in Slack and started coordinating. We found that hospitals wanted these masks, and most accepted them. There was one that wouldn’t accept them, but only the one. The rest of the hospitals were happy to have these masks because they literally couldn’t get any PPE from anywhere else.
Edmund: Wow. Are these masks donations?
Danielle: People who are doing the sewing are people who normally get paid for their work, but are ready to volunteer whatever supplies and time that they have. A lot of people have time now because they can’t go into work and want to do something with their hands. Of course, this is not as efficient as a factory, but there are no money transactions. People are also offering to deliver stuff by doing a round in their car and picking it up masks from people locally and dropping them off according to the instructions of a hospital.
Edmund: Are there any contracts associated with this? What happens if there’s a problem with the mask?
Danielle: No, there are no contracts now because things are so chaotic. Right now, we are using a feedback form for the hospital to say whether or not they were up to standards. So, it’s a really cool feedback form where they can say if the PPE was good, does it need improvement, or was it unusable? Then, there’s a field where they can describe why. The issue is that I don’t think everyone is using this form that I created. There are so many rules and instructions that it’s difficult to wrangle all the people making stuff and tell them to do things in a specific way.
Edmund: So, there’s some issues with consistency. Is that what you’re saying?
Danielle: A lot of this is because the crafting and delivery that is happening is totally undocumented. No one knows there was a record of a transaction; therefore, if a hospital is accepting 500 masks, we have no way to change that number to 400, if 100 have been deleted. Unless they use my form, which I don’t think they all are, because, in our form, if anyone answers, then it will auto-update in our spreadsheet, and then we can update the quantities. Right now, hospitals are receiving stuff, and the makers are not necessarily getting feedback because the hospitals have so much chaos to deal with that they don’t have time to provide feedback. It’s very undocumented.
Edmund: What do you think is going to happen with these other groups? As you mentioned, there are some other groups that are working to provide masks. How is this landscape emerging and where do you see it going?
Danielle: I created Mask Force literally last Sunday, and it’s crazy that within 72 hours, I found out about eight organizations doing this, and some of us have merged our databases together. I think that the best way to do this properly is to have an organization that is very strict about the pattern we follow. “Here’s the form you need to print out,” and to have a lot of hand-holding and constant communication with the volunteers to make sure that this is done right. Honestly, I see that masksnow.org seems pretty organized. They have a different volunteer list than we do; they are part of the Relief Crafters Coalition. The issue is that there are so many organizations doing this, and there is no communication between the organizations. Ultimately, this leads to us not knowing which hospitals have been served.
Maybe an organization in Boston convinced people to make 3000 masks that are up to spec and deliver them. That information is not transmitted to all the other databases, so a lot of time might be wasted by other people int the area making massive deliveries to that hospital, where they would have been better off by shipping it to an underserved hospital. There isn’t one central database on who’s receiving stuff and what they still need in real-time.
Edmund: Basically, once an order is fulfilled, there is not a record of that fulfillment. So, the same orders could be being filled over and over again, where other hospitals are not getting anything.
Danielle: Exactly. And this will take time, but having cold callers that live all over the country just contact different institutions and ask if they need stuff, this will make sure that we’re sending supplies to at-risk, underserved hospitals that need things. This includes homeless shelters, cancer rehab centers, auxiliary workers, and smaller hospitals.
Edmund: How do you see that dynamic changing as, potentially, the pandemic moves towards more rural areas from urban centers with international airports? I mean, the supply network right now is very dense. It feels like there are lots of people in the same place who are providing masks to people that might live within 100 miles of them.
Danielle: The nurse at a small hospital who confirms that they need more masks, where are they finding out that they can request masks besides doing a Google search or on Facebook? It is difficult right now to have one central database that everyone knows about. Simultaneously, I think a lot of these PPE coalitions and organizations are somewhat competitive for being the leaders on having the best database and system. This is strange, you know, to have business competition. Still, it is actually good because I think there should be an organization that people can easily point to as having the best database and tracking.
Otherwise, you have information spread across way too many groups who are all doing a different level of a good job. I think masksnow.org is doing a better job at wrangling volunteers than Mask Force, and so I’m totally willing to shut down Mask Force and direct all our traffic to them. But our database is growing too, so I don’t know who should be the dominating force because we’re all trying to solve the same problem. Besides wanting to do a good job, we all want to collaborate. It’s this weird mix of us being competitive to have the best database, but also wanting to merge databases and conversations that should be happening between us aren’t happening between these different orgs to see how we can work together.
Edmund: I mean, I think that’s not only incredibly pragmatic but also very candid about the dynamics that are emerging. Of course, crafting PPE in the first place is both incredibly well-intentioned and ultimately super urgently needed at this time. Still, also it’s just interesting to see how even in the zeal for service, data becomes divided, and information siloed that can frustrate the optimal delivery service. Do you think that people will specialize? What does phase two of this of this org building frenzy look like?
Danielle: Whether it lives in one domain or multiple domains is still a question, but I think having regional coordinators and specific databases that specialize in specific hospitals or groups in need. So I think that that sort of specialization has to be divided among different teams for the problem of tackling distribution across the nation, and to everyone who needs supplies, to move out of its current complicated process.
Edmund: Do you think there should be a queuing model here where some people should go to the front of the line depending on the urgency of their need and other people whose need is less urgent are deprioritized? How would you triage that?
Danielle: I think figuring out what is the rate at which people are being admitted into the hospital. That’s part of it. This is an ethics question, right? Do you serve the hospitals are the most crowded, because they serve the most amount of people, and reduce your effort going to small towns? I think that we should, but if you only have a finite resource and you have to save the most amount of people, who gets it?
Edmund: To your point, you know, in the context of scarcity, these ethical questions become very daunting. And so it seems that the only way to resolve them is to just increase the aggregate supply. That seems to be unquestionably the most good. Earlier, you had mentioned that you saw this kind of more informal supply chain network or system of “need-a-mask, have-a-mask,” giving way to a more formalized manufacturing supply chain as the capacity ramps up over the next few weeks.
Danielle: I think having data on which manufactures are making stuff that hospitals need and what their lead times are, is critical. A lot of stuff is unknown, right? If a factory is making 100,000 masks, and it’s going to this hospital first, and then their next batch is going to the smaller hospitals, they should know that they have to wait nine days, so that way they know how often they should be reusing their current N95s and stuff like that. It’s hard to give anyone who’s requesting stuff a time estimate.
Edmund: That’s interesting. I mean, it also seems to suggest that there’s an agent that we haven’t even discussed in the supply chain, which is going to be the distributor. Now on the production side, on the maker culture and the crafters, you have the aggregators that are bringing masks together from different groups of people that are making them. Once that supply chain is displaced by much larger order quantities, the problem is almost exactly flipped on its head. You’re going to need people to aggregate the POs for a much larger order sizes and then actually distribute them to the final location. What role do you see, if any, for these emerging orgs to play in distribution?
Danielle: We built a database in Airtable to track all this stuff. I think that organizations that have built their own system for distributing the maker-made stuff would apply it to larger-scale factory production. I think, potentially, a lot of the maker-made organizations want to handmake stuff, and the volunteer effort might not switch over. If you’re communicating with a local crafter, you might not want to communicate with the manufacturer because your specialty is small crafters. And so I don’t know if people will totally shift what they’re working on, even though they built a great spreadsheet and have an organizational structure.
They might continue the maker-made stuff. Potentially, the maker-made stuff is still important because, for example, some hospitals are requesting cloth covers for PPE to extend their life. So, wearing a 100% cotton mask over your N95, then, if that’s washable, the N95 is more sterile, and it lasts longer, and potentially a lot of these craft organizations could continue to exist to work with manufacturers. What you have now is a hybrid medical-grade plus handmade cotton cover. Simultaneously, the cotton covers could also be made by factories.
Edmund: So we’re gonna put this interview up on up on the web and hopefully get some interested supply chain people who are curious about the Wild West of crowd sourcing masks. What’s one message that you would you tell a supply chain professional who might be unfamiliar with these informal craft networks, or just someone who who’s feeling they’d like to use their skills in supply chain to help? What’s something that people can do?
Danielle: I think the thing that’s missing and what’s confusing people is communication. Having constant communication and checking in where people are. This identifies bottlenecks, and if there are questions people have that aren’t being answered. Something as simple as, “Hey, is this type of elastic okay?” I feel like there isn’t enough checking in with everyone who is involved. I think there needs to be more manual hand-holding. Maybe this could be automated through a chatbot, just like a drip e-mail that asks everyone each day to check-in where they are. Right now, you have a lot of questions that aren’t being answered because making this stuff is new. Especially if it’s a factory, for example, a window blinds factory signed up on our list because they want to start making face shields because they’re used to cutting plastic. However, there are questions about which materials. There’s a lot of hand-holding and communicating with that. Imagine all these factories that are emerging, not just small crafters, but a 50 person factory that wants to shift efforts, and we need to understand their output and what questions they have. Currently, this has to be done through a person communicating with them. There are volunteers that just want to help, and I just think that they just need to start sending e-mails and doing more hand-holding.
Edmund: I could not agree more. I think instant real-time communication that tracks the steps in a process develops the common understanding for where a project is at and helps drive it towards the finish line is absolutely one of the most important things in supply chain, whether it’s for mass or for anything else. I think your comment is well-taken. I want to say a big thanks to you for having us this chat with me and sharing some timely insight.
Danielle: It’s super fascinating. It’s great that these problems exist, it means a lot of people are trying to work on it, which is cool. It’s actually almost too many people now, but that’s a good problem, and showing how people are coming together to make PPE.
Edmund: Yeah, absolutely. Well, Danielle, thanks. What’s the best place to find you on the web?
Danielle: On Twitter, at djbaskin. Also, our database is on maskforce.org, which is also part of us getusppe.org.
Edmund: Thanks, Danielle. Have a good one. Take care. Stay safe.