399- Masking for a Friend

Episode Summary

Title: Masking for a Friend Summary: The podcast discusses the history and culture around mask-wearing in China versus the United States. It starts by contrasting the experience of Shanghai-based reporter Rebecca Kanther, who was surprised to see everyone wearing masks during the early stages of the COVID-19 outbreak in China. This is different from the US, where masks were not commonly worn before the pandemic. The podcast traces the origins of mask-wearing in China back to 1910, when a doctor named Wu Lien-teh helped contain the Manchurian Plague outbreak by designing a simple gauze mask and recommending everyone wear them. His mask design spread globally during the 1918 influenza pandemic. Mask-wearing fell out of favor in the US after 1918, but continued in China through subsequent public health campaigns. During the 2002 SARS epidemic, masks became common again in China, which helped normalize mask-wearing. As a result, people knew what to do when COVID-19 hit. In the US, mask-wearing has been less normalized and sometimes seen as strange or even threatening to Asian-Americans. But mask-wearing is now becoming more common in the US as people realize it protects others from infection. The podcast explores how the culture and history around masks is different in China versus the US. It also tells the origin story of masks through Dr. Wu's role in the Manchurian Plague outbreak. Overall, it contrasts the experience of mask adoption in China versus the US during the COVID-19 pandemic.

Episode Show Notes

Why the culture behind epidemic masks developed so differently in China and the doctor who started it all

Episode Transcript

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Over the past month, we've all had to make some adjustments to try to stop the spread of COVID-19. Some of them have been small, like me recording this episode underneath a comforter in my bedroom instead of in our studio in beautiful downtown Oakland, California. I mean, that experience is unique to me. But another adjustment that I've made, and one that you probably had to make too, is wearing a mask in public. If you've been paying attention to the directives about where and when or even who should be wearing masks, then there's a good chance you've been a little confused because they've changed dramatically. Here in the US, we're just not used to needing to cover half of our faces in public. But if you look at the other side of the world, it's a different story. In parts of Asia, wearing a mask in response to the coronavirus pandemic was a totally easy and normal adjustment. Rebecca Kanther is a reporter based in Shanghai who has lived in China for the past 17 years. And she is here to tell us why the culture of masks developed so differently there and the doctor who started it all. SPEAKER_10: Yeah, I remember the first time I really started taking this seriously, I was traveling on my way home to see my in-laws actually for Chinese New Year. And the night before, I had gone out, everything was normal. And then that morning I walked out the door and I put the location on my GPS app on my phone. And you know how on your phone, the GPS app will tell you in this nice calm voice which direction to start off in? Well, this time my GPS app said this. SPEAKER_09: So it's saying, please wear a mask if you're going out. SPEAKER_10: Be safe. SPEAKER_05: Wow, I don't think my GPS has ever been quite that intimate with me before. Yeah, my phone's never gotten that personal with me before. SPEAKER_10: I mean, it's like totally weird. So it stuck with me. And then, you know, after I heard that, then I, you know, I was looking around and I started noticing everyone around me on the street was wearing a mask. It was like between the day before and that day, like a switch had been flipped. Everyone knew exactly what to do. So a week later I got back to Shanghai and the change was just even more drastic. You know, people weren't going outside, but anyone who did go outside was wearing a mask. And there were posters all over reminding people to wear masks. And I was riding my bike one day and I passed this loudspeaker with a voice that was just like on a loop reminding people to wear a mask. SPEAKER_10: And so the thing is, like everyone has to wear a mask, but at that time you couldn't buy one anywhere. Like the pharmacies were all sold out. I mean, I tried online. SPEAKER_05: So does that mean that everyone just already had a mask? SPEAKER_10: Yeah, I guess. I mean, I think people had masks at home. So I mean, eventually a friend gave me some, which was really nice. But the whole experience got me wondering, like, how come everybody else was so prepared? And I'm like the only idiot, like got caught off guard. SPEAKER_05: I mean, right. I mean, it seems like, I mean, you're from the US and you know, I'm here in the US and we just seem to have a very different relationship with masks in general. Yeah. SPEAKER_10: I mean, it's like nothing that I counted as something I should keep in my first aid kid at home. And I think everyone else here was doing that. SPEAKER_04: And so why do you think that is? Why does China have a different relationship with masks? SPEAKER_10: Yeah. I mean, I was really curious about that. So I started looking into the history of masks in China and it turns out they've been used here for a really long time. So Roman, I sent you a photo in the Zoom chat. Do you have it there? SPEAKER_05: Yeah. So this is a black and white photo. It's a couple of people wearing big white masks. Like everything is kind of covered except for the eyes, but it's like a little thicker and gauzier than the ones that we might see people wearing around today. But it's basically the same principle. You know, it's a mask. SPEAKER_04: So when was this photo taken? SPEAKER_10: So this photo is from over a hundred years ago when China was the scene of another devastating epidemic, the great Manchurian plague. Oh, wow. Okay. Manchuria at the time was contested territory. It's where Northeast China is today. And in 1910, it became the site of a really deadly outbreak of plague. Ninety five percent or more of those that got infected died and they died fast within just a few days of contracting the virus. And this outbreak was really well documented, especially in photographs. SPEAKER_02: It was the first time that you had cameras that could readily cover an epidemic. But also it was the first time that newspapers could carry these images, you know, could carry good quality photographic images. SPEAKER_10: So this is Christos Linteris. He's a medical anthropologist at University of St. Andrews in the UK. And he said that at that time, photos of the outbreak in Manchuria were seen in newspapers around the world. SPEAKER_02: And photography played a key role in establishing this idea of a global outbreak, you know, an outbreak which is spreading across the globe. SPEAKER_10: So a lot of these photographs were quite graphic scenes of victims. But there were also a lot of photographs of people wearing masks like the one I showed you. SPEAKER_02: And at the center of this photography is the mask. Now why the mask? Masks had been used before for surgery. So I think the official history of the mask in a clinical setting or on the operation theater dates back from around 1897. But masks have never been systematically used in an epidemic before. SPEAKER_05: So masks had been used by doctors, but they weren't being used by the general public at this point. SPEAKER_10: Right. But that changed in Manchuria because of one guy. His name was Wuyiand De. Dr. Wu was a young Chinese Malaysian doctor who had gone abroad to study medicine in Europe. And he was actually the first ethnic Chinese person to study at Cambridge. The Qing Dynasty government called him in to lead the Chinese efforts against the plague, since it was an international effort. And he was surrounded by all these much more experienced doctors from Russia, Japan, France, Great Britain. And he was only in his early 30s, but he was really smart. SPEAKER_02: And he was a brilliant scientist. And he soon came across people with symptoms and he concluded, OK, this is a pneumonic plague. And he had this idea that it spread in an airborne manner. SPEAKER_10: So meaning it spread from droplets in the air coming from people's noses or mouths. SPEAKER_04: And was this a new idea? I mean, how did people think it was being spread at the time? SPEAKER_10: Well, you know, there's different kinds of plague. There's bubonic and septicemic. Those ones are spread by fleas from small animals. And at the time, most of the experts thought that was how this plague was spreading. But Dr. Wu, he figured out that this outbreak was a different kind of plague. I mean, he was treating all these people with respiratory symptoms and he was convinced that the plague bacteria was spreading through the air. And he was right about it. SPEAKER_04: Way to go, Dr. Wu. SPEAKER_10: Yeah. And he made us like it seemed like a simple suggestion. Everyone should start covering their mouth and noses with face masks. SPEAKER_05: Right. Which is the suggestion that we're all getting today to stop the spread of coronavirus. SPEAKER_10: Right. But that was the first time someone had suggested that. And he was really serious about this idea. He designed face masks himself. And so I talked to this historian at Shanghai Library. Her name's Vivian Huang. And she's been researching the history of Wu's mask. And she was telling me about how it was designed. She speaks Chinese, so I'm just going to translate what she said. SPEAKER_09: She said it was this basic gauze mask with two layers. SPEAKER_10: And in between the layers, there was about a four by six inch piece of cotton that was about a half inch thick. And then there were these two strings to tie the mask behind your head. And all of these materials were really cheap and easy to find at the time. SPEAKER_02: So it was something that was meant to be very simple, very easy and cheap to produce, and which he envisioned that all his doctors, all his nurses and all his sanitary staff should use while engaged in anti-clague operations. And he wants the general public to wear these masks as well. SPEAKER_10: But the other doctors in Manchuria at the time, they wouldn't listen to him. I mean, maybe it was because he was young or maybe because China at that time wasn't really known for its scientific prowess. They just didn't believe him. SPEAKER_05: Or maybe it's because they're racist. No, but even the local leaders were suspicious of him. SPEAKER_10: I mean, he was just nobody believed him. And I think it was because he was kind of a nobody compared to all these famous European and Japanese doctors. SPEAKER_02: So they antagonized him very, very actively. And there is this incident which he recounts in his autobiography, which is called The Plague Fighter, where he's confronted by a famous French doctor, Gerald Mezny. And Mezny hears Wu expounding his airborne plague theory and he humiliates him in a very racist manner. And then Mezny goes on to operate in one of the hospitals to attend the sick without worrying what Wu had suggested is an essential device, which is the mask. SPEAKER_10: So I think you can guess where this is going. SPEAKER_02: Unfortunately for the French doctor, he dies soon after. He catches the plague and he dies. So Wu is suddenly and completely unexpectedly, for most people, vindicated. SPEAKER_04: Wow, that is dramatic. Yeah. SPEAKER_10: I mean, we don't know if the mask would have saved him, but after he died, it was just this huge case in point that proved that Wu had been right. SPEAKER_02: So the moment when Mezny dies and basically everyone starts accepting Wu's theory, you know, this mask goes viral. SPEAKER_05: I don't know if I'll ever be able to use that phrase quite the same way as I used to, but I get his point. At this point, like it just spreads everywhere. SPEAKER_10: Yeah, exactly. I mean, it was reported on all over the world. The Manchurian Plague ended after seven months. Some people say it ended because spring came and the weather warmed up. But Dr. Wu claimed victory because of the recommendations he made to stop its spread — wearing masks, quarantining sick patients, cutting off the Trans-Siberian railway lines. But Dr. Wu's mask became the symbol for successfully controlling the outbreak. SPEAKER_02: Everyone wants the mask and everyone starts photographing the mask. And the mask becomes this kind of the symbol of scientific success and medical ability to cope with this dreadful disease in Manchuria. And Wu is praised, of course, as a genius in having invented it. So it's a huge success story for Wu. And he came out of this as, you know, the guy who was internationally recognized as having controlled the epidemic, which was astonishing because he was a nobody until then and he was competing with very, very famous doctors. SPEAKER_10: Dr. Wu went on to form China's first organization dealing with disease control. And then later he formed the Chinese Medical Association. His work is the basis for China's disease control and public health system today. SPEAKER_05: And do people remember him today? I mean, did he get the recognition that he deserved? SPEAKER_10: Well, I mean, in 1935, he was nominated for a Nobel Prize. SPEAKER_05: Well, that's pretty good. OK. SPEAKER_10: And today, I mean, he never became a household name, not even in China. I mean, yeah, people don't know him. But still, you know, he's one of the most significant epidemiologists of the 20th century. SPEAKER_02: So it's a shame that he's not better known. SPEAKER_05: So what happens with Wu's mask after the Manchurian plague? Where does it go? SPEAKER_10: Well, Dr. Wu's design inspired others around the world to try their hand at mask design too. SPEAKER_02: And so there were competing models. So it becomes kind of a medical competition and design competition for the best mask. You know, it's the holy grail of that epidemic. You know, who is going to produce the best mask, the most efficient mask? And some of them are really kind of weird things. You know, they look like, I don't know, like a diver's suit or something. Others are more simple. But Wu's is the one which prevails. SPEAKER_10: One of the key things I think about Wu's design was that it was disposable, so it didn't need to be disinfected. Some of the other designs were just too complicated. Right, that makes sense. SPEAKER_10: So seven years later, when the 1918 flu epidemic hit, masks similar to the ones that Dr. Wu designed started being used around the world. SPEAKER_02: This was a device that was globally recognized by doctors as well as the public as a necessary and efficient anti-contagion device. You know, I don't know, you know, how easy it would have been to make people accept these masks, you know, and adopt them if it had not been part of a recent outbreak that had been successfully controlled. SPEAKER_10: And during the 1918 flu, Americans wore masks a lot like Dr. Wu's. Nancy Toms is a history professor at SUNY Stony Brook, and she's written a lot about the epidemic. She told me about all these great photos of Americans wearing masks during the flu epidemic. So there's this really wonderful picture of a baseball game in Pasadena, California. SPEAKER_07: And you can see the umpire, the catcher, and the pitcher, who's up to bat, all wearing masks. And then behind them, you can see the spectators also wearing masks. SPEAKER_05: So if people were wearing them during a baseball game, like I can barely wear one, like on a brisk walk for a couple blocks. So like, does this mean that everyone was wearing masks at this point? SPEAKER_10: Okay, so to be fair, I think that was the only baseball game where people wore them. It was reported as the first baseball game where players wore masks, and it was probably also the last one. And yeah, so it was a little bit of propaganda to get people to wear masks. SPEAKER_05: Yeah, it was for show. SPEAKER_10: Professor Toms said that these photos, they're mostly police officers, nurses, but also baseball players and society ladies. They were meant to convince more people to wear masks. SPEAKER_05: So they were like Instagram influencers. SPEAKER_10: Totally, totally. Yes. So I mean, this time around during this pandemic, I've been seeing news items and on social media photos from back in the 1918 pandemic. And you see these photos and it's, I guess it's easy to assume that everyone was wearing the mask. But Professor Toms says we shouldn't assume that it was that universal. It's more, I don't want to call it an elite practice, but a specialized practice. SPEAKER_07: So you're going to find it among certain groups and they're wearing of it, it's going to be replicated as a way to make everybody feel calmer and safer. But what's the expectation that every American should go around with the gauze mask? I don't think that happened. SPEAKER_10: Still, local health officials were calling on people to wear masks and in some cities there were mask ordinances. So if you were caught without one, you were fined or you went to jail. And women were being called upon to sew masks for the cause. SPEAKER_05: Yeah, which is another thing you see today. SPEAKER_10: So right after that 1918 pandemic ended, Americans kind of stopped using masks. SPEAKER_05: So it was just kind of this like blip in American history where it wasn't unusual to wear a mask. SPEAKER_10: Yeah. Masks basically fell into obscurity in the US after that. I mean, there were other epidemics throughout the 20th century, but they weren't spread by coughing and sneezing in the US. But in China, there was never a chance for people to forget masks for too long. SPEAKER_02: First of all, in China, you have a continuity of the use of the mask, right? So the mask story does not end in 1911 or 1918. It continues through several other outbreaks in the 20s and the 30s. And then in Maoist China after 1949, again, the mask plays an important role in public health campaigns. You see the masks in a great number of public propaganda posters. SPEAKER_10: I think this is kind of an important point. A lot of folks would say that wearing a mask is kind of a cultural thing in China. I think that's kind of true, but Vivian Huang was telling me that it's only normalized in China because they were required to wear them by the state. SPEAKER_09: Huang told me that public health campaigns on neighborhood chalkboards or posters on SPEAKER_10: telephone poles all promoted wearing masks. And in the 20s and 30s, Shanghai newspapers, they published articles and cartoons that tried to popularize the use of masks. Yeah, and women's magazines showed masks as kind of like a status symbol. And there were these magazine articles teaching readers how to knit their own masks. SPEAKER_05: I'm falling for this fashion thing as well because I have a kind of a more technical store-bought mask, like an N95 leftover from the wildfires of California. But I also have a handmade one and it might not have the efficacy of the manufactured one, but I like wearing it more because it's prettier. SPEAKER_10: Exactly, exactly. Like you're more willing to wear something that you like the way it looks. Yeah, sure. Anyway, through it all, Dr. Wu's gauze mask design or something similar to it survived. And then if we flash forward to the 2002 SARS epidemic, again, masks appeared. Doctors were wearing surgical masks, but Vivian Huang remembers seeing people on the streets wearing masks similar to the ones that Dr. Wu designed. So, we were able to see the people wearing masks. SPEAKER_09: So, we were able to see the people wearing masks. Back then, she says she was a student. SPEAKER_10: She was stuck on lockdown on her university campus in Shanghai. And once again, there were public health campaigns on hand washing and wearing masks. And she says that's why this time around everyone remembered and knew what to do. SPEAKER_05: So it's not exactly that, you know, people in China are more like inclined culturally to wear masks. They just had more occasion in recent history to wear masks. And so they know what to do and they know what the deal is. SPEAKER_10: Yeah, exactly. But that's not to say it's been easy for Chinese people to get used to wearing masks. I mean, even this time around, at first, older people really resisted. Right. SPEAKER_05: That can happen here too. We're trying to convince our boomer parents to stay in because they were fearful they would die. You know, so. SPEAKER_10: Yeah. And it's the same thing. I mean, younger people here were telling me that at first they were really having to nag their parents and grandparents to wear masks. And they were joking that they had to nag their older relatives with the same intensity that they were being nagged to get married. SPEAKER_05: So like direct and relentless. Exactly. SPEAKER_10: They're calling up their family every day saying, please wear a mask, please wear a mask. So yeah, Vivian Huang told me it's really taken Chinese people a hundred years to get to this point of acceptance of wearing masks during an infectious disease outbreak. And now it's to the point where people will just wear them when they've got a cold. It's just normal here. SPEAKER_09: She said at least wearing a mask is not strange. SPEAKER_10: You wear it in the winter to keep warm or to protect from pollution or if you have a cold. It's a normalized daily behavior and no one would look at you strangely for choosing to wear one. SPEAKER_05: Yeah. And that really wasn't the case here in the U.S. I mean, if you were wearing a mask before all this, like people would wonder why. SPEAKER_10: It seems like that's really starting to change in the past couple of weeks. SPEAKER_05: Yeah. I mean, now I would say that maybe like 80 percent of the people in stores are wearing masks and even walking along the street. I mean, the strange thing is that in the Bay Area, we actually have a little bit of a history of wearing N95 masks because there's wildfires here every year. And so it's not uncommon for people to have a couple in their home to deal with smoke. So I think we were more ready to take on masks, but I've never seen them like this. I mean, it's totally like people are wearing every type of thing, homemade masks, N95 masks. They're really everywhere. Yeah. SPEAKER_10: And that's quite different from the past because I've been hearing from Asian-American friends that there was like real trepidation about wearing a mask in public because the culture of masks is so different or has been so different in the U.S. And there was a lot of fear about how they would be perceived wearing a mask. And Professor Linteris talked about this. SPEAKER_02: The masks have become very aggressively and viciously racialized, right? They're associated with China, with Chinese people in a very sinophobic manner. SPEAKER_10: So sinophobia is basically racism towards ethnically Chinese people. SPEAKER_02: And so you have this phenomenon where with some journalists call it maskophobia, which is basically an attribute of sinophobia, people being attacked, like people who look Chinese or who look Asian being attacked on the streets of London and other places because they're wearing masks. SPEAKER_10: Professor Linteris says this kind of insidious racism isn't even recognized by most people, but it's always been connected with disease. SPEAKER_02: So from the very birth of sinophobia in modern Europe and America, sinophobia has been connected with this idea of epidemics coming from China and being spread by Chinese people. And I think that the mask and maskophobia is tied to these racist and xenophobic attitudes. SPEAKER_10: But in China, there's no maskophobia. It's people who aren't wearing masks during this pandemic that are seen as strange. It is, you know, the baseline, as it were, of self-protection. SPEAKER_02: But more importantly, it's not so much about protecting yourself against being infected. It is more of protecting others. SPEAKER_05: I think this is something I didn't really fully appreciate at the beginning of all this. I mean, I think I had this instinct that when people were wearing masks before that they were trying to protect themselves, they were really worried about their own health when it came to a pandemic. But the truth is, it's like the opposite of that. Like they have a little bit of cold and they don't want to spread it to you. You know, a mask does a really good job of keeping them from spreading it to you. They're protecting me. SPEAKER_10: Exactly. They're being conscientious. SPEAKER_05: Yeah. So have you gotten used to wearing a mask regularly? SPEAKER_10: I mean, it's definitely not fun to wear a mask. I mean, I'm not going to lie. I mean, I have glasses. Wearing masks. Oh, it's the worst. SPEAKER_05: Yeah, it's tough. SPEAKER_10: My glasses are always fogged up. And I hated wearing them on polluted days in Shanghai. They made me feel really depressed. But during this outbreak, I'm really surprised. They do not make me feel depressed. And I feel like seeing everyone around me wearing a mask, I feel like a sense of solidarity. SPEAKER_10: I mean, I can't see their face. I can't see their whole face, but I feel like we're telling each other, I'm watching out for you. SPEAKER_10: Right. Right. And I mean, I'm paying much more attention to people's eyes because that's how I can tell what their expression is. SPEAKER_05: Right. You can see that they're smiling. SPEAKER_10: Yeah. So I mean, when I see other people wearing a mask, I feel like it's a reminder that we're all in this together. SPEAKER_05: That's a Ange. probiotics. In other words, it's all your daily nutrients in a glass. Some folks choose to take it as the foundation of a healthy breakfast or lunch, while others lean on it as a delicious protein-packed snack to curb cravings and reduce grazing. If you're in a hurry, you can just add two scoops of Kachava Super Blend to ice water or your favorite milk or milk alternative and just get going. 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A SPEAKER_05: mechanical ventilator that could assist someone who has trouble breathing because they have COVID-19. And anytime you're starting a design process you SPEAKER_03: need something. As you're communicating with teams the first thing you put together allows people to understand direction and it defines things you never thought you'd define. So just having a physical construct can always be very helpful. So Tyler and his colleagues are in the Home Depot and SPEAKER_05: none of the stuff on the wall is designed for ventilators. Staring at a SPEAKER_03: wall of one-way valves for PET connections like they didn't fit onto what we were using at all they were silly but they and they were the wrong pressure grater that everything was wrong about it but we needed to understand what it is we were working with. It was interesting it was a throwback to the scene in Apollo 13. This is the scene where the mission control SPEAKER_05: technicians have to figure out how to fit a square filter into a round hole using only the items that can be found in the Apollo 13 spacecraft or all the astronauts are going to die. SPEAKER_01: Okay people listen up. People upstairs, candidates missed one and we gotta come through. We gotta find a way to make this fit into the hole for this. Using nothing but that. Damn that's the greatest scene in movie history. Anyway. SPEAKER_05: We just started throwing stuff in a cart I think I put 150 200 bucks on my credit SPEAKER_03: card and ran a bunch of stuff to the lab and we started piling things together until it made our first iteration of a ventilator. As you can tell Tyler Mantell SPEAKER_05: doesn't normally make ventilators. So most of the time I make robots that swim SPEAKER_03: through water pipes to find leaks. This is a huge problem with old SPEAKER_05: infrastructure 20% of the world's clean water is lost to leaky pipes but suddenly that wasn't the most pressing problem in the world. When coronavirus SPEAKER_03: came and hit us like it did the ability to travel and do you know some of the big projects we have coming up went away so we started to look at what else we could do and my co-founder of the ventilator project is actually also my roommate. We work in the same building and we just started talking about the fact that ventilators are gonna be a huge shortage and so I started digging into it and you start to find out that a ventilator is not a difficult product. The lack of difficulty doesn't mean it's easy it means it's straightforward. SPEAKER_05: So Tyler and his co-founder at the ventilator project Alex Frost assembled a team of over 200 remote volunteer engineers medical regulatory and business professionals to try and help solve the global ventilator shortage as fast as possible. And even though the details from company to company are very different a lot of manufacturers are making a similar pivot. You know if SPEAKER_08: you're a manufacturer that's kind of what you're always looking like could we make something like that can we make that that's sort of in our blood you know. This is Matt Anderson the co-founder of Sound Devices they SPEAKER_05: normally make high-end audio mixing and recording consoles. A couple weeks ago I SPEAKER_08: was texting back and forth with my head of manufacturing Lisa and said you know I wonder if we could make the ventilators or masks or something. They SPEAKER_05: ended up concentrating on face shield masks. I came in and talked to my sales SPEAKER_08: guys and said hey do you guys want to call some hospitals and see if this is true about there being a shortage because I don't know and they made some calls and they came back and they said yeah definitely hospitals really need these badly. So that's you know a few minutes later we just started buying parts. You know that was on a Monday that we started that and then it was 32 hours later we had the first ones coming off the end of the line. And today if you go SPEAKER_05: to the product page on sounddevices.com you can order a 32 channel 36 track mixer and a 100 pack of single-use medical face shields. And much like the ventilator project when Matt described his company's pivot to our producer Emmett Fitzgerald who you'll hear in the next clip it wasn't the technology or the know-how needed to make the product that was the hard part. You take the foam SPEAKER_08: stick it on there staple on the elastic and you're done it sounds really simple but getting these three parts in volume has been difficult so we have supplier it's it's our normal suppliers for the plastic shield and for the foam luckily we've got great suppliers for them they're right nearby in Wisconsin and we buy them and that's all great. The elastic piece that's been kind of a nightmare to get in quantity. I'll give you a for instance last week two of our purchasing people Lorraine and Chinyi were driving all around northern Wisconsin going from Walmart to Walmart and Joann's fabric to Joann's fabric buying up all the elastic they could find. I feel like when you picture SPEAKER_11: manufacturing you don't picture manufacturers driving to Joann's fabrics to get the stuff they're making. Well and normally you don't but this is a special situation right? SPEAKER_08: So yeah right right. It's typical when you call you say I want to buy this much foam and they say lead time is six weeks and you go okay no problem you plan for that well in this pandemic six weeks does us no good. Supply chains, SPEAKER_05: regulations, and factories have to be more nimble than ever before because the virus is a moving target. Just ask Jen Garino, CEO of the Industrial Sewing and Innovation Center in Detroit which normally makes fashion apparel. I will SPEAKER_06: tell you that this has been such a quickly changing environment at first it was mass mass mass mass so we sampled all these masks all these masks and then it was no longer massive it was really gowns and gowns has really turned out to be the big the big problem and really what we're most suited to make. And what is an SPEAKER_05: isolation gown exactly? So an isolation gown is there's varying degrees and SPEAKER_06: and trust me when I say I have learned a lot in the last three weeks I have Wow I mean acronyms I didn't know before the whole thing what makes an isolation gown is that it has particulate protection to varying degrees so if you're in surgery you have you know really tight cuffs around your wrist and tied around your neck and the highest grade material and the level one it's just sort of like a sheet that you put over that just you know helps you a little bit. The SPEAKER_05: Industrial Sewing and Innovation Center also known as ISAC was already a mission-driven company before coronavirus. So the Industrial Sewing SPEAKER_06: and Innovation Center is designed to be a people-centered institute that trains people for advanced manufacturing of sewn goods like apparel and to do so in a way that is responsible. The fashion industry is a very polluting irresponsible industry for the most part it puts about 45 billion units of garments into landfills every year before consumer. One of the solutions to changing these bad practices is to manufacture closer to home. So instead of SPEAKER_05: stores speculatively buying clothes they think will sell nine months in the future they use more advanced and local manufacturing to quickly fulfill orders on demand. So you get rid of a whole waste stream and now you have a whole SPEAKER_06: resource pool that you can now allocate to paying higher wages and being sustainable from that standpoint we really believe that having a sustainable product is not sustainable unless the people making them have sustainable lives. You can't fight every battle at the same time right I totally get that SPEAKER_05: but how have you approached balancing your mission to the moment? That's right SPEAKER_06: you can't make everything first priority. So sustainability I will have to tell you right now is not our number one you know priority because I mean we're working on polypropylene and these are disposable gowns you wear once and you throw them out it's the opposite of sustainable. No but you know we have learned we've learned a lot about how that stuff gets recycled. So you know we're learning as we go about these waste streams and what you can do about these waste streams. So it's interesting that even though we're creating more ways we're also understanding what you do with it when it's done. But I think what hasn't changed is our commitment to training people and treating people differently than they've been treated in a factory environment. So we were just making different products. So how do you physically make the factory safe so that SPEAKER_05: workers can be separate and still do their jobs? Good question yeah so one of SPEAKER_06: the things that we had to do is when you're when you're manufacturing in a lean way you reduce cost by reducing the space by which you hand things to each other. So in a typical cell. A cell is a team of people working on different SPEAKER_05: parts of an item once the items through the cell it's completed. Literally you SPEAKER_06: have pieces of fabric that are tied together that are kind of making their way around you know the cell. So you're very very very close and that's how you remain competitive. So we had to distance that. So literally what we did was we have these brand new gorgeous machines that you know they're programmable they're really beautiful. And in between them we've rigged these you know corrugated cardboard pathways sort of duct taped you know between machines so that we can create enough distance at least six feet to pass the you know material cross and then to wear masks and the gloves. So it's been this real you know just figure it out make it work. As we continue to SPEAKER_05: navigate the pandemic notably without the proper planning and guidance from our federal executive relying on the ingenuity and generosity of these manufacturers to fill in the gaps there will be a lot of just figuring it out. To find out more about the ventilator project sound devices and the industrial sewing and innovation center go to 99pi.org. 99% invisible's impact design coverage is supported by Autodesk. Autodesk enables the design and creation of innovative solutions to the world's most pressing social and environmental challenges. To address the shortage of personal protective equipment Autodesk is helping connect design and manufacturing resources to develop new solutions for PPE and life-saving devices. Learn more about these efforts at Autodesk.com slash redshift a site that tells stories about the future of making things across architecture engineering infrastructure construction and manufacturing. I have a special announcement we have a book coming out it's by Kurt Kohlstedt and me and illustrated by Patrick Vale it's called the 99% invisible city. When we're back outside and ready to appreciate the everyday design of the city and broader world around us this will be your guide. It comes out on October 6th from Houghton Mifflin Harcourt and right now you can see the beautiful cover and find links to pre-order it on our website it's 99pi.org slash book. 99% invisible was produced this week by Rebecca Kanther, Emmett Fitzgerald and Vivian Lay. Mix and tech production by Sharif Yousif, music by Sean Rial. Katie Mingle is our senior producer Kurt Kohlstedt is the digital director. The rest of the team is senior editor Delaney Hall, Joe Rosenberg, Chris Berube, Avery Truffleman, Sophia Klatsker and me Roman Mars. We are a project of 91.7 KALW in San Francisco and produced on Radio Row which is distributed in multiple East Bay apartments but in our heart it is located in beautiful downtown Oakland California. We are a proud founding member of Radio Topia from PRX a fiercely independent collective of the most innovative listener supported podcasts in the world. Find them all at radiotopia.fm you can find the show and join discussions about the show on Facebook you can tweet me at Roman Mars and the show at 99pi.org. We're on Instagram and reddit too. We have design stories upon design stories and a link and view of the brand new book at 99pi.org SPEAKER_13: you can get your favorite thing delivered to your door so you can eat your favorite thing while you watch your favorite thing at home. 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