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May 9, 2020

(Un)protected

Co-produced with PRX Logo

At a time when America is relying on health care workers more than ever, we look at why there’s not enough protective gear to keep them safe. 

Reveal’s Elizabeth Shogren reports on why the Centers for Disease Control and Prevention relaxed guidelines for protecting health workers during the pandemic and how that’s led to a patchwork of protections for doctors and nurses, who are vulnerable to catching and spreading COVID-19. 

Next, we look at the supply chain for personal protective equipment and why it’s been so difficult to ramp up production. Reveal’s Michael Montgomery chronicles one person’s attempt to navigate the system and manufacture N95 masks for doctors and nurses. 

Host Al Letson then speaks with a member of another group on the front lines that’s been affected by the pandemic, funeral director Douglas Hawkins. They talk about how the job has changed and what that’s meant for families saying goodbye to loved ones. We end with the story of a gospel choir that’s figured out a creative way to practice together, despite shelter-in-place orders. 

Credits

Reporters: Elizabeth Shogren, Jennifer Gollan, Michael Montgomery and Priska Neely.

Producers: Christopher Harland-Dunaway

Edited by: Taki Telonidis and Kevin Sullivan

Additional editorial support: Esther Kaplan and Byard Duncan

Production manager: Mwende Hinojosa

Production assistance: Amy Mostafa

Sound design and music by: Jim Briggs and Fernando Arruda

Mixing: Jim Briggs, Fernando Arruda and Claire Mullen 

Special thanks: Dwight Rivera and members of the Selah Gospel Choir

Executive producer: Kevin Sullivan

Host: Al Letson

Episode art by Ben Fine.

Support for Reveal is provided by the Reva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, Democracy Fund, and the Ethics and Excellence in Journalism Foundation.

Transcript

Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal's radio stories is the audio.
Al Letson: Over the past few months, just like the rest of the world, a lot has changed at Reveal. For one, I'm recording right now in a hacked together studio in my bedroom, and instead of traveling the country and world to bring you stories that matter, our reporters are doing almost everything remotely. But, one thing hasn't changed, we remain committed, week in and week out, to reporting and producing shows that inform, investigate, and matter. Right now, Reveal has dedicated nearly all of its resources to reporting on the coronavirus, its impact on our health, economy, and democracy, and the ways this crisis has made the vulnerable even more vulnerable.
Al Letson: There are tens of millions of Americans who are now unemployed, and we know in these times that many of you can't afford the work we do. But, if you can, if this kind of investigative journalism has value to you, please support us. Just text the word 'Reveal' to 474747. It's easy, it only takes a few minutes, and it helps make this show possible. Again, text the word 'Reveal' to 474747. Thank you, and remember the only way forward is together.
Speaker 2: Reveal is support by Everlane. When you're staying at home for an extended period of time, 24/7 pajamas just won't cut it. Look and feel great at home with their comfortable, affordable, modern basics, like the organic cotton crew t-shirt and perform legging. And right now, their popular 100% human collection is donating all proceeds to feeding America's COVID-19 response fund. Check out our collection at Everlane.com/Reveal. Plus, you'll get free shipping on your first order. That's Everlane.com/Reveal, Everlane.com/Reveal.
Speaker 2: We've all hear similar advice, whatever you do, don't bring up religion. However, consider that religion holds the power to unite or divide us. Sacred and Profane, a new podcast, isn't afraid to tackle religion. From a Rwandan man trying to help his neighbors heal after genocide, to a Hare Krishna community in West Virginia wrestling with fracking on their land. These stories explore how religion changes everything. Sacred and Profane is produced by the religion, race, and democracy lab at the University of Virginia. Catch season two where you listen to podcasts.
Al Letson: From the Center for Investigative Reporting and PRX, this is Reveal, I'm Al Letson. It's been just three months since the illness we're all afraid of getting was given a name by the World Health Organization.
Speaker 3: And I will spell it, C-O-V-I-D hyphen 19.
Al Letson: As of May 4th, COVID-19 has claimed the lives of around 70,000 Americans, and completely changed daily life for the rest of us. The pandemic has been a stress test on America, and it's exposed weak spots, cracks that were there already now being pushed even wider. A lot of what we're witnessing in hard to take in, poor communities without access to healthcare, bearing more than their fair share of victims.
Speaker 4: More than 80% of those COVID-19 patients were African-American. The CDC says-
Al Letson: School kids who now have to learn from home, only they don't have computers or internet access.
Speaker 5: In fact, five million households with school aged kids around the country don't have access to the internet at home.
Al Letson: Institutions we're all depending on collapsing.
Speaker 6: Under a worse case scenario, the spokesman said, The Postal Service could run out of money.
Al Letson: The stress points raise big questions about how things work in our country and who's responsible for making them better. That's the focus of our coverage during the pandemic. This week, we go on the front lines with healthcare workers. We wanted to know why nurses, doctors, and others, are being asked to work without the personal protective equipment or PPE they need to keep them safe. Well, we've uncovered policy that's driven more by supply chains than science. Reveal's Elizabeth Shogren brings us the story.
Speaker 7: Welcome to [crosstalk 00:04:33].
Elizabeth Shogr...: Martha [Marks] is a visiting nurse in New London, Connecticut. While we are all hibernating, she goes into six different homes every work day. She's taking a video as she enters an apartment building for the elderly and disabled.
Martha Marks: So, this is the lobby. This is usually full of people. There's usually couches there where they sit, and as I walk in they all say, "[inaudible 00:05:01] Marta, [inaudible] Marta."
Elizabeth Shogr...: Nurse Martha, the residents call her. They're mostly latino. She's been here countless times, to care for people fresh out of the hospital or with chronic illnesses. It's never been this quiet.
Martha Marks: And it's sad now because no ones here, and everyone's in their room, and everybody's very lonely.
Elizabeth Shogr...: COVID-19 hit early here. The building managers are trying to keep it from spreading. Back in her car between patients, Martha points to what her company gives her to wear to protect herself and her patients.
Martha Marks: This right here is the one level one surgical mask that my employer gave me.
Elizabeth Shogr...: You've probably seen surgical masks on TV, worn by doctors coming out of operating rooms. They're made of tissue-like paper and held on with elastic. They fit loosely, with gaps around the edges. They're meant to be thrown out after each patient, but Martha's supposed to wear hers over and over.
Martha Marks: So, that is kind of gross. You're like, okay, so this mask has been on my face now, by the end of four days, for 24 patients and all of their germs are in that paper bag sitting next to me on the front seat of my car. It is bizarre. I would have been fired for doing that before. There is science, this is not what you do for infection control.
Elizabeth Shogr...: Martha has unruly curls, the gift of gab, and usually an infectious smile. But these days, she wears a worried look.
Martha Marks: My greatest fear is that I've been exposed, and that I'm going to bring it to one of my patients and I'm going to get one of my patients sick. That is what that's really, really hard, and that's what brings me incredible anxiety, and why I really don't like being a nurse right now. And I love being a nurse, I love, love, love my job.
Elizabeth Shogr...: But, that job puts her right in the danger zone for possible exposure.
Martha Marks: We're dealing with wounds that are oozing drainage and we're a foot from their faces.
Elizabeth Shogr...: Martha's the vice president of a nurses' union at her company. She's been pushing for better gear for herself and her colleagues. The coronavirus can hang in the air after someone coughs, sneezes, or even breathes. That's why she wants N95 masks, the ones that seal tightly around your face, and filter out 95% of airborne particles. The kind of mask Martha is given isn't designed to do that, but her company says it's following federal guidelines.
Martha Marks: They're telling us what to do, and it's based on the CDC, so I'm saying that the CDC is wrong.
Elizabeth Shogr...: I call Martha's boss, Mary Lenzini. She's the CEO of the Visiting Nurse Association of Southeastern Connecticut. It's part of the Yale, New Haven Hospital Group.
Mary Lenzini: I am also a nurse, but primarily these days, a paper pushing nurse.
Elizabeth Shogr...: So, what do you tell your staff when they say, "We want N95s."
Mary Lenzini: We tell them that they're not available, and they'll be given an N95 when they are assigned to either a suspected or COVID positive patient.
Elizabeth Shogr...: And do you feel that your nurses are safe when they go out to serve patients?
Mary Lenzini: I do. I do. I would have a very hard time doing my job every day as I have for almost 39 years if I thought they weren't safe. I do consult the CDC and the Department of Health websites constantly for advice on all of the PPE.
Elizabeth Shogr...: Your safe wears the same surgical mask until it's soiled, and I just wonder, where did you come up with this idea for this policy, and do you think that it's adequate?
Mary Lenzini: Oh, this is definitely following the advice, or the guidance I should say, of the CDC and our state health department. I don't have, for instance, research behind any of that personally, however I do trust our Department of Public Health and the CDC to give good guidance.
Elizabeth Shogr...: She says she's following the CDC guidance, but what she's not mentioning is that guidance was weakened. It used to be a lot stricter. In the early weeks of the COVID crisis, the CDC's official recommendation was that healthcare workers use respirators that filter the air, like those N95s Martha is asking for. Experts like Dr. Melissa McDermot of the University of Maryland supported these guidelines. They suspected early on that people with COVID-19 could spread the virus into the air and other could breathe it in.
Dr Melissa McDe...: I thought that the inclusion of the requirement to wear respiratory protection for health workers was an important inclusion.
Elizabeth Shogr...: But, on March 10th, the CDC reversed course and loosened its guidelines. Shortages of respirators drove the change, not science about how to best protect medical staff.
Speaker 13: The CDC posted new guidelines saying healthcare workers could use the looser fitting surgical masks as-
Elizabeth Shogr...: The guidance states face masks are an acceptable alternative when the supply chain of respirators cannot meet the demand. So, when did you hear that they were going to change their instructions?
Dr Melissa McDe...: I would say several weeks before they came out and changed them.
Elizabeth Shogr...: In the days before the change, there was a desperate attempt by labor unions and some health experts to stop the CDC from weakening its guidance. Melissa thought the CDC was moving in the wrong direction.
Dr Melissa McDe...: I did call some people and say, "You know the science hasn't changed, so I don't understand why they might be doing this."
Elizabeth Shogr...: So, why did the CDC change its guidelines? I found out that hospitals and the influential lobby groups that represent them had put a lot of pressure on the CDC. I reviewed letters from them, as well as from health departments and member of congress, urging the agency to weaken its standards.
Kim Schrier: My name is Kim Schrier. I am the representative from Washington's 8th Congressional district.
Elizabeth Shogr...: And a democrat. She wrote one of those letters.
Kim Schrier: Previous to being a member of congress, I spent 20 years as a pediatrician.
Elizabeth Shogr...: Schrier says she heard a lot from hospitals, who told her there just weren't enough N95 masks available.
Kim Schrier: Can we have every healthcare provider putting on a new N95, gown and gloves for every patient? You could, but you would run out in about two days, and the country would be left with nothing.
Elizabeth Shogr...: Experts say there was another reason hospitals were lobbying for looser standards. They were concerned about legal and financial liability if hospitals were required to provide N95s but couldn't. They could get sued by families of hospital workers who get sick or die, or by the unions that represent medical staff. For Schrier, pushing for a looser standard made sense, but she never thought it would be in place for such a long time.
Kim Schrier: I am a physician, and I would have felt comfortable with these temporary recommendation, knowing or expecting or hoping that our government would then get enough personal protective equipment on the ground, that that would be only a temporary situation.
Elizabeth Shogr...: But, two months later, hospitals still don't have enough N95 respirators. Schrier blames President Trump for failing to use the Defense Production Act to order US manufacturers to ramp up N95 production. We heard the same criticism from a former White House official, who headed President Obama's Ebola response, and from lots of frontline doctors and nurses.
Kim Schrier: Look, hindsight is 20/20, and if we knew about the virus what we know now, I would not have necessarily written that letter.
Elizabeth Shogr...: Have you changed your recommendations? Have you written back to CDC to say now you think more protection is needed for healthcare workers?
Kim Schrier: So, I hear the question you're asking, and it seems like an impossible question to answer because we're living in a world where we don't have enough of the equipment we need, and so we're forced to make these really difficult choices about what we do.
Elizabeth Shogr...: I asked the CDC for an interview multiple times, but they turned me down and they sent me a statement instead. "While these strategies do not adhere to the typical standards of care in the US, they reflect the hard realities on the ground as a result of the COVID-19 pandemic." Those hard realities, again, the lack of N95s. But, Dr Melissa McDermot says that people expect the agency's guidance to be based on science not shortages.
Dr Melissa McDe...: One of the downsides of changing the guidance from CDC, it can be misunderstood as a change because the science has changed, and that's not what happened. If anything, since that CDC guidance has come out, it looks even more clear that you really do need to wear a respirator, so that's concerning.
Elizabeth Shogr...: Nurses and doctors told us they believe that if the CDC still required N95s, their hospitals and the White House would try much harder to find them.
Dr Melissa McDe...: I can agree that there is probably a little less hustle going on to try to find the N95s or other alternatives.
Elizabeth Shogr...: Which leaves nurses like Martha terrified. Martha is 57 and in good health, but a few weeks ago, she updated her will.
Martha Marks: I talked to my kids. Actually, last night we were talking because when John Prine died... He wrote Angel from Montgomery. That's my favorite song.
John Prine: (singing).
Martha Marks: So, I was telling my kids, I'm like, "You know, I want you to play that song at my funeral," and they're like, "Mom, you've talked about your funeral more in the last month..."
John Prine: (singing).
Elizabeth Shogr...: We've talked with a lot of nurses and doctors. Some are treating patients deathly ill with COVID-19 and wearing only minimal protections, like the flimsy surgical mask Martha has. Some told us they've consulted lawyers, drafted wills, and written directions for whether doctors should resuscitate them if they get very sick. We've learned that as of April 30th, more than 26,000 healthcare workers have confirmed cases of COVID-19. But, some hospitals seem to be doing a much better job of keeping their staff safe, despite the mask shortages and weakened guidance from the CDC.
Jade Flynn: So, I feel very protected whenever I go into a patient room, because I know that my training and my team around me will make sure that I am safe.
Elizabeth Shogr...: Jade Flynn is a critical care nurse at Johns Hopkins Hospital in Baltimore. It's a leader in infectious diseases, and even started making its own protective equipment. Its standards go way beyond the CDC guidelines for outfitting doctors and nurses.
Jade Flynn: We put our first layer of protection on, which is exam gloves. Then, we put a yellow, plastic gown on and we tie that in the back, and then after that we put on a second pair of gloves, plus the respiratory and eye protection.
Elizabeth Shogr...: Jade feels for nurses like Martha, who aren't as well protected.
Jade Flynn: The haves and the have nots is something that is morally distressing to me. I feel incredibly guilty almost, because I have what I need to take care of myself and to take care of the patient safely.
Elizabeth Shogr...: Other countries seem to have had more success in keeping nurses and doctors healthy. In China, at first many hospital staff got COVID-19. The government imposed stricter standards, and according to the World Health Organization, their infection rate dropped. In Hong Kong, doctors caring for high risk patients have to wear N95 respirators, and only one healthcare worker got sick.
Elizabeth Shogr...: One of the times I caught up with Martha, she told me her greatest fear was coming true. Healthcare workers are catching and probably spreading the coronavirus because they are not adequately protected. This didn't happen to her, but to a colleague.
Martha Marks: She's brilliant and wise and kind, and just one of my favorite, favorite people in the whole world. She called me and sobbed. She sobbed because she was so afraid that she got some of her clients sick.
Elizabeth Shogr...: What did her test say?
Martha Marks: Oh, she's positive. She's positive and now her significant other is also positive, and he's very, very sick.
Elizabeth Shogr...: Martha's colleague had seen five patients the day before she felt sick. One of them lives with his mother, who's in her 80s. About a week later, they both were coughing.
Martha Marks: [inaudible] called the other day, and the mother was so sick with a temp of 101.4, she had diarrhea, she was so weak. She's in a walker, with her son in a scooter wheelchair, he can't walk. We're just devastated.
Elizabeth Shogr...: A few days later, the mother and son were both in the hospital with COVID-19, the mother on life support. Another patient also had it, and a third was dead. We can't know for sure who's spreading COVID-19 to whom, but Martha says it's obvious visiting caregivers are playing a role.
Martha Marks: We've been saying this was going to happen since day one. We knew this was going to happen. How's it not going to happen?
Elizabeth Shogr...: And Martha fears that it will keep on happening unless nurses get the respirators and other equipment they need to keep themselves and their patients safe.
Al Letson: Our story was reported by Reveal's Elizabeth Shogren and Jennifer Gollan. So, will nurses like Martha get the better masks they need to protect themselves? Right now, the mask shortage is creating a worldwide scramble to make and import masks. Up next, a California woman decides to jump into the fray.
Speaker 17: What's going through my mind is are we going to get taken advantage of? Are we doing the right thing in working with this commercial entity?
Al Letson: You're listening to Reveal.
Al Letson: From the Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. The shortage of personal protective equipment or PPE has been a perfect storm. Bad policy decisions by the government and healthcare providers, widespread factory closures, and a breakdown in the global supply chain, and that's the short list. Michael Alkire has watched this unfold close up. He's the president of Premier, a company that buys medical supplies for hospitals and healthcare systems. He's seen demand for those N95 respiratory masks, the ones that hospitals can't get ahold of, surge by nearly 600%.
Michael Alkire: Before pandemic, we used 22 to 25 million N95 in the medical field a year. Today, we have a run rate of about 150 million a year. 150 million a year.
Al Letson: The flipping of supply and demand is one of the reasons for the shortages. Another, Michael says, is that to cut costs, the healthcare industry relies too heavily on Chinese factories for medical supplies. When the pandemic hit, production came to a screeching halt.
Michael Alkire: We have to create more resiliency and redundancy in the supply chain. When I say we, I mean the entire industry as a whole.
Al Letson: Michael says we should produce more of this essential equipment in the US. Today's crisis with PPEs reminds him of a shortage of pharmaceutical drugs back in 2011. At that time, he testified before congress about how middle men stepped in and took advantage of the situation.
Michael Alkire: We found that average markups were 650% and the highest markup was 4500%.
Al Letson: Today, he says the middle men are back with a vengeance.
Michael Alkire: We probably have had three or four hundred people reach out to us over the last six weeks or so, three or four hundred, and only five of them were vetted. So, there's a lot of fraud going on, there's mischaracterize of the product.
Al Letson: With no central authority taking charge, in this case, the Trump administration, states, cities, small towns, and hospitals are in a wild west scramble to track down their own supplies. A lot of Americans are shocked that this could be happening, and we've seen everyone from celebrities and sports teams to large nonprofits offering to help out. Even private citizens, with no experience in the field, are getting into the PPE business. Reveal's Michael Montgomery follows the story of one Bay Area woman as she tries to navigate the global supply chain.
Michael Montgom...: Her name is Kelly Jones. She's a 30 year old college administrator at University of California Berkeley, and like a lot of us, she's been watching the news and has been really disturbed to see healthcare workers begging for protection.
Speaker 20: We are demanding that we get all the hoarded supplies that exist of PPE so that we can protect ourselves, our families, and our beloved patients and communities. We can't do it if we're dead.
Kelly Jones: Seeing nurses crying and expressing that they're out of the things that they need to keep them safe, so that they can in turn save lives and help people, it's really upsetting to me.
Michael Montgom...: Kelly has worked on social causes before, like programs for at risk youth, and she feels a gnawing desire to help the healthcare workers. She's not sure what to do, until one day in late March she comes across a Facebook post from an old friend named Daniel Montague.
Kelly Jones: It said, "I have direct access to factories making medical masks, thermometers, hand sanitizers and other medical supplies. I'm looking for clients or even cities or local governments or hospitals that might be in need of them. Any way to help, please share." I'm thinking that someone hijacked Daniel's account.
Michael Montgom...: Kelly decides to get in touch with Daniel right away.
Daniel Montague: Hey, can you hear me?
Kelly Jones: I can hear you, hello. When I saw your post, I was like, "Daniel, are you scamming people?"
Daniel Montague: It took me probably about two weeks to make that post because I didn't want to come off to people that would go through their feed and be like, "What is Daniel talking about?"
Michael Montgom...: Kelly and Daniel grew up together in Columbus, Ohio. They were so close, some people called them the twins. But, they lost touch after graduating high school in 2008. Kelly went to college in California, Daniel stayed in Ohio for school, then went to China and started teaching English. He's now living in South Africa, and has a small company recruiting English language teachers. Most of their work is in China, where he has a business partner named George Ho.
Daniel Montague: George and I are working as a team, and once recruitment went belly up because of the outbreak in China, he said, "Daniel, I have my father in law's company. It's a medical supply export company and they make thermometers. They're also getting machinery in for masks. So, we get factory prices."
Michael Montgom...: Daniel's looking for a way to bring these PPE supplies, mainly hospital gowns and masks, to the US. Kelly realizes she has no experience in this field, but she knows other people how have tapped their professional and family networks to do exactly this. So, she agrees to work her connections in the US while Daniel and George work to secure the goods in China. Lesson one, you got to trust the people you're working with.
Kelly Jones: I just want to make sure that we're not going to agree to anything that would allow the seller to jack up the prices and for us to be one of the other people who are profiting off of this pandemic.
Daniel Montague: Yeah, no, I mean, I think that it is really worrisome when you see some of the numbers of these products. It's crazy, it has skyrocketed, and it's unimaginable to think that a mask would go for $13 or something like that.
Michael Montgom...: They agree to sell the supplies at a fair price. Kelly trusts Daniel, Daniel trusts George. But, they'll have to get other business partners to trust them. Part of that is proving they have what it takes to get ahold of certified PPE supplies. That leads to lesson two, you got to have really good connections. Daniel tells Kelly that's where George comes in.
Daniel Montague: Do you know what guanxi is?
Kelly Jones: No, no. What's guanxi?
Daniel Montague: So, guanxi is basically connection. By having high levels of guanxi, you have more connections and you have pretty much better trust. That's what George brings to the table. Him and his family have this guanxi with the factories, this built up trust that allows us to enter.
George Ho: Hey, Daniel. This is George.
Daniel Montague: Hey, George. How's it going?
Michael Montgom...: Daniel's been talking with George throughout the crisis on WeChat. George says he's working his contacts who produce isolation gowns and surgical masks, plus those N95 respiratory masks, and the Chinese version the KN95s. But, George says all the suppliers are demanding at least 50% of the money up front.
George Ho: All they want to see is do you have the order. If you do, show me the money, I'll give you the product. Otherwise, they don't even bother to talk to you at all.
Daniel Montague: Yeah. That's the difficulty to explain to foreign clients because they aren't used to this kind of market.
George Ho: Yeah, that sucks because that's the situation right now. It used to be it's a buyer's market, what we call, so buyer can make the demand because they're the boss. But now, the factory is the boss. So, what we call in China, we call this seller's market right now.
Michael Montgom...: What's more, George says middle men are scooping up supplies, driving prices higher. Even with these obstacles, by early April, Daniel thinks he might have a buyer, a medical supplier in the UK. Meanwhile, Kelly connects through friends to a well placed business executive in New Jersey, J.D. Gray. He's at a big engineering firm, has experience importing machinery, and has contacts at hospital chains. He tells Kelly he's open to helping out.
J.D. Gray: I don't want a dime out of this. I consider this societal money, okay?
Kelly Jones: Exactly.
J.D. Gray: If we can get the presidents of the hospitals involved and the state department involved and the federal government involved and it's real... So, here's what I'd like [crosstalk 00:29:52]-
Michael Montgom...: J.D. asks Kelly and Daniel to send more info, maybe he'll send it on to his friends. That gets us to lesson three, don't get your hopes up.
Kelly Jones: How are you doing?
Michael Montgom...: Kelly and J.D. talk again two days later.
J.D. Gray: We're doing fine. I got an email, very interestingly, from your colleague, Daniel.
Kelly Jones: Yeah, yeah.
J.D. Gray: What it sounds like is that he does not have any product made. They may have some product materials, but anybody legitimately involved in the welfare and safety of anybody will not buy anything sight unseen.
Michael Montgom...: Daniel says the factories won't produce the gear until they have an order and at least half the money up front. They want to make sure they don't get stuck with products if the US or China decides to change the regulations around medical supplies, which they've been doing since the pandemic hit. From J.D.'s point-of-view, he's been asked to find money for a product that isn't sitting in a warehouse ready to ship.
Kelly Jones: So, what do you need as the ultimate proof of legitimacy?
J.D. Gray: The ultimate proof is product capability, and it sounds like they want a down payment. That's a red flag, okay? The burden of proof right now rests with Daniel to prove that he's not just doing a money grab, okay?
Kelly Jones: Yep.
J.D. Gray: You and I will stay in touch. Please accept the fact from me that you are a very kind, nice person, and I just say this to you, stay that way.
Kelly Jones: Thank you. Thank you, and you too. I appreciate... J.D. is telling me that we're completely ignorant, and says it's absurd to demand 50% upfront for a product that's not in place. So, all of this starts to sink in for me, and I start to second guess what we're doing.
Michael Montgom...: The day after the call with J.D., Kelly and Daniel hit another roadblock.
Daniel Montague: So yeah, Kelly, some disappointing news today.
Michael Montgom...: The deal to import masks to the UK falls through.
Daniel Montague: Because it's a new supplier and the risk of putting the 50% down, they thought that the risk was much higher than the actual reward. None of their concerns was about the quality of the products. They felt the quality was great, it was fine, it was good for their clients-
Kelly Jones: Well, that's good news.
Daniel Montague: Yeah.
Michael Montgom...: With both the UK company and J.D. bowing out, we go to lesson four, be persistent. Kelly connects with a group of social entrepreneurs, people who try to integrate business and social causes. That leads her to a man named Everett Findlay.
Kelly Jones: Everett's important to me because he actually understands the dilemma that we're facing, and he's going through the same things we are.
Michael Montgom...: Everett is a New York based consultant who pairs clients with causes they care about. He's worked in fashion and design, and with the UN in New York City and his native, Trinidad and Tobago, on sustainable development.
Everett Findlay: The whole thing for us is we want to be ethical. We are selling ethical PPE to people that need it. That's what we have to do, or not do it all.
Michael Montgom...: Everett is teamed up with a small New York marketing firm called the Star Brands Group. The company has pivoted from selling luxury goods to consumers in China, to securing PPEs from China for American hospitals. After weeks of phone calls and emails, Kelly and Daniel finally set up a video chat with Everett and Star Brands CEO, Matthew Hise.
Matthew Hise: You represent factories in China that you have a direct relationship to, we're putting things into play to plug your supply chain in. As we understand it, PPE and especially masks, respirator masks, will be a part of our lives for an unforeseen future, so we think the supply and demand is there.
Michael Montgom...: Kelly tells Matthew, she's still a little concerned about working with a marketing firm.
Kelly Jones: I'm not going to lie, I'm still skeptical. Star Brands is a commercial entity, right?
Michael Montgom...: Matthew says they've already sold millions of masks to healthcare providers at a fair price.
Matthew Hise: We list our prices, we are about ethical transparency, and we're not price gouging. That's the stance that we had from the beginning.
Kelly Jones: Those prices show a really minimal margin to the factory prices. That has given me substantial reassurance, so I appreciate that.
Michael Montgom...: The call goes on for an hour. They talk about a possible deal to deliver medical gowns to medical gown to hospitals in Virginia.
Matthew Hise: Gowns are a premium right now. Gowns are very hard to get.
Michael Montgom...: They agree to keep talking, and hope to reach a deal in the next few weeks.
Kelly Jones: The difference between what Star Brands and what Daniel are doing is that Star Brands is trying to make deals, whereas me and Daniel are trying to open up new channels of the supply chain. So, very different goals. It's hard to see another option right now.
Michael Montgom...: It's been almost two months, but it feels like a year since Kelly and Daniel first started trying to get a deal done.
Kelly Jones: The thing that sticks out to me is that nobody really knows what they're doing and everybody is flying by the seat of their pants and learning as they go. That, I think, was the most shocking thing for me. The bigger picture here is that we shouldn't be in this position in the first place, especially as private citizens, the government should be doing this.
Al Letson: That story from Reveal's Michael Montgomery. As Kelly and others try to get PPE into the country, people on the front lines of the COVID crisis scramble to protect themselves. When we come back, I talk to someone who describes himself as being at the back of the frontline, a funeral director. You're listening to Reveal.
Al Letson: From the Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. There are lots of workers on the front lines, who struggle to get the PPE they need to protect themselves, delivery workers, nurses and doctors. And when someone dies from COVID-19, there's another line of workers standing right behind the healthcare professionals. People we don't think about right away, like funeral directors. They need to protect themselves when they handle the bodies of the dead. I wanted to understand what the job has been like for them.
Speaker 27: Please enjoy this ring back tone while your party is reached.
Al Letson: So, I called one.
Louis Armstrong: (singing).
Al Letson: I also wanted to know what it's been like for funeral directors in communities of color that have been hit harder than others by the virus.
Douglas Hawkins: My name is Douglas Hawkins and I'm a funeral director with Ideal Funeral Parlor in Florence, South Carolina. I have been a funeral director for over thirty years and it is a pleasure to be here.
Al Letson: Mr. Hawkins says these are uneasy times to be in his profession.
Douglas Hawkins: There's a heightened sense of anxiety. The heightened anxiety comes from our understanding of the way that this disease is transmitted. With it being airborne, a lot of times a individual who passes expels air in what you would call the last breath. So, if they're expelling air and they have COVID, then they have expelled COVID. It puts us in a situation where we're walking into a room and we may be infected.
Al Letson: So, take me through step by step, how you and your staff protect yourself when you go to collect the body of someone who you think may have been a victim of COVID-19. What do you do first? What do you wear to protect yourself, do you have enough of it, those type of things?
Douglas Hawkins: The answer to the second question is no, we don't have enough. The answer to the first question is, we have both the isolation suits, the tyvek suits, and we also have the plastic or polyethylene gowns. Each of those are long sleeves which has a band around the wrist. We require our people to double glove on each hand. We also require them to put on shoe covers, wear a mask, and a face shield.
Al Letson: When you say you don't have enough of this, what's going on there? How come you don't have enough?
Douglas Hawkins: I was calling for gowns yesterday. They don't have any, or they have the most expensive gowns. They're requiring that we purchase... Their minimum requirement exceeds our maximum budget.
Al Letson: So, I'm just curious, given what's going on now and a lot of the reports that we've heard... I have a friend of mine who's father passed away from COVID-19, and they're not able to have a funeral. They're not even able to really say goodbye. How has that changed the business for you?
Douglas Hawkins: That's more of a psychological change that I think that this country will experience for years to come. We have always been able to, in some way, say goodbye to those who have left this life. Seeing that body lying in a casket, seeing that person lying there peacefully, it has an effect of giving a family comfort. It is those little things that actually move a person from a point of witnessing a death to the acceptance of that death and moving on.
Douglas Hawkins: Yes, that does include the tears, it does include the comforting of someone. In our comforting, in the culture that we're in, comforting does mean touching, comforting does mean putting your hand on the back, comforting means offering that shoulder to cry on. Not being able to do that has a detrimental effect.
Al Letson: What is it like for you personally to not be able to comfort people?
Douglas Hawkins: This is the hardest thing that I have ever done in my life. I want to be there for them through their tears. But, not to be able to physically be there, for that person to be able to hold my hand, for that person to be able to feel comfortable putting their head on my shoulder to cry their hearts out, is extremely, extremely hard. By the rules changes of people not being able to do that, I hear of some people who have limited their services to 10 people. I've seen one cemetery who has limited their services to one family member. To tell a family that, look, there are only 10 of you that can go out to the cemetery, and this man has 12 children. To have to be able to say to a family, only one of you can go out and see your mother be buried.
Al Letson: I mean, because for everybody it's hard. For the one who gets to go, there's the guilt that your siblings didn't get to go. Then, for the ones that don't get to go, it's like you didn't get to say goodbye properly.
Douglas Hawkins: That's correct.
Al Letson: One of the things that I've been thinking a lot about is in a state like South Carolina, African Americans make 27% of the population, but they're 43% of the coronavirus cases. What are you seeing out there and what do you make of this?
Douglas Hawkins: It's multifaceted. We as African Americans are more likely to have those quote underlying conditions, such as COPD, such as the asthma... And when I say these, these are untreated, such as the uncontrolled diabetes, such as the uncontrolled blood pressures, the uncontrolled heart disease. That's a part of it. You bring with that our gregarious nature. We believe in social gathering rather than social distancing.
Al Letson: How do you keep going on with everything that has changed in your industry, the whole world is shifting around us, how do you keep going forward and doing the work that you do now?
Douglas Hawkins: There's a reason that we do what we do. I like to call it a calling. Although we bury the dead or we handle the dead, our job is more so the handling of the people during this period of time. As long as we don't lose sight of the fact that we're supposed to show love and that we're supposed to do love, then that's how I keep going. I'm doing something to move this family from what we call point of death toward point of acceptance of the death, because God gives me strength. He gives me strength to go on, and this is my ministry, this is what he has called me to do. This is my contribution. This is my contribution.
Al Letson: Well, Mr. Hawkins, I can't tell you how much I appreciate your contribution. Thanks for talking to us.
Douglas Hawkins: Well, thank you for having me.
Al Letson: Douglas Hawkins is the director of the Ideal Funeral Parlor in Florence, South Carolina.
Al Letson: In times of distress, music can be a great comfort. Over the years, it's been just that for Reveal producer, Priska Neely, who sings in a gospel choir. But, with the new normal of physical distancing, the choir had to get creative.
Priska Neely: When I lived in Los Angeles, I sang with Selah gospel choir. Usually this time of year, we'd be busy getting ready for a big spring concert. This is our performance from last May.
Speaker 31: (singing).
Priska Neely: We rehearsed every Tuesday for two and a half hours. About 50 of us in the community choir would pack into our rehearsal space in Pasadena, folding chairs squeezed tightly together.
Speaker 32: But now, we have 49 participants.
Speaker 33: Woo hoo. We going to break 50 tonight?
Speaker 32: Yes.
Priska Neely: The members have packed into a Zoom meeting instead.
Priska Neely: Hey, you all.
Speaker 34: Hey everybody.
Speaker 35: Hey.
Speaker 34: Hi.
Priska Neely: One of the bright spots of this strange time is that even though I don't live in LA anymore, I can join them.
Speaker 32: I'm just happy to see everybody's faces. It's nice to see Priska here.
Speaker 34: Oh my gosh.
Priska Neely: Like in most video conferences these days, there are some technical difficulties.
Speaker 33: This is weird. Some people are saying can't hear me, piano's fine, some people are saying the piano is super soft. This is not good.
Priska Neely: You see some pretty amusing things, cats climbing on shoulders, children popping into view asking questions or leaning in for a cuddle.
Speaker 32: Oh, [Annie's] baby. Hi baby.
Priska Neely: But, we're here, we're having prayer rehearsal.
Speaker 33: Let's go C major.
Priska Neely: The director, David Lee gets us started warm ups.
Speaker 33: Let's just do a nice easy hum.
Priska Neely: So, at this point, you're only hearing me singing. The key to a virtual choir rehearsal is that everyone has to be on mute. So, it's just me, singing scales, alone in my apartment, pretty awkward. When I tell friends about this, a lot of them ask me, "Wait, why do you have to be on mute?" Well, the only time when it's mics on for everyone is when we sing happy birthday, and here's what that sounds like.
Choir: (singing).
Priska Neely: Okay, you get the idea. Programs like Zoom are designed so that only one voice is in the clear at any given time. Plus, everyone's internet runs at a different speed, so yeah, we're on mute. This choir sings tradition and contemporary gospel music. There are no auditions and you can join if you're religious or not. We learn parts by ear rather than reading sheet music, so David, who can sing all of the notes, teaches each part.
Speaker 33: (singing) and a one, and two. (singing).
Priska Neely: In this rehearsal, we're learning a song called Grateful by gospel artist, [Deandre] Patterson.
Speaker 33: Altos, here we go.
Priska Neely: I sing alto. (singing). To be honest, and you know this if you've ever been in a choir, even during a regular in person rehearsal, the worst part is when you have to just sit there quietly as the other sections go over their notes.
Speaker 33: So, let's go tenor part. (singing), tenors, and-
Priska Neely: But, the payoff in a normal rehearsal is hearing all of the voices come together, hearing the beautiful harmonies as they lock in place, hearing your voice vibrate off of someone else's. There's something magical about that. In these virtual rehearsals, you just don't get it, you're just singing by yourself, probably confusing your neighbors.
Priska Neely: (singing). And what exactly are we rehearsing of? Well, like a lot of things in life right now, that's unclear. Jyvonne Haskin, the co executive director says the spring concert it's going to happen this year, still...
Speaker 32: What's more important for us to having these virtual rehearsals is being able to see each other and to have this community and how helpful and healing it can be at times.
Priska Neely: And just as the wonders of technology can allow us to rehearse without leaving our homes, the wonders of technology can bring our voices together virtually.
Choir: (singing).
Priska Neely: I had a few singers in each section send me voice recordings so I could layer them on top of each other and voila. I don't know when, but one of these days, we'll be able to make this magical harmony and experience that hope and healing together, in person.
Choir: (singing).
Al Letson: That story was from Reveal's Priska Neely. Thanks to the members of the Selah gospel choir and Dwight Rivera on the piano. Our producer this week were Michael Montgomery and Christopher Harland-Dunaway. Taki Telonidis edited the show. Special thanks to Reveal's Jennifer Gollan, Esther Kaplan, and Byard Duncan for the help with the story about the CDC. Victoria Baranetsky is our general counsel. Our production manager is Mwende Hinojosa, score and sound design by the dynamic duo, [J-Breezy 00:51:22], Mr. Jim Briggs and Fernando, my man yo, Arruda. They had help this week from Amy Mostafa and Claire C-Note Mullen. Our CEO is Christa Scharfenberg. Matt Thompson is our editor in chief. Our executive producer is Kevin Sullivan. Our theme music is by [Camerado 00:51:36], Lightning. Support for Reveal is provided by the Reva and David Logan Foundation, the John D. And Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, the Democracy Fund, and the Ethics and Excellence in Journalism Foundation.
Al Letson: Reveal is a co production of the Center for Investigative Reporting and PRX. I'm Al Letson. And remember, the only way we get through this is together.
Choir: (singing).
Speaker 37: From PRX.