Masking for a Friend

Roman Mars:
This is 99% Invisible. I’m Roman Mars.

Roman Mars:
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 the 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 U.S., we’re just not used to needing to cover half our faces in public. But if you look at the other side of the world, it’s a different story. In parts of Asia, a mask in response to the coronavirus pandemic was a totally easy and normal adjustment. Rebecca Kanthor is a reporter based in Shanghai who has lived in China for the past 17 years. She’s here to tell us why the culture of masks developed so differently there, and the doctor who started it all.

Rebecca Kanthor:
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. The night before I’d 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 like nice calm voice, which direction to start off in?

Roman Mars:
Mm-hmm, yeah.

Rebecca Kanthor:
Well, this time my GPS app said this. (Chinese language audio)

Rebecca Kanthor:
So it’s saying, “please wear a mask if you’re going out. Be safe.”.

Roman Mars:
Wow. I don’t think my GPS has ever been quite that intimate with me before.

Rebecca Kanthor:
Yeah. My phone has never gotten that personal with me before. It’s like totally weird. So it stuck with me. And then, after I heard that, then I was looking around. I started noticing everyone around me on the street was wearing a mask. It was like between the day before and that day, 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. 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. (Chinese language audio) And so the thing is, 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.

Roman Mars:
So does that mean that everyone just already had a mask?

Rebecca Kanthor:
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, how come everybody else was so prepared? And I’m like the only idiot, got caught off guard.

Roman Mars:
I mean, right. It seems like, you’re from the US and I’m here in the U.S. And we just seem to have a very different relationship with masks in general.

Rebecca Kanthor:
Yeah. I mean, it’s nothing that I counted as something I should keep in my first aid kit at home. But I guess everyone else here was doing that.

Roman Mars:
And so why do you think that is? Why does China have a different relationship with masks?

Rebecca Kanthor:
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 on the Zoom chat. Do you have it there?

Roman Mars:
Yeah. So this is a black and white photo. It’s a couple of people wearing big white mass. Like everything is kind of covered except for the eyes. But it’s a little thicker and gauze here than the ones that you might see people wearing around today. But it’s basically the same principle. You know, it’s a mask. So when was this photo taken?

Rebecca Kanthor:
So this photo is from over 100 years ago when China was the scene of another devastating epidemic, the Great Manchurian Plague.

Roman Mars:
Oh wow. Ok.

Rebecca Kanthor:
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 [it]. And this outbreak was really well documented, especially in photographs.

Christos Lynteris:
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.

Rebecca Kanthor:
So this is Christos Lynteris. 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.

Christos Lynteris:
And photography played a key role in establishing this ideal global outbreak, an outbreak which is spreading across the globe.

Rebecca Kanthor:
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.

Christos Lynteris:
And at the center of these photography is the mask. Now, why the mask? Masks have 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.

Roman Mars:
So masks had been used by doctors, but they weren’t being used by the general public at this point.

Rebecca Kanthor:
Right. But that changed in Manchuria because of one guy. His name was Wu Lien-teh. Dr. Wu was a young Chinese Malaysian doctor who’d gone abroad to study medicine in Europe. He was actually the first ethnic Chinese person to study at Cambridge. The Qing Dynasty government called them in to lead the Chinese efforts against the plague since it was an international effort. 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.

Christos Lynteris:
And he was a brilliant scientist. He soon came across people with symptoms and he concluded, okay, this is pneumonic plague and he had this idea that it spread in an airborne manner.

Rebecca Kanthor:
So meaning it spread from droplets in the air coming from people’s noses or mouths.

Roman Mars:
And was this a new idea? I mean, how did people think it was being spread at the time?

Rebecca Kanthor:
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’s right about it.

Roman Mars:
Way to go, Dr. Wu.

Rebecca Kanthor:
Yeah. And so he made it like it seemed like a simple suggestion. Everyone should start covering their mouth and noses with face masks.

Roman Mars:
Right. Which is the suggestion that we’re all getting today to stop the spread of coronavirus.

Rebecca Kanthor:
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 with 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 gonna translate what she said.

Vivian Huang:
(Speaking in Chinese)

Rebecca Kanthor:
She said it was this basic gauze mask with two layers. 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.

Christos Lynteris:
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-plague operations. And he wants the general public to wear these masks, as well.

Rebecca Kanthor:
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.

Roman Mars:
Or maybe it’s because they’re racist.

Rebecca Kanthor:
No. But even the local leaders were suspicious of him. 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.

Christos Lynteris:
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 is confronted by a famous French doctor Gerald Mesny. And Mesny hears Wu expounding his airborne plague theory and he humiliates him in a very racist manner. And then Mesny goes on to operate in one of the hospitals to attend the sick without wearing what Wu had suggested is an essential device, which is the mask.

Rebecca Kanthor:
So I think you can guess where this is going…

Christos Lynteris:
Unfortunately for the French doctor, he dies soon after. Catches plague and he dies. So Wu is suddenly and completely unexpectedly, for most people, vindicated.

Roman Mars:
Wow. That is dramatic.

Rebecca Kanthor:
Yeah. 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.

Christos Lynteris:
So the moment when Mesny dies and basically everyone starts accepting Wu’s theory, this mask goes virally.

Roman Mars:
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, it just spreads everywhere.

Rebecca Kanthor:
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.

Christos Lynteris:
Everyone wants the mask and everyone starts photographing the mask. And the mask becomes this kind of a 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 is 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.

Rebecca Kanthor:
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.

Roman Mars:
And do people remember him today? I mean, did he get the recognition that he deserved?

Rebecca Kanthor:
Well, I mean, in 1935, he was nominated for a Nobel Prize.

Roman Mars:
Well, that’s pretty good.

Rebecca Kanthor:
But today, he never became a household name, not even in China. I mean, yeah, people don’t know him.

Christos Lynteris:
But still, you know, he’s one of the most significant epidemiologists of the 20th century. So it’s a shame that he’s not better known.

Roman Mars:
So what happens with Wu’s mask after the Manchurian Plague? Where does it go?

Rebecca Kanthor:
Well, Dr. Wu’s design inspired others around the world to try their hand at mask design, too.

Christos Lynteris:
And so there were competing models. It becomes kind of a medical competition and design competition for the best mask. It’s the holy grail of that epidemic – who is going to produce the best mask, the most efficient mask. And some of them are really kind of weird things. 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.

Rebecca Kanthor:
One of the key things, I think, about the design was that it was disposable. So it didn’t need to be disinfected. Some of the other designs were just too complicated.

Roman Mars:
Right. That makes sense.

Rebecca Kanthor:
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.

Christos Lynteris:
This was a device that caused globally recognized by doctors as well as the late public as a necessary and efficient anti-contagion device. I don’t know how easy it would have been to make people accept these masks and adopt them if it had not been part of a recent outbreak that had been successfully controlled.

Rebecca Kanthor:
And during the 1918 flu, Americans wore masks a lot like Dr. Wu’s. Nancy Tome 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.

Nancy Tomes:
So there’s this really wonderful picture of a baseball game in Pasadena, California. 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.

Roman Mars:
So if people were wearing them during a baseball game… like I can barely wear one on a brisk walk for a couple blocks… So, does this mean that everyone was wearing masks at this point?

Rebecca Kanthor:
Okay, so to be fair, I think that was the only baseball game where people wore masks. It was reported as the first baseball game where players wore masks and it was probably also the last one.

Roman Mars:
So it was a little bit of propaganda to get people to wear masks.

Rebecca Kanthor:
Yeah, it was for show. Professor Tome said that these photos are mostly police officers, nurses, but also baseball players and society ladies. They were meant to convince more people to wear masks.

Roman Mars:
So they were like Instagram influencers.

Rebecca Kanthor:
Totally. Totally. So, this time around during this pandemic, I’ve been seeing news items on social media, photos from back in the 1918 pandemic. And you see these photos and I guess it’s easy to assume that everyone was wearing the mask. But Professor Tome says we shouldn’t assume that it was that universal.

Nancy Tomes:
I don’t want to call it an elite practice, but a specialized practice. So you’re going to find it amongst certain groups and they’re wearing it now that it’s going to be replicated as a way to make everybody feel calmer and safer. But was the expectation that every American should go around with a gauze mask? I don’t think that happened.

Rebecca Kanthor:
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.

Roman Mars:
Yeah, which is another thing you see today.

Rebecca Kanthor:
So right after that 1918 pandemic ended, Americans kind of stopped using masks.

Roman Mars:
So it was just kind of like this blip in American history where it wasn’t unusual to wear a mask.

Rebecca Kanthor:
Yeah, masks basically fell into obscurity in the U.S. after that. I mean, there were other epidemics throughout the 20th century, but they weren’t spread by coughing and sneezing in the U.S. But in China, there was never a chance for people to forget masks for too long.

Christos Lynteris:
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, you know, through several other outbreaks in the 20s, in the 30s, and then in Mao’s China after ’49. Again, the mask plays an important role in public health campaigns. You see the masks in a great number of public health propaganda posters.

Rebecca Kanthor:
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.

Vivian Huang:
(Speaking in Chinese)

Rebecca Kanthor:
Huang told me that public health campaigns on neighborhood chalkboards or posters on 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. 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.

Roman Mars:
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. (laughs)

Rebecca Kanthor:
Exactly. You’re more willing to wear something that you like the way it looks.

Roman Mars:
Yeah, sure.

Rebecca Kanthor:
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.

Vivian Huang:
(Speaking in Chinese)

Rebecca Kanthor:
Back then, she says she was a student. 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.

Roman Mars:
So it’s not exactly that people in China are more inclined culturally to wear masks. They just had more occasions in recent history to wear masks and so they know what to do. They know what the deal is.

Rebecca Kanthor:
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.

Roman Mars:
Right. That’s kind of happened here too, where we’re trying to convince or boomer parents to stay in because we’re fearful they would die.

Rebecca Kanthor:
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.

Roman Mars:
(laughs) So like, direct and relentless.

Rebecca Kanthor:
Exactly. 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 100 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.

Vivian Huang:
(Speaking in Chinese)

Rebecca Kanthor:
She said at least wearing a mask is not strange. You wear it in the winter to keep warm or to protect from pollution or be it a cold. It’s a normalized daily behavior, and no one would look at you strangely for choosing to wear one.

Roman Mars:
Yeah. And that really wasn’t the case here in the U.S. I mean, if you were wearing a mask before all this, people would wonder why.

Rebecca Kanthor:
It seems like that’s really starting to change in the past couple weeks.

Roman Mars:
Yeah. I mean, now I would say that maybe like 80% 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.

Rebecca Kanthor:
Yeah. That’s quite different from the past because I’ve been hearing from Asian-American friends that there was 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. I think there was a lot of fear about how they would be perceived wearing a mask and Professor Lynteris talked about this.

Christos Lynteris:
The masks have become very aggressively and viciously racialized. Right? They’re associated with China, with Chinese people in a very sinophobic manner.

Rebecca Kanthor:
So sinophobia is basically racism towards ethnically Chinese people.

Christos Lynteris:
And so you have this phenomenon where which some journalists call that mask-ophobia, 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.

Rebecca Kanthor:
Professor Lynteris says this kind of insidious racism isn’t even recognized by most people. But it’s always been connected with disease.

Christos Lynteris:
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 mask-ophobia is tied to these racist and xenophobic attitudes.

Rebecca Kanthor:
But in China, there’s no mask-ophobia. It’s people who aren’t wearing masks during this pandemic that are seen as strange.

Christos Lynteris:
It is the baseline, as it were, of self-protection. But more importantly, it’s not so much about protecting yourself against being infected. It is more of protecting others.

Roman Mars:
I think this is something I didn’t really fully appreciate at the beginning of all this. I think I had this instinct that when people were in 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 spread it to you. A mask does a really good job of keeping them from spreading that to you. They’re protecting me.

Rebecca Kanthor:
Exactly. They’re being conscientious.

Roman Mars:
So have you gotten used to wearing a mask regularly?

Rebecca Kanthor:
I mean, it’s definitely not fun to wear a mask. I’m not going to lie. I have glasses. Wearing masks-

Roman Mars:
That is the worst. It’s the worst.

Rebecca Kanthor:
Yeah, it’s tough. 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. 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.”

Roman Mars:
Right.

Rebecca Kanthor:
And I’m paying much more attention to people’s eyes because that’s how I can tell what their expression is.

Roman Mars:
Right. You can see that they’re smiling.

Rebecca Kanthor:
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.

Roman Mars:
Coming up, individual people are not the only ones changing their habits to deal with coronavirus. Manufacturers are also finding themselves in uncharted waters, switching to produce the masks and gowns and ventilators that we need so desperately. Some stories of the great manufacturing pivot of 2020 after this.

[BREAK]

Roman Mars:
About three weeks ago, Tyler Mantel was in a Home Depot at 6 am, taking his first steps in trying to solve a huge global problem.

Tyler Mantel:
Just looking at just a wall of parts and pieces and hoses, just trying to figure out what I could put together to put together a baseline ventilator.

Roman Mars:
A mechanical ventilator that could assist someone who has trouble breathing because they have COVID-19.

Tyler Mantel:
Any time you’re starting a design process, you need something. As you’re communicating with teams, the first thing you put together allows people to understand direction. It defines things you never thought you’d define. So just having a physical construct can always be very helpful.

Roman Mars:
So Tyler and his colleagues are in the Home Depot and none of the stuff on the wall is designed for ventilators.

Tyler Mantel:
Staring at a wall of one-way valves for PET connections, like they didn’t fit on to what we’re using at all. They were silly and they were the wrong pressure. 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.

Roman Mars:
This is the scene where the mission control 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.
Apollo 13 Clip: “Okay people, listen up. The people upstairs handed us this one and we gotta come through. We gotta find a way to make this fit into the hole for this using nothing but that.”

Roman Mars:
Damn, that’s the greatest scene in movie history anyway.

Tyler Mantel:
We just started throwing stuff in a cart. I think I put 150, 200 bucks on my credit card and ran a bunch of stuff to a lab and we started piling things together until it made our first iteration of a ventilator.

Roman Mars:
As you can tell, Tyler Mantel doesn’t normally make ventilators.

Tyler Mantel:
Most of the time I make robots that swim through water pipes to find leaks.

Roman Mars:
This is a huge problem with old infrastructure. Twenty percent of the world’s clean water is lost to leaky pipes. But suddenly that wasn’t the most pressing problem in the world.

Tyler Mantel:
When coronavirus came and hit us like it did, the ability to travel and do some of the big projects you 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 going to 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.

Roman Mars:
So Tyler and his co-founder of 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.

Matt Anderson:
You know, if 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.

Roman Mars:
You know, this is Matt Anderson, the co-founder of Sound Devices. They normally make high-end audio mixing and recording consoles.

Matt Anderson:
A couple of weeks ago, I 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.”

Roman Mars:
They ended up concentrating on face shield masks.

Matt Anderson:
I came in and talked to my sales 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. 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.

Roman Mars:
And today, if you go 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, Emmet 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.

Matt Anderson:
You take the foam, 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 suppliers – 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 Shin Hye, were driving all around northern Wisconsin, going from Wal-Mart to Wal-Mart and Jo-Ann’s Fabric to Jo-Ann’s Fabric, buying up all the elastic they could find.

Emmett FitzGerald: I feel like when you picture manufacturing, you don’t picture manufacturers driving to Jo-Ann Fabrics to get this stuff or anything.

Matt Anderson:
And normally you don’t, but this is a special situation, right. And so yeah….

Emmett FitzGerald: Right. Right.

Matt Anderson:
It’s typical when you call, you say, “I want to buy this much foam.” And they say, “The 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.

Roman Mars:
Supply chains, regulations, and factories have to be more nimble than ever before because the virus is a moving target. Just ask Jen Guarino, CEO of the Industrial Sewing and Innovation Center in Detroit, which normally makes fashion apparel.

Jennifer Guarino:
I will tell you that this has been such a quickly changing environment. At first, it was masks, masks, masks, masks. So we sampled with all these masks. All these masks. And then it was no longer masks. It was really gowns and gowns has really turned out to be the big problem and really what we’re most suited to make.

Roman Mars:
And what is an isolation gown exactly?

Jennifer Guarino:
So an isolation gown is… there’s varying degrees. 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 wrists and tight around your neck and your highest grade material. And a level one is just sort of like a sheet that you put over that just, you know, helps you a little bit.

Roman Mars:
The Industrial Sewing and Innovation Center, also known as ISAIC, was already a mission-driven company before coronavirus.

Jennifer Guarino:
So the Industrial Sewing 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 forty-five 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.

Roman Mars:
So instead of stores speculatively buying clothes they think will so nine months in the future, they use more advanced and local manufacturing to quickly fulfill orders on demand.

Jennifer Guarino:
So you get rid of a whole waste stream and now you have a whole 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.

Roman Mars:
You can’t fight every battle at the same time, right? I totally get that. But how have you approached balancing your mission to the moment?

Jennifer Guarino:
That’s right. You can’t make everything first priority. So sustainability, I will have to tell you right now, it’s not our number one priority because I mean, we’re working on polypropylene and these are disposable gowns. You wear them once and you throw them out. It’s the opposite of sustainable! But you know what we have learned? We’ve learned a lot about how that stuff gets recycled. So, 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 waste, 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’re just making different products.

Roman Mars:
So how do you physically make the factory safe so that workers can be separate and still do their jobs?

Jennifer Guarino:
Good question. Yeah. So one of the things that we had to do is when you’re manufacturing in a lean way, you reduce costs by reducing the space by which you hand things to each other. So in a typical cell-

Roman Mars:
The cell is a team of people working on different parts of an item. Once the item’s through the cell, it’s completed.

Jennifer Guarino:
Literally, you have pieces of fabric that are tied together that are kind of making their way around 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 had brand new gorgeous machines that are they are programable. They’re really beautiful. And in between them, we’ve rigged these, corrugated cardboard pathways, sort of duct-taped between machines so that we can create enough distance, at least six feet, to pass the material across. And to wear masks and gloves. So it’s been this real, “just figure it out, make it work.”

Roman Mars:
As we continue to 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.

Roman Mars:
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/Redshift, a site that tells stories about the future of making things across architecture, engineering, infrastructure, construction, and manufacturing.

Roman Mars:
I have a special announcement. We have a book coming out. It’s by Kurt Kolhstedt and me. And illustrated by Patrick Vale. It’s called “The 99 Percent 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/book.

Roman Mars:
99% Invisible was produced this week by Rebecca Kanthor, Emmett FitzGerald and Vivian Le. Mix and tech production by Sharif Youssef. Music by Sean Real. Katie Mingle is our senior producer. Kurt Kolhstedt is the digital director. The rest of the team is senior editor Delaney Hall, Joe Rosenberg, Chris Berube, Avery Trufleman, Sofia Klatzker, and me, Roman Mars.

We are a product 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 member of Radiotopia 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 @romanmars and the show @99piorg. We’re on Instagram and Reddit, too. We have design stories upon design stories and a link in view of the brand new book at 99pi.org.

Credits

Production

Reporter Rebecca Kanthor spoke with Christos Lynteris, a medical anthropologist at the University of St. Andrews; Vivian Huang, a historian at the Shanghai Library; Nancy Tomes, Professor of History at SUNY Stonybrook.

For the coda, host Roman Mars and producer Emmett FitzGerald spoke with Tyler Mantel, the cofounder of Watertower Robotics who has pivoted to work on ventilators due to the COVID-19 problem as cofounder of The Ventilator Project; Matt Anderson, founder of Sound Devices, who recently made a similar PPE pivot to making face shields; and Jennifer Guarino,  CEO of the Industrial Sewing and Innovation Center (ISAIC), who has been working on PPE projects including isolation gowns for particulate protection. ISAIC is an Autodesk Foundation grant recipient and Watertower Robotics is a resident at the Autodesk Technology Center in Boston.

This episode was edited by Emmett FitzGerald and Vivian Le.

  1. Andy

    When I first came to Japan in the mid-90s, I was surprised by the number of people wearing masks. Not wanting to get others sick is one of the primary reasons they are worn. But a second important reason is allergies. Tons of folks in Japan are allergic to tree pollen (there’s a story in there about how millions of trees were planted around Tokyo post WWII to get people working and how it has backfired tremendously now that those trees are mature and pollinating like crazy, but I digress) and wear masks throughout the spring because they are absolutely miserable. Anyhow, thought you might appreciate one more reasons why masks are so common in this corner of the globe.

  2. Person

    Two words: air pollution. That’s the only reason why everyone had masks when this thing started. Ppl had masks prepared and wore them on the days when it’s really bad.

  3. Thisfox

    Interesting article with embedded photos ends with a faceful of advertisement about autodesk in the same formatting after an embedded image so you automatically read the ad too. Smooth, guys, real smooth. Well done making me regret reading the rest of the article.

  4. Fabio

    In quite a few countries, wearing surgical masks would be illegal to some extent (because you cannot be covering your face in public). Luxembourg – where I live – is one such place.

    cf. https://en.wikipedia.org/wiki/Anti-mask_law

    Lux’g government has made it compulsory to wear mask in public now.

  5. Van Tran

    I’m a little surprised that pollution was mentioned super briefly, just one time in a minor sentence I think.

    People in Asia wear masks because of air pollution. I do understand that plagues made it more popular, but the fact that everyone has masks all the time was because of air pollution. Go to any Asia country, especially East Asia and you will see everyone wearing fabric masks when they do outside. There were even a fashion industry around the masks just because it’s such an essential everyday that people want to look good in them. It’s only during plagues that people wear medical masks. It’s not by chance that when the Covid-19 crisis started, medical masks were all bought up, it’s not because people in Asia don’t have a fabric masks, which they uses everyday, but because they would prefer to have a medical mask to protect themselves. If masks are popular only because of medical reasons, the fabric masks would not have been such a huge industry.

    Another point is people wear masks to protect themselves. It’s still good for the public, but let’s look at it from a real perspective. It’s very easy to see people wearing masks and then open them to sneeze, or try to get the best medical masks available, as to filter the virus from the air.

  6. Johnny

    I read recently how during the Spanish Flu Pandemic, there was an anti-masking league that met at least once in San Francisco. What that article didn’t talk about was the racialized associations with masks, and how the anti-masking league thus also had enormous racist subtext.

    This also reminds me of a recent episode of “What Trump Can Teach Us About Con Law”: San Francisco created explicitly racist quarantines around the businesses and homes of Chinese residents of Chinatown (but not the white businesses in the same neighborhood) in response to an outbreak of plague in 1904, but the Supreme Court ruled that particular quarantine to be unconstitutional (while maintaining that states and municipalities have legitimate power to enforce quarantines on a legitimate medical basis). https://trumpconlaw.com/39-quarantine-powers

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