Paul Graham donates to flexport.org for healthcare worker protective gear in SF | Hacker News Reader

Paul Graham donates to flexport.org for healthcare worker protective gear in SF

twitter.com

73 pointssamdung32 comments

Someone I know was recently collecting money to buy masks for a distressed hospital directly from a factory in China. When asked why the hospital doesn’t just buy the masks themselves, they said this:

“They absolutely should. But hospitals don’t buy from individual factories in China, they buy supplies from catalogues from approved vendors. In the meantime, we can help protect the workers with a short-term donation. Also from what I hear, China has been slowing down “official” export of medical supplies. What I’m doing is placing a private order via DHL that should go through faster.”

If it’s true, this could help explain how PG’s donation would create an incremental benefit rather than just increasing the demand/prices on the limited supply.

Yes. The root of the problem is that the hospitals' supply chain is brittle, and broke under the stress. One hopes it will get redesigned to be more robust. But in the meantime Flexport can get PPE now, and now is when it's needed.

I've been shipping hundreds of thousands of masks to different institutions from China for the last 6 weeks - Universities, Government Agencies, Postal Companies, etc through my company ZipX.

Supply is a factor - the prices are ridiculous - but not the biggest limiting factor

The two main issues are

1. How do you trust the factory?

Unless you have worked with or vetted a factory for awhile how do you know the masks are actually rated at the level they say or that they will even deliver once they get the money?

So so many websites and factories can supposedly sell you millions of cheap BFE 99% or N95 masks yet did not even exist 2 weeks ago. Certificates can be photoshopped. Most of the countries that manufacture these days have no legal recourse if they scam you. We have local offices in all the countries we import from, did multiple visits in person, tested out larger and larger sample orders and they still tried to scam us by switching out the masks for used ones 3 weeks in.

2. How you do you deliver it?

The customs laws are changing all the time. Unless you have contacts there to check the current status you may have information that's a week out of date. India just banned the export of masks a few days ago. The Shanghai gateway blocks 3-ply masks to Hong Kong but the Shenzhen gateway doesn't.

Also flight space is extremely limited. You have to have dedicated space booked or a contact for large space like these supplies need. Your average person isn't going to get 1,000,000 of anything on a cargo plane within a week.

Flexport has been around long enough and has local offices and contacts to deal with these.

I'm highly skeptical of the claim that it will pay for _all_ of SF health workers PPE needs. How many masks and gowns does $1 million buy? How long will the supplies last at the exponential growth we're seeing?

That being said, pg is amazing person for donating and an inspiration to many.

Before the outbreak, N-95 masks used to cost 58 cents. So if it was spent on masks only, around 1.7 million masks at those prices. I don't know how many health workers SF has, but at a population of 800k and a US average of 2.6 physicians per 1000 people I'd guess it's hundreds of masks per worker.

I don't know about the costs or the currently available supply though, or what the real price increases should be due to a pinched supply chain, and I haven't been able to find any data - would appreciate pointers.

I have been shipping masks for the last 5 weeks. Prices I am seeing are in the $1.50 and up range

I think this could be useful to ramp up production if nothing else. But your estimate is extremely optimistic with current prices way past 58 cents.

You also need 3 masks per shift for all heathcare workers including receptionists and janitors at risk. In the worst case that may include volunteers to help cover temporary wards setup like those for the 1918 flu pandemic.

Really though this is a situation where money is not the problem.

Yeah, like I said I don't know what the current available supply is, which IIUC is the more limiting factor. I also don't know what the current prices are, and I don't know which part of it are production costs and which part is just profiteering.

And even if it's hundreds of masks per worker, I'm sure it won't last through this thing.

Whoa the outright pessimism in this thread is horrific. The guy literally donated $1m to try help a certain aspect of the crisis. What did you do? Did you do anything at all to help? Think about your own actions in the face of this pandemic before criticising others.

I hate to break it to you man but you don't need to be Mother Teresa to critique other peoples contributions.

I don't think anyone in this thread is criticizing pg or his generous donation. More just that the tweet seems very exaggerated and self serving.

Virtue is what you do in silence

A bit of signalling in a crisis might pressure other wealthy people to do the same. So it might have value.

Then again, public given non-virtuous money helps more then no money.

I think signaling that you've donated money towards something is the best way to get others to donate, virtue be damned.

The American healthcare system seems really broken. Requiring private donations to function instead of the state paying just sounds bonkers.

Of course we should thank @paulg for this, but it also highlights the need to tax fairly so that the State can adequately provide for the health of all of its people.

California has some of the highest taxes of any state; I don’t think the issue is that they are not taxing “fairly” as you put it.

In any case, the people of California do not seem to be getting very much for their tax money throughout all of the recent disasters there.

Is your comment saying that they need to be taxed more by California? Less?

The Surgeon General told the public masks don’t work to reduce the risk of infection. The FDA is saying it’ll take 90 days to approve a new factory for PPE that healthcare workers need right now. The CDC screwed up the supply of tests for COVID while forbidding hospitals and private companies with the ability to do so to test when they were fully capable of doing so. The US administrative state has not covered itself in glory during this crisis.

Isn't the problem right now not money, but lack of supply?

The US gov is ready to pay for 500 mil respirators, but has nowhere to buy from.

The donation above was to the charitable arm of a logistics company. Supply chain disruption is a big issue.

For regular PPE, there does exist supply abroad. The issue is quickly getting it where it needs to go.

(N95 has the biggest supply constraints, but I imagine this is helping with surgical masks, gloves, etc)

Money is not the problem indeed, the best donators now are those who have some factories and convert them to make masks/hydroalcoholic gel/ventilators (LVMH in France would be an example, producing the first two in their parfume and clothing factories).

Virtue signaling, but maybe there's other places where capital is a constraint and this will inspire other wealthy donors who can move capital faster than government.

Subtly, extreme capital can drive extreme solutions. Picking a random example, if less-effective-but-better-than-nothing masks can be manufactured by hand locally, then (say) $20 per mask would motivate millions of citizens to hustle, especially if they're out of work.

Lol a million? How can that possibly be enough? Every other hospital has way more than that in their rainy day fund / bank credit line.

This is not to belittle PG (other rich people please follow!), but seriously this can't be meaningful.

Some hospitals are already reporting that they wont have money for salaries and such in few weeks.

I'm sure hospitals can arrange credit. It's one of the industries that will not be in a recession.

And again, nothing to belittle PG, but $1M is nothing.

Patients are starting to skip visits to GP’s and specialists for new and existing conditions bc of fear of catching covid.

Elective procedures are postponed indefinitely. Procedures contribute a hefty chunk of revenue in healthcare.

I’d be careful being absolutist with that comment. The cash flow of many hospitals is going to get strained at the very least in the near future if they aren’t billing for a large chunk of their services.

> $1M is nothing.

Nothing it is not. It is something, and if the beneficiaries are limited (like hospitals in SF) it is certainly much more than something.

Everyone needs to pitch in in order to get over this hump. PG pitched in $1M. Your contribution could be not to belittle his contribution, which you chose not to do, for reasons that are entirely unclear.

Fuck yes to paul graham. Funding America's best amid this crisis.

I don't see how this helps. The problem is not the fact US states cannot afford to buy protective gear, the issue is there is no gear to buy. Even so, if it was about money, San Francisco would be one of the least likely places to not be able to afford protective gear given the concentration of wealth there. There is a serious shortage right now and the only thing that will fix it is increased production. It just so happens this virus has spread to 188 countries and territories, all wanting protective gear as well.

Seriously, all I see here is Paul Graham providing money for a logistics company to outbid other states for supplies. They need to provide more information to show otherwise.

We need people making links earlier in the supply chain to increase production, not funding a shipping company.

Not only the equipment - the real problem is a shortage of qualified personal (read: doctors and nurses) that can take care of people in dire condition. You can build as many respirators you want, if there is no one them to operate them and to stabilize sick people your approach will fail.

You need a doctor/experienced medical professional per 3-4 people in ICU condition. The math does not look good.

To think that people here forego social isolation protocol and celebrate 'Corona parties' is an incredible display of ignorance. The number of younger patients with a medical condition and elderly people is very high, and once (note: we will see if our isolation procedures are good enough) the pandemic patients overflow the hospital system we will see that the events in northern Italy can happen everywhere. Their undertakers can't bury/burn their dead fast enough.

Areas in southern France ask German hospitals to take in patients, the army is active and is building tents around the region in Basel. To make things worse, there are more and more infections with hospital personal in the southern Germany, and the chain of infection are not really clear.

[sources: friend of mine one of the strategic Corona boards in Germany]

Reply on news.ycombinator.com