Normally, the masks and other gear, are shipped via boat, and it takes over 30 days to transport it. But this is an emergency, so that lag in transport would have killed even more people and health care workers. Hence, the need to deliver it by air.
The problem is that the air freight companies are now resource constrained, that they are charging 3 to 4 times more than normal. These are the people that are causing the price gouging.
Then, to make matters worse, some European countries went on a media blitz to complain about shoddy Chinese made products. They bought non-medical masks, and were expecting it to be medical grade products!
So they complained about it on Twitter, which forced the China central government to crack down on manufacturers, and only allow “medical grade” certified masks to be shipped. This placed an even larger burden on the supply chain. (However, other masks not stamped with a “medical” label on it, were allowed to normally ship, as a consumer-grade item. So buy it at your own risk.)
So, this resulted in news that some expensive air freight flights, were only returning half-full. The other half was still sitting in the warehouse, awaiting customs export inspection approval, from the new Quality Control regulation.
Then, to make matters even worse, all countries all over the world, are now competing for the same products from China. And the Americans are buying the product outright, and in cash, and paying double or triple, what European countries are paying.
This all adds to the cost per product, which ends up justifying the 5x increase.