Workers package face masks in the Zhejiang Kaierhai Textile Garments Co in Shaoxing of East China's Zhejiang Province. The clothing maker recently started to produce and export face masks and other COVID-19 prevention materials when their traditional business is threatened by pandemic, with foreign customers suspending their orders. Photo: Yang Hui/GT

As demand for life-saving medical supplies continues to skyrocket globally, China, as a major world supplier, is sparing no efforts to ensure steady supplies, with factories running 24 hours a day to make everything from masks to test kits and ventilators, airlines and shipping firms scrambling to expand transport channels and officials stepping up efforts to help boost the supply chain.

However, even as China ramps up efforts to increase medical supplies, major logistical hurdles remain due to restrictions put in place by many countries to combat the global coronavirus pandemic. There are also concerns over the quality of some of the equipment, in light of recent media reports about some malfunctioning masks and test kits - attracting calls for intensified quality-control efforts both in China and abroad.

Surge in supplies

Beijing Aeonmed Co, which makes ventilators that help COVID-19 patients breathe, has kept its machines running 24 hours a day and has converted other production lines to focus on ventilators to meet surging export orders.

"There are too many overseas orders," Li Kai, an executive at the company told the Global Times on Sunday, noting that the company has received "tens of thousands" of overseas orders from about 40 countries and regions, including Italy, the UK, Mongolia and Ukraine.Aeonmed is not alone. Since February, there are 12,000 new companies in China that have started to produce masks and ventilators, bringing the total to 53,000, with over 17,420 of them being certified exporters, according to media reports. Some companies, such as Beijing Siriusmed Medical Device, said that all of its output of 80 to 100 per week are for the overseas market, Cui Gang, clinical director of the company, told the Global Times.

As the number of confirmed COVID-19 cases surges across the world, global demand for ventilators, has increased as much as 10 times, according to some estimates. Facing dire shortages of the devices, public health workers in countries from Italy to the US have been or will reportedly be forced to decide which patients to save and which ones not to.

Apart from ventilators, global demand for personal protective equipment (PPE) such as masks, gloves, gowns and other medical devices such as test kits and infrared thermometers has also been surging. Maria Van Kerkhove, an official with the World Health Organization, warned on Wednesday that the world was facing a "significant shortage" of PPE and other devices, though she did not offer a specific amount.

Airport staff unload boxes of face masks and medical supplies from an airplane of Air China, in Athens, Greece, on March 21, 2020. Approximately eight tons of medical supplies provided by the Chinese government to Greece after Athens' urgent request arrived on Saturday morning at Athens international airport on an Air China flight.The aid consists of 550,000 masks and sets of protective gear, according to a release issued by the Chinese embassy in Greece. (Xinhua/Marios Lolos)

While the Chinese government and other organizations continue to donate PPE to dozens of countries around the world, the number of export orders has also been rising significantly. More than 17 countries such as the UK and Italy have signed purchase contracts with Chinese firms, Geng Shuang, a spokesperson for the Chinese Foreign Ministry, said last week. Over the weekend, France ordered one billion masks with the vast majority from China and will dispatch 56 cargo flights to transport them.

"The overseas demand for masks is far more than supply," Cao Jun, General Manager at the Zhejiang-based Lanhine Corp, told the Global Times on Sunday, noting that half of the company's 1.2 million daily mask output will go to overseas markets, including Germany and the US.

Shenzhen-based BGI Genomics said that it has exported 7 million test kits to 70 countries and regions and has increased its daily output to 600,000, the company said in a statement to the Global Times.

Overall, China has significantly increased the output of PPE and other medical devices and the numbers could further grow, according to industry insiders. Between February 1 and March 15, 28,000 companies have expanded their operations to production of masks, gowns and other medical equipment, according to business data provider Tianyancha. For example, daily output of masks has increased by 16 folds to around 116 million a day and the number could further jump, according to media reports.

"Just like the response to the epidemic itself, China is really making a nationwide effort to ensure medical supplies to support in the global battle against the coronavirus pandemic," Wang Jun, an analyst at the China Center for International Economic Exchanges, told the Global Times on Sunday.

China's nationwide efforts

Not just Chinese factories, officials and other companies have also been scrambling to ensure steady supply of medical equipment for the world. Apart from domestic fiscal and other policy support for medical equipment producers to expand production, Chinese officials have also been arranging transportation for the supplies.

As of Thursday, China's airlines had conducted 23 flights that carried a total of 406 tons of medical supplies to countries around the world, Zhang Qing, a senior official with the Civil Aviation Administration of China, told a press briefing on Sunday, adding that the agency will offer cash incentives to help airlines.

SF Express, a delivery services firm, said that since February 13, it has opened routes, including to New York, and has delivered 742 tons of supplies to more than 50 countries and regions, the company said in a statement to the Global Times on Sunday. China Postal Airlines and YTO Express have also operated over 100 cargo flights and delivered a total of more than 710 tons of supplies overseas, Jin Jinghua, an official at China's State Post Bureau (SPB), told a press briefing on Sunday.

Chinese officials have also maintained operation of the China-Europe cargo train services, given the strict deadlines for the supplies, air cargo remains the best option for transportation of medical equipment, as sea transport and even intercontinental trains could take too long, industry analysts said.

For example, cargo shipped from Northwest China's Shaanxi Province could take as many as 18 days to reach Germany, Xu Yuanyuan, manager of Shaanxi Further Strategy Supply Chain Management Co, told the Global Times.

Xu said that logistics could be more rapid and smoother for orders made by foreign embassies. Many foreign governments, including Russia and the UK, have also reportedly dispatched airplanes to pick up supplies directly from China.

Logistics, quality concerns

Still, there are major hurdles that remain for logistics, according to Chinese officials and businesses. "We are also seeing delays in overseas packages caused by insufficient global air capacities and disruptions to global shipping channels because of the pandemic," Jin with the SPB said.

Sally Gao, an employee from the Wuhan Guide Infrared Co, said that the company has been facing difficulties to ship its infrared thermometers overseas and a batch of 20 thermometers are still held up at US customs. "The biggest problem is that overseas clients are in a hurry for our products but transportation takes too long," Gao told the Global Times on Sunday, adding that air cargo is too expensive.

In light of recent reports about quality issues with Chinese-made medical supplies, several factories on Sunday said that quality comes first even as demand surges.

Aerial photo taken on March 24, 2020 shows staff members transport cargo by a crane at Luokou freight station in Jinan, capital of east China's Shandong Province. The freight station of China Railway Jinan Group Co., Ltd has transported 14,409 tons of supplies in the last three months, including 378 tons of food and medical materials to Hubei Province, helping the full resumption of work and production across China. (Xinhua/Wang Kai)

"Ventilators go through various inspections before obtaining certifications and must be in line with regulations on quality," Li from Beijing Aeonmed said, adding that the company has been exporting its products to more than 100 countries and regions even before the pandemic.

Still, after the Netherlands reportedly recalled Chinese-made masks because they did not meet quality standards, there are mounting calls in China to intensify efforts to ensure the quality of all its medical supplies not just because of safety concerns but also its impact on China's manufacturing sector.

"No doubt, quality is crucial for medical supplies. It's very important for China to make sure that all products are up to global standards," Wang said, noting that apart from domestic quality-control efforts, foreign regulators' cooperation is also necessary to make sure purchases are made through proper channels.

Some companies said that they have been facing frequently changing rules and regulations from foreign governments over the requirements of medical supplies, which may have caused some "misunderstandings" and confusion but insisted that only a small amount of products have quality issues.

Some have also denied raising prices in light of the surging demand, while others say that certain increases in prices are normal given the rising prices of raw materials.

Cao from mask producer Lanhine said that it's inevitable that masks would see price hikes due to the increasing prices of raw materials. "Price hikes are in compliance with market supply-demand relations, for which, the Western media cannot apply 'double standards' to," said Cao.