States Recently Threw Out Millions of Dollars of Unused Masks and Other Pandemic Gear. But the Story is Not What You Think.

A case study of how, once again, government officials, and their health advisors, do not practice evidence-based public health.

Recently, the Associated Press published an investigative report titled “States are trashing troves of masks and pandemic gear as huge, costly stockpiles linger and expire.” The piece detailed the extraordinary sums of money lost as states threw away or held fire sales on tens-of-millions of dollars worth of PPE (Personal Protective Equipment) that they had purchased during the pandemic but no longer need. Ohio vaporized $29 million of taxpayer money; Maryland $93 million.

The AP report was reprinted or covered by media around the country, from major national outlets, including NPR and PBS, to innumerable local news operations from New York to California.

At first, this may seem like a story of government waste, albeit waste that was the result of well-intentioned over-purchasing during an emergency. But a brief investigation suggests that much of this equipment did not need to be discarded. And the fact that authorities, and their advisors, operated without even a modicum of due diligence is indicative of a pervasive problem with the public health establishment.

You may wonder why the states don’t simply hold on to these materials, such as masks and gowns, in case they are needed in the future. The answer, we are told, is that much PPE has a limited shelf life and is not considered or guaranteed to be effective after its expiration date. For this reason, South Carolina dumped 650,000 expired masks. “Wisconsin tossed nearly 1.7 million masks and almost 1 million gowns,” the report noted. FEMA sets the value of expired supplies at zero dollars, the AP wrote.

Over time the materials used in PPE can degrade, weakening their effectiveness. As such, manufacturers have “best by” dates or accepted shelf-lives for their masks and other gear to ensure quality. Except several studies suggest that the stated expiration dates of masks and gowns are largely false.

A study conducted between April and June 2020, and published in August 2020, in JAMA Internal Medicine, tested the effectiveness of expired masks and compared them to new masks. N95 respirators that had expired in 2009 and 2011—roughly a decade before the study period—had unchanged effectiveness. Both batches of expired N95s exceeded the benchmark of 95% fitted filtration efficiencies.

Table from JAMA paper. Red boxes added by Dave.

Moreover, the masks were tested in a highly controlled environment, and measuring their effectiveness at blocking particles was limited to just over 4 minutes.

Graph from JAMA paper.

As I’ve written about before, evidence has shown mask mandates to not be meaningfully effective, in part, because interventions do not often operate in the real world the same as they do in a lab. Kids wearing masks in schools and workers wearing them in offices do so for hours each day, not for four minutes. Obviously, the ability for someone to keep a respirator tightly sealed to their face diminishes over time and will lead to lower effectiveness than what a lab test shows. Outside the “perfect” environment of the laboratory, as the frailties of human behavior increasingly diminish the effect of an intervention, any theoretical difference between expired masks and new ones likely vanishes anyway.

Back in February 2020, the CDC also had conducted a test of old masks, which had been manufactured between 7 and 17 years earlier. The study indicated that many were beyond the manufacturer-designated shelf life. There were 11 models taken from 10 different storage facilities around the US. The CDC found that “the majority of respirator models tested continued to meet performance standards.”

Gowns used by healthcare professionals need to meet certain standards for liquid resistance, and, like masks, the materials can degrade over time. So gowns, too, have shelf life dates. Yet gowns beyond the expected shelf life of five years also performed well in a test by the CDC in 2018. In fact, the old gowns outperformed newer gowns that were still within the acceptable time period.

Table from CDC gown tests. “Green” means passed benchmark for effectiveness.

None of these studies provides a definitive assessment of the quality of all supposedly outdated PPE. Yet they certainly suggest that, at minimum, the states should not have been so rash in junking millions of dollars worth of masks and gowns based on the false notion that they were no longer effective.

Why not run a test once a year on a sample batch from the stockpiles to test their effectiveness, and if the results are good, continue to retain the equipment? While there are some costs associated with storage, surely maintaining a few warehouses to hold stockpiled PPE is cheaper and wiser than dumping the supplies and, inevitably, scrambling to purchase new products at the onset of the next emergency.

The AP investigation revealed important data about wasted PPE. Unfortunately, though, the report—which was covered by news outlets all over the country—did not assess the imprudence of the states’ actions. None of the journalists bothered to look at what the evidence actually shows regarding shelf lives of PPE.

Worse still, state public health officials around the US did not advise the decision makers to hold on to their stockpiles. They, too, seem to just assume the shelf lives stated by manufacturers, and approved by government agencies, were accurate. (Did it occur to anyone that it’s in the manufacturers’ self interest for their products to have shortened stated shelf lives?)

With just a small amount of research I found studies, published by the CDC and in a prestigious medical journal, that showed the expiration narrative was false. This debacle is a case study of yet more public health policy decisions being made without officials actually looking at the evidence. And—following unsupported claims about the benefit of mask mandates, six feet of distancing, and school closures that lasted more than a year, among other errors— it’s yet another mark against the authorities’ trustworthiness.