By Austen Hufford | Photographs by Gabriela Bhaskar for The Wall Street Journal

A surge of Covid-19 cases and stockpiling of N95 masks in much of the country have put fresh strains on the supply of critical protective gear, manufacturers and health officials say.

While the national supply of protective equipment has improved since the first months of the pandemic, levels at some health-care facilities remain well below what regulators recommend. Many health-care facilities continue to ration and reuse masks, even as manufacturers have raised production, and some state health departments said they expect supplies to tighten further.

States have been trying to build up supplies of N95 masks, which guard wearers from tiny particles including the coronavirus that causes Covid-19, and other gear like gloves since the start of the pandemic. A few have mandated that hospitals do the same. But the stockpiling efforts are being slowed by the increase in Covid-19 cases.

In Michigan, for example, nearly two-thirds of health systems are reporting less than a three-week supply for one or more types of protective gear. The state's health department recommends a 90-day supply.

MidMichigan Health has enough N95s for a few weeks, and many of them are stored in a vacant Sears store, said Jeff Wagner, supply chain manager for the network of seven major health-care facilities in central and northern Michigan.

MidMichigan's doctors and nurses are reusing masks with a decontamination system to stretch supplies as they treat a rising number of Covid-19 patients. The system is treating its highest number of hospitalized Covid-19 patients to date, and the state recently reported a record number of new confirmed cases.

"We would really like to beef up our stockpiles, but volume is high for everyone, so you can't," Mr. Wagner said. "The N95s are really the most challenging."

Demand for N95 masks continues to run ahead of production in much of the country. New Mexico said last week that nearly 90% of its hospitals were reusing N95 masks under emergency guidelines as new cases have risen substantially in recent weeks. Wyoming's health department said its hospitals could revert to emergency reuse of N95 masks if hospitalizations rise further.

"We expect the need to increase and supplies to tighten again," said Jon Ebelt, spokesman for Montana's public-health department.

3M Co., maker of the first approved N95 and the biggest domestic manufacturer, is on-track to produce nearly 100 million masks a month in the U.S. this year, more than four times what it made before the pandemic. Honeywell International Inc. is producing 20 million N95 masks a month in the U.S. Other companies have added capacity for at least 20 million N95 more masks a month. It still isn't enough, manufacturers say.

"N95s are still in high demand. We have more demand than we can supply," 3M Chief Executive Mike Roman said in an interview.

3M said it is working with federal agencies to direct masks to hot spots, rather than to stockpiles in states with less immediate need. The company expects demand to persist as officials move from fighting the current pandemic to planning for the next one.

"We see demand from fighting the pandemic to continue in 2021 and beyond, " Mr. Roman said.

Will Mijangos, operating manager at Pandmedic Solutions Inc., an N95-maker in Las Vegas that began production this year, said orders have risen about 40% over the past two weeks. A typical order has swelled from around 30,000 to as many as 100,000 masks, he said.

"As fast as we are making them, they are leaving our facility," he said.

The National Institute for Occupational Safety and Health said it certified about 20 new makers of N95s and similar products this year, including Pandmedic Solutions. Some new producers said long wait times for certification and for the equipment needed to make masks has scared off some prospective manufacturers.

"It's a daunting task," said Brian Wolin, CEO of Protective Health Gear, which recently started making more than one million N95 masks a month in Paterson, N.J.

WellSpan Health, a Pennsylvania hospital network, recently won approval to produce N95 masks thanks to the work of an internal team named after the TV show "MacGyver." The hospital will start making 500,000 masks this month with a local manufacturer.

Lloyd Armbrust, an entrepreneur in Austin, Texas, raised $5 million for a mask-making company and is raising another $1 million through an online crowdsourcing campaign that will give funders masks and a share of future profits. He is working to get Niosh approval to make N95 masks, he said, and has already sold $8 million of surgical masks.

"Selling masks during a pandemic is not that difficult," he said.

Many states and hospitals that couldn't find N95 masks this past spring and summer instead purchased what are known as KN95 masks, a similar certification used in China. The "95" in both labels refer to standards that require masks to be able to filter out at least 95% of very-small particles.

During the pandemic more than 3,500 Chinese manufacturers registered to sell KN95 masks in the U.S. But many KN95 masks have failed quality checks. The Food and Drug Administration said last month that it wouldn't approve new KN95 manufacturers for U.S. hospitals. The masks are still viewed as a workable alternative to cloth masks for people who aren't working with Covid-19 patients.

The result is more demand for certified N95 masks.

New Jersey and New York implemented emergency measures in recent weeks requiring hospitals to have 90-day supplies of N95s and other protective gear. California passed a law in September requiring hospitals to have a 45-day stockpile by 2023.

In Michigan, which is recommending a 90-day supply of N95s and other gear, some hospitals are reporting less than seven-day supplies.

A spokeswoman for Michigan's health department, said: "We realize this is a lofty goal and could prove challenging both to a facility's budget as well as storage capacity."

(END) Dow Jones Newswires

11-04-20 1622ET