The demand for higher-quality, N95-style masks has never been higher – but they’re currently near impossible to find in New Zealand. What’s going on?

On January 18 this year, the same day the household contact of an omicron-infected MIQ worker in Auckland tested positive for Covid-19, a 25-pack of P2-grade masks was retailing online at PBTech for $73.78. The next morning the same box was $93.13. There were similar instances of price increases on respirator masks across the country. Retailers blamed the rise in pricing on the significant increases in demand, and the additional cost of air freighting to meet urgent demand.

Even if you could afford the hiked price, by the afternoon the box at PBTech had sold out – and they have remained out of stock since. 

Unless you’re brave enough to buy them from a potentially dubious TradeMe seller or questionable-looking website, it remains nearly impossible to find a certified respirator mask from local retailers. Most of us have cottoned onto the fact that respirator masks are more effective at protecting ourselves and others from omicron, so why are they so elusive?

It’s not the first time we’ve faced a mask shortage locally. On February 28, 2020, the first positive Covid-19 case was detected in Aotearoa. Almost immediately supermarkets and pharmacies reported selling out of both hand sanitiser and masks – despite masks not being recommended by the WHO or Ministry of Health at that time. In the early stages of the pandemic, director general of health Ashley Bloomfield said, “At this point we’re not recommending people use face masks routinely: we don’t think it’s an important part of our overall measures.” This was at a time when there was a massive shortage of face masks worldwide.

It was also at a point in the pandemic when science on the transmission of the virus was in its early stages. The prevailing belief at the time was that large droplets and surface transmission were the greatest risks – so there was less emphasis on masks as a whole and if anything, simple cloth masks and surgical masks were seen to offer adequate protection. It was only after the second outbreak in New Zealand in August 2020 that masks were mandated on public transport and the Ministry of Health began recommending the public wear masks. 

We’re now three years into the pandemic and scientists have a far better understanding of the virus, and agree that for the most part, it’s spread by aerosol droplets. Because of this, respirator masks like the N95 and P2, which, when worn correctly, filter out airborne particles, are considered by experts to be most effective at protecting against the spread of Covid-19.

While there’s been relatively  little awareness of respirator masks in Aotearoa until the last few weeks, they’ve actually been part of the Covid discussion overseas for a few years now. 

Both Austria and Germany mandated respirator masks on public transport and in shops in January last year. In the same month, French health Minister Olivier Véran said, “the recommendation that I make to the French people is to no longer use fabric masks”. Instead of cloth masks, he recommended FFP2 masks, surgical masks and fabric masks that meet specific standards. 

On the other hand, at the same time, the CDC (US Centers for Disease Control and Prevention) straight up discouraged the public from using respirator masks or medical masks, saying they should be conserved for healthcare workers. 

Because our response model meant we had next to no community transmission for a very long time, New Zealanders, travelling about on the bus and train with our hand-made cloth masks, remained happily unaware of the changing discourse around masking. 

It was only when the more transmissible delta variant reached our shores in August 2021 that our interest in masks was heightened, and it was then that we started to discuss and debate whether cloth masks were effective enough. 

On January 13, Brisbane-based data scientist Jeremy Howard, who in 2020 undertook the world’s largest review of evidence on face masks, told The World Today that the evidence around masks had evolved. “Ditch your cloth masks and also ditch your surgical masks,” he said, instead recommending respirator masks like N95s.

Later that week, the CDC advice was updated to say that approved respirator masks “provide the highest level of protection from particles, including the virus that causes Covid-19”. A few days later, the White House announced its decision to distribute “high quality” masks to people across the US. The mask game moved quickly overseas.

A few days later, amid skyrocketing cases in Australia, and when most of us had finally returned from the summer break, the New Zealand media began reporting on respirator masks. Reports pointed out that despite growing overseas evidence, the New Zealand government still hadn’t budged on its seemingly outdated advice around which types of masks offered the most effective protection, or ensured New Zealanders could access them.

A classified across government situation report leaked to Māori Television in the same week revealed government advisers’ fears that home-made face coverings are “unlikely to be effective”. “Facial coverings made from cloth materials are not sufficient in preventing or reducing infection of omicron,” the document prepared for the Department of Prime Minister and Cabinet said.

During a Sunday afternoon press conference on January 23, Bloomfield signalled that the government was considering changing the official advice on mask use in response to research around mask effectiveness. The director general cited the issue of fit as the reason the government wasn’t yet recommending N95-type masks for the general public: “If they’re not fitted properly then they can be less effective than a normal cloth or indeed a surgical/medical mask,” he said. 

Asked whether the government was considering distributing the pricey N95 masks to the public, Ardern said it had not been considered. Shortly after the conference, the Green Party issued a media release urging the government to consider subsidising masks for the most vulnerable.

“No more scarves or bandanas,” Jacinda Ardern declared two days later. The government announced it was tightening rules for mask use under the red traffic light settings. The changes, which officially came into effect at midnight last night, mean that “a face covering will need to be an actual mask and attached to the head by loops around the ears or head. This means scarves, bandannas, or t-shirts should not be used.”

Workers who are mandated to be vaccinated will need to wear at least a medical-grade mask when working in public-facing roles. It was a relatively subtle change, with still no mention of respirator masks or of double-masking (which some experts have recommended as an alternative). 

Hipkins explained the reasoning for not recommending respirator-style masks, despite knowing they are more effective in healthcare settings, saying “they’re more expensive and they’ve also got to be fit-tested, so if you don’t have the right fit for your N95 mask, it’s not necessarily a better mask than using one of the hospital-grade masks you can buy from the supermarket”. He added that there was a “plentiful supply” of respirator masks for frontline healthcare and border workers.

Public health researcher Lucy Telfar-Barnard thinks the suggestion that a non-fit-tested respirator mask could be worse than a surgical mask for the general public is potentially misleading.

Research by the American expert panel ACGIH pandemic task force says that N95 masks are far more effective than surgical or cloth masks, regardless of whether or not they’re effectively fitted. 

Bloomfield defended the information that supported the decision not to recommend respirator masks: “Well, the evidence is from the studies that are done on these,” he said.

There have been calls from public health experts for everyone in the country to be given a free mask ahead of the predicted surge of omicron cases in the community. Telfar-Barnard says it’s the government’s job to make sure people can access high-quality masks, “It’s really important those who are most likely to be impacted by poor outcomes have access to them,” she says. In March 2020 the government supplied four million masks to non-health-sector essential workers. And in August that year, the Ministry of Health distributed three million free face masks through local community groups and two million to Countdown for customers to buy.

Fast forward to 2022, and Hipkins has signalled that targeted support could see some masks distributed to parts of the community, but it’s unlikely everyone will be offered a free supply of masks.

Despite the increased demand locally, the market hasn’t delivered in supply and it’s near impossible to buy a certified respirator mask. Talking to Stuff, a PPE importer said some local mask suppliers “got burned when demand for masks dived after the first lockdown, so they got lazy about stocking up, failing to take notice of what happened with omicron in Australia”. Stuff’s source described how over two days in January, he received more than 100 emails from non-governmental organisations and corporates wanting to buy P2 masks to meet the terms of the updated mask guidance, but said it will be early March before more stock arrive. He also mentioned the impact of timing – omicron arrived in New Zealand during the lunar New Year, when factories in China that manufacture most masks typically shut down for two weeks.

On being contacted by The Spinoff, a 3M company spokesperson said “demand goes up and down which means it’s an ever-evolving situation”. The company’s stance is “prioritising frontline and healthcare workers around the world”.

The process to make respirators masks is relatively intricate, and the low stock despite consumer demand could be reflective of the risk of relying on just-in-time or lean manufacturing (where items are made to order rather than stored in inventories) for products, like masks, that are health essentials. It means that the supply chain has little or no ability to respond to any significant changes – such as, sudden spikes in demand or factory shutdowns. 

Telfar-Barnard remains confused as to why the government isn’t recommending respirator masks or making plans to order and distribute them – especially because they’re so unaffordable and difficult to find for everyday consumers. Telfar-Barnard says she “understood the initial reluctance” around masking by officials, “but now masking evidence has become so strong and we’re so far behind”.

In the meantime, if you can’t get your sanitised hands on a respirator mask, keep wearing what you have but ensure it maintains a tight seal with no gaps, double mask with a surgical mask underneath a cloth mask, or follow these tips to make your surgical mask fit better.