Throughout the COVID-19 pandemic, the U.S. has continued to experience essential PPE shortages. While the need for surgical masks and protective gowns dominated early headlines, in recent months there has been a huge surge in demand for nitrile gloves. By the end of December 2020, nitrile gloves were the second-most sought after PPE item in the U.S. - and industry projections show demand is likely to continue well into the summer as vaccinations continue at a rapid clip. While the federal government did take some steps to support domestic production of ventilators and N95 masks early in the pandemic, less progress has been made on gloves. Last May, U.S. Health and Human Services (HHS) set a goal to have a 90 day supply in the national stockpile or 4.5 billion gloves by the end of 2020; as of December, the stockpile had only 72 million gloves to help support an estimated demand for 8.7 billion gloves per month, or 104 billion gloves per year. As a New York-based PPE manufacturer that’s partnered with a number of impacted healthcare facilities, we’d like to discuss why there’s a nitrile glove shortage and what the consequences have been to date. A Global Problem From 2019 to 2020, total annual global demand for nitrile gloves doubled from 290 billion to 585 billion pieces. This far outpaced global production capacity, which in early 2020 could meet a demand for 370 billion gloves per year. In 2021, 50 billion additional gloves will be produced, but that still leaves a supply chain shortfall of 165 billion gloves. While boosting U.S. production capacity has been offered as a solution for other PPE shortages, nitrile gloves are challenging to produce in the U.S. due to the unique raw materials required. Synthetic rubber - a core ingredient - is almost exclusively produced in Asia, with estimates that 99 percent of all nitrile gloves are manufactured in Malaysia and China. One North American supplier estimates that it can take four to six months to add a new nitrile gloves production line and a minimum $2 million investment. This market concentration means that disruptions to the global supply chain are difficult to circumvent. For example, Top Glove, the largest global nitrile gloves producer, temporarily shut down 28 factories in late November due to a COVID-19 outbreak amongst its staff. With Top Glove producing 90 billion gloves a year orone quarter of the world’s supply, this one outbreak meant two to four weeks of added shipping delays, as well as a longer lead time for orders impacting a significant number of customers. The Impact on U.S. Facilities Between November 2020 and February/March 2021 glove spend by healthcare providers has increased by 250 percent. This can partially be attributed to heightened need. Nitrile gloves are intended to be discarded after every single use and on a typical day, front-line workers can go through several pairs to complete essential tasks that include the administration of the COVID vaccine. Hospitals and community-based health clinics, many of which are financially strained due to COVID-related costs, also face pricing spikes. One box of 100 nitrile gloves can now cost as much as $32, up from around $3 pre-pandemic; individual pricing has increased by an average of 600% over the course of the pandemic. Of the facilities that requested gloves from the nonprofit Get US PPE this February, 82% reported having needed to reuse disposable gloves due to a lack of supply. In late December the CDC even released updated guidance for how to curtail nitrile glove use which, for extreme scarcity conditions, includes a recommendation to “cancel all elective and non-urgent procedures” that require gloves. Looking forward, while we’ll likely be navigating a strained supply chain for nitrile gloves for quite some time, as production capacity increases and pandemic demand abetts, we can expect some improvement. Notably, the U.S. federal government has recently announced plans to begin building domestic plants to make gloves and needed raw materials so that by the end of 2021, there’s potential for the U.S. to be producing 1 billion nitrile gloves per month here at home.