One April morning at 4 AM, the chief physician at Baystate Health in Massachusetts left his house and traveled to a warehouse outside the state to receive a shipment of masks and gowns from China. Two FBI agents interceded. They approached him and threatened to confiscate the shipment on behalf of the federal government, only relenting when the doctor called his congressman. Still fearing that the goods would be intercepted by another state, the physician divided the shipment into two trucks, with the hope that at least some of the goods would reach Massachusetts.

Meanwhile, halfway across the country, state officials in Illinois wrote a shot-in-the-dark email to a thousand small businesses (most of which had nothing to do with health care) requesting help gathering personal protective equipment (PPE). The email was answered by someone who operated a moving business, who happened to “know a guy” in China, and who was able to cobble together enough contracts, one assembly line at a time across many factories, to produce 1.5 million masks.

In the end, the state comptroller drove a check for $3 million a couple hundred miles away to meet the guy who knew a guy at a McDonald’s parking lot. They had to act fast: the state of Louisiana had already offered $2 million more for the masks. And Illinois had previously lost a contract for three hundred ventilators overnight when New York State went directly to the supplier and purchased the ventilators at double the price.