On a tree-lined block located an hour outside of Boston sits a secret warehouse filled with hundreds of boxes labeled "pandemic product."
The boxes, containing items like IV fluid, gloves and gowns, remain shrink wrapped in neat rows inside the facility until the day Massachusetts General Hospital orders an emergency infusion of supplies.
With the coronavirus spreading across the U.S., that day may soon be approaching.
Pictures: COVID-19 outbreak around the world
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People wearing face masks cross a road in Shanghai, China, on March 2.
A paramedic wearing a protective suit sanitizes the hands of people in Ashkelon, Israel, on March 2.
Personnel from the health ministry check tourists' temperatures and for any symptoms at the Rumichaca border bridge in Tulcán, Ecuador, on March 1.
A South Korean soldier wearing protective gear sanitizes a street in front of the city hall in Daegu on March 2.
Students of Hanoi National University of Education attend the first day of classes after returning to the university, which was closed for over a month due to the coronavirus outbreak, in Hanoi, Vietnam, on March 2.
U.S. President Donald Trump speaks during a news conference on the coronavirus outbreak as (L-R) U.S. Secretary of Health and Human Services Alex Azar, National Institute of Allergy and Infectious Diseases Director Anthony Fauci, U.S. Vice President Mike Pence, Director of the Centers for Disease Control and Prevention Robert Redfield and U.S. Surgeon General Jerome Adams look on, at the White House on Feb. 29.
Pedestrians wearing face masks cross a square in Tehran, Iran, on Feb. 29.
A police officer wears a protective face mask on the street in Mexico City, Mexico, on Feb. 29.
A member of the Iraqi security forces wears a protective face mask in Baghdad on Feb. 29.
A researcher works in a lab that is developing testing for the COVID-19 at the Hackensack Meridian Health Center for Discovery and Innovation in Nutley, New Jersey, U.S., on Feb 28. The facility develops novel therapies for some of the worlds most difficult diseases.
A health worker takes part in a drill to handle suspected carriers of coronavirus, at a hotel in Guatemala City, Guatemala, on Feb. 26.
Personnel wearing protective gear spray anti-septic solution at a traditional market in Seoul on Feb. 26.
Spanish police officers patrol outside the H10 Costa Adeje Palace hotel in Tenerife, Canary Island, Spain, on Feb. 25.
South Korean President Moon Jae-in talks during a special government meeting to discuss measures to prevent the further spread of COVID-19, at the Daegu City Hall in Daegu on Feb. 25.
Fans wear masks at Stadio San Paolo in Naples, Italy, on Feb. 25, prior to the UEFA Champions League round of 16 first leg match between SSC Napoli and FC Barcelona.
A newly wed couple wear protective masks as they take photos with family in Hong Kong on Feb. 24.
Two men ride a bike as they wear protective masks in Najaf, Iraq, on Feb. 24.
Bruce Aylward of the World Health Organization (WHO) attends a news conference on the WHO-China Joint Mission on coronavirus in Beijing, on Feb. 24.
U.N. Secretary General António Guterres speaks during an update on the situation at the WHO headquarters in Geneva, on Feb. 24.
A street vendor sells face masks outside a railway station in Milan, Italy, on Feb. 24.
Figures depicting coronavirus and "carnevals-virus" are seen at the Shrove Monday celebrations in Düsseldorf, Germany, on Feb. 24.
A reveler wears protective face mask at the Venice Carnival, the last days of which were called off after third death was reported in the country, in Italy on Feb. 23.
Media personnel chase after a passenger (C) who disembarked from the Diamond Princess cruise ship at the Daikoku Pier Cruise Terminal in Yokohama, on Feb. 19.
Indians who were airlifted from Wuhan wait to collect their release certificates before leaving the ITBP quarantine facility in New Delhi, India, on Feb. 17.
Military medics stand in a formation after deplaning from a transport aircraft of the People's Liberation Army Air Force (PLAAF) at the Tianhe International Airport in Wuhan, China, on Feb. 17.
A teacher gives a lecture with the help of her smart phone during an online class at a middle school in Donghai, China, on Feb. 17.
Pictures of Pakistani students studying in Wuhan, China, are displayed by their family members during a demonstration in Lahore, Pakistan, on Feb. 16. The family members are demanding the evacuation of their relatives.
A U.S. passenger gives a thumbs up to reporters while arriving at the Haneda Airport in Tokyo, Japan, on Feb. 17, after disembarking in Yokohama from the Diamond Princess cruise ship.
Nepalese nationals who were in Wuhan walk out from a Nepal Airlines plane at Tribhuvan International Airport in Kathmandu, on Feb. 16. The chartered plane brought back 175 nationals from Hubei province.
A classroom is cleaned in preparation for students' return to school in Hanoi, Vietnam, on Feb. 15.
A woman is seen wearing a protective mask as she holds a rose on Valentine's Day, while waiting for the subway at a station during rush hour in Beijing, on Feb. 14.
An employee receives payment from a customer through a container on a stick, in Beijing on Feb. 12. A ramp has also been set up to deliver food from the counter.
A laboratory technician helps a colleague remove the protective suit after leaving a laboratory in Shenyang, China, on Feb. 12.
Members of the media stand near the cruise ship Diamond Princess, where dozens of passengers were tested positive for coronavirus, at Daikoku Pier Cruise Terminal in Yokohama on Feb. 11.
A Malaysian Royal Guard wears a protective mask as he stands guard outside National Palace in Kuala Lumpur, Malaysia, on Feb. 10.
Workers produce protective clothing at a factory in Wuxi, China, on Feb. 8. The factory, which previously produced suits and sportswear, switched to production of protective clothing as demand increased due to the ongoing coronavirus outbreak.
A Hindu devotee wears a mask as she carries a milk pot on her head at a shrine in Batu Caves during the Thaipusam festival in Kuala Lumpur on Feb. 8.
Hong Kong Chief Executive Carrie Lam speaks to the media during a press conference on the coronavirus situation in Hong Kong on Feb. 8. Lam said that the government has bought 48 million masks and received 17 million more from China to counter the shortage of masks in Hong Kong.
South Korean Prime Minister Chung Sye-kyun has his temperature checked during a visit to a clinic in Gyeonggi, South Korea, on Feb. 8.
Flight attendants wearing protective clothing and masks serve snacks to Canadians, who had been evacuated from China due to the outbreak of novel Coronavirus on an American charter plane, on another aircraft taking them to Canadian Forces Base (CFB) Trenton from the Vancouver International Airport in Richmond, Canada, on Feb. 7.
Workers in protective gear are seen on Japan Coast Guard boats in Yokohama, on Feb. 5, bringing patients from the quarantined Diamond Princess cruise ship.
Beds are set up at an exhibition center, which was converted into a hospital, in Wuhan on Feb. 4.
This handout photo released by Malaysia's Ministry of Health shows citizens being directed onto a bus by health officials as they arrive at the Kuala Lumpur International Airport in Malaysia in Feb. 4.
Members of the Association for Sri Lanka and China Social and Cultural Cooperation (ASLCSCC) hold candles during a vigil to pray for people who are suffering from coronavirus across the world, in Colombo, Sri Lanka, on Feb. 1.
(L-R) Sabine Hagenauer of the infection department at the 4th medical department of Kaiser Franz Josef Hospital, Michael Binder, medical director of the Vienna Hospital Association, and Judith Aberle of the department of virology, Medical University Vienna, address a press conference at Kaiser-Franz-Josef hospital in Vienna, Austria, on Jan. 26. A Chinese flight attendant was quarantined in the hospital with symptoms of flu, in what authorities suspected as the first coronavirus case in the country.
Dozens of diggers work to build a new hospital in Wuhan, on Jan. 25. Due to the large number of infected people, the government decided to establish a temporary 1,000-bed hospital.
Calculations like these are being made by healthcare professionals across the country as hospital systems eye their own supplies in preparation for an influx of patients needing treatment from the coronavirus illness, COVID-19. So far 18 states have reported more than 100 coronavirus cases and 11 people have died from the disease in the U.S. On Wednesday, congressional leaders reached a bipartisan deal to provide nearly $8 billion in emergency funding to fight the disease.
In the meantime, Mass General is preparing for a surge in patients as well as potential shortages caused by a disruption in Chinese manufacturing.
"We've been looking, since January, at our pharmaceuticals, our other medical supplies, to identify what's manufactured from China," Biddinger said. "And look at our contingency strategies for what we have to do if we don't get as much as we need."
Shortages of essential medicines had already been an issue for hospitals and now, with the spread of coronavirus worldwide, Biddinger says his team has been working to map out what drugs could be impacted and whether there are any alternatives.
"Certain drugs don't have alternatives," he said. "And when we face a drug shortage of critical medications that really threatens patient care."
Healthcare providers, experts and lawmakers have long noted the risks of a medical supply chain increasingly dependent on China, warning of the lack of alternatives should the country fail to provide products to the U.S. Some experts have even said the country's dependence on China poses a national security risk.
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Image: As the nation prepares for a coronavirus outbreak, ventilators will be essential for those undergoing respiratory failure, says chief of emergency preparedness at Mass General Dr. Paul Biddinger.
According to FDA data, approximately 85 percent of manufacturing facilities used to make ingredients for American drugs are located overseas -- many in China and India. But even India has signaled they are feeling the effects of a disruption in their supply chain, restricting exports of 26 pharmaceutical ingredients and drugs. The list includes antibiotics and products like paracetamol, a common pain-reliever.Even before the coronavirus, the fragility of the drug supply chain was apparent.
Last year, there was a widespread recall of the blood pressure medication valsartan due to contamination. And most recently, nearly 9.1 million surgical gowns were recalled because of quality concerns.The conversation took on an elevated sense of urgency late last week when the FDA issued a press release indicating a manufacturer had notified the agency of a drug shortage linked to a site affected by coronavirus.
The agency also said it has identified about 20 other drugs that have the potential to be impacted due to their sourcing from China.When asked why the FDA did not name the specific drugs described in the press release, the agency said it could not disclose "confidential commercial information."
"We need the cooperation of the drug companies in order to obtain accurate information as we proactively take steps to mitigate drug shortages, and companies will be less willing to provide this voluntary information if they cannot trust FDA not to discloses commercial confidential information such as drug names, company names or exact location of facilities," an FDA spokesperson said in a statement to NBC News.
But some resources at Mass General are already in short supply regardless of whether they are sourced from China, including N95 respirators, a protective mask designed to filter out airborne particles.
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Image: Medical supplies such as IV fluid, gloves, and gowns are stockpiled inside a warehouse an hour from Mass General in case of a pandemic.
"We've been going direct to the manufacturer for information. And they have told us that they're manufacturing at a higher-than-normal capacity," Ed Raeke, the director of materials management.
Mass General has made their staff aware of the need to conserve resources. Inside one of the hospital's supply closets, several laminated pink signs remind employees to grab only one box of N95 masks per request. In a worst case scenario, ventilators could become a concern. Biddinger said they are vital for patients undergoing respiratory failure due to the coronavirus. The emergency preparedness chief said the hospital has somewhere between 150 to 200 ventilators to treat patients — enough for now.
"If the peak of illness is narrow, meaning we need lots for a short time, we could run out of our traditional ventilators," Biddinger said.
As it is, he said the medical center considers itself lucky given that smaller hospitals may struggle with less resources.While Mass General says it has not yet had a patient with coronavirus, the hospital's emergency response team — made up of physicians, nurses, support services and security — meets daily to assess the situation.
"And as soon as we started to see some of the information coming out of China, this looked like an outbreak that really could spread more broadly and really put stress on the healthcare system, on our patients, on the public and on our facilities," Biddinger said.
In a Tuesday press briefing, the Centers for Disease Control and Prevention (CDC) confirmed they are also monitoring the nation's supply of protective gear, working with state and local health departments to figure out how to keep health care workers protected.
Back at the warehouse, the facility's chief compliance officer Mark Sotir remembers working the 2009 H1N1 swine flu pandemic and says his team is ready to provide same-day delivery on a request for more supplies.
"Anybody that deals in emergency medicine or this type of thing, has to plan for that catastrophic event, just in case," Sotir said.
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