“Sales have dropped to basically nothing,” the head of one large promo distributor told me in the early going. “Schools are buying zero. Restaurants are buying zero. Businesses are basically buying zero. Retail is buying zero. The only thing being bought now is medical supplies, but these are coming from large vendors such as 3M or Medtronic.”

At the time, this was true of medical supplies vendors. But as major U.S. hospital systems saw a surge in COVID-19 patients or geared up to meet impending surges, demand for personal protective equipment, or PPE, skyrocketed. Health systems faced shortages as the typical supply chains for PPE soon became overwhelmed, hindered by inadequate stockpiles and political factors too messy to get into here. Hospital systems and other health providers needed to look elsewhere, and fast.

And almost as suddenly as the usual orders had dried up, resourceful and fast-acting promo companies—typically accustomed to dealing in T-shirts, water bottles and pens—found themselves in the PPE business.

It hasn’t always been an easy transition. There are complex supply chain issues, RFPs and regulations to learn and navigate. Import and export rules change, then change again. Lead times are long. Available stock fluctuates wildly. Information from suppliers outside the usual promo channels isn’t always reliable. Forbes reported that a Chicago-area Fully Promoted franchise owner had yet to receive a shipment of surgical masks from China 21 days after placing the order. Another promo distributor I spoke to said he had spent the last four-plus weeks “living in PPE hell.”

But PPE has been a lifeline for industry companies savvy enough to get in early and adapt quickly. PPE sales have helped promo businesses partially offset the drop in other orders and, in some cases, actually increase revenue. And even as the market for PPE changes, seemingly by the day, it appears to have strong long-term potential as a revenue stream for industry companies, perhaps into next year and beyond. Here, a few of those businesses shared their experiences with PPE and told us about their challenges, successes and projections for the market.

Masks break down into three main subcategories. Respirators, like the medical-grade N95 and K95, have higher filtration ratings and protect against both aerosols and respiratory droplets, the two primary ways coronavirus is believed to spread. Surgical masks have lower filtration ratings and don’t protect against aerosols, but protect fairly well against respiratory droplets. Cloth or fabric masks have the lowest filtration ratings, but offer some level of protection that varies with materials and construction. (Read our full guide to mask types here.)

For the most part, hospitals and medical facilities require the first two types. But even within individual departments requirements may vary. Respirators are the standard for doctors and nurses working directly with COVID-19 patients, but three-ply surgical masks, for example, may be approved for use by ER staff in hospitals short on respirators. All masks for hospitals must meet NIOSH filtration standards, FDA approvals and more, and with potentially spotty documentation and certifications from unfamiliar mask suppliers, this can be difficult to guarantee. These distinctions and varying requirements bring with them significant liability risks for companies selling masks.

“This is currently the greatest challenge with PPE,” says Terry McGuire, senior vice president of vendor relations and communication for HALO Branded Solutions, Sterling, Ill. “We have a thorough vetting process through our safety team to assure the supplier has the necessary certifications per PPE product, and we will only accept orders for those suppliers. We have rejected several suppliers based on faulty or expired documentation.”

Medical masks, especially those shipping from China, are also subject to major logistics issues. Distributors have reported placing and prepaying for orders of certain quantities of masks, only to be told later that Chinese customs requires a higher quantity to pick up. Orders under certain weight thresholds may not be accepted, but those thresholds have sometimes increased without notice. Restrictions on commercial air travel have reduced global shipping capacity by up to 50 percent, slowing delivery. China is now requiring an extra license for medical exports in response to safety and quality control concerns. Counterfeit masks are on the rise.

This is a lot to track for distributors. And it’s added up to make stock a moving target for medical-grade masks. McGuire says supplier mask inventories change by the day, if not the hour, with quoted prices and lead times often changing in the time it takes to place the order. Others in the industry have run into similar issues. Jo Gilley, CEO of Overture Promotions, Waukegan, Ill., told me the company’s entire sales team is working almost nonstop on quoting, tracking available stock, price fluctuations and regulations changes. (“This is where having a larger sales organization helps,” she says.) Tom Kronberger, director of vendor relations and marketing support for United Franchise Group, parent of promo distributor Fully Promoted, West Palm Beach, Fla., said many suppliers guarantee pricing only for that day.

Mike Chong, owner of Merch Monster, a screen print and T-shirt shop based in Oakland, Calif., called it a “commodities market,” citing daily changes in pricing and inventory, inconsistencies from vendor to vendor and other challenges. “There is very high demand and supply is low, due to issues with importing, the offshoring of manufacturing, customs delays, returned shipments and delayed shipments,” he says. “Also, big PPE vendors are taking large orders first and backordering small orders for infinity (two-plus weeks).”

“If a smaller distributor is smart about shaking the trees and staying a step ahead of the need, I think it would be possible to come close,” she says.

Chong believes it, too, likely because he’s seeing that exact scenario unfold. Even while donating a significant percentage of his mask inventory to organizations in need, he’s having a record quarter in gross and net sales. He’s done that by finding a niche—in his case, two-ply cloth face masks—and ignoring other varieties, like medical-grade masks, that may be more difficult to work with. He’s also focused on sourcing from suppliers that manufacture in the U.S. or have landed products, removing some of the customs issues. “I didn’t want to deal with every product, just this one,” he tells me. “They are cheap to ship, and don’t break, unlike hand sanitizer [laughs].”

His strategy has paid off. Chong says he’s had big orders from large, non-medical companies, especially those with higher numbers of employees and multiple locations. He’s also seen a strong market for online e-commerce with brands and businesses selling direct to consumers. “That’s not as strong of a vertical for me, but we sold a few thousand units through there, also,” he says. Overall, he thinks the market will remain hot until supply rebounds, which he still sees as a few months out. “There is a lot of opportunity to sell if you can get good quality items that ship in a reasonable, under one-week timeframe,” he says.

McGuire, who said the first few weeks selling PPE at HALO were mayhem, has since seen demand for medical-grade masks slow. Health care clients have stabilized mask inventory levels in the past few weeks, he says, while established medical supply distributors have increased available stock. But he still sees a booming overall market for PPE, albeit a changing one.

“The market is migrating from health care organizations and local and state government to more traditional businesses as they prepare to reopen with PPE for their workers and customers,” he says. “Disposable and cloth masks, which are geared for general consumer use, are increasing in demand and have deeper supply chains. We live in a ‘new normal’ world. Our traditional customers will have an ongoing need to protect their employees and their clients in face-to-face environments. There will be continued demand for PPE products, and our traditional supply chain will respond to this demand with more products from trusted and reliable sources.”

Kronberger, at Fully Promoted, also believes the PPE market has legs. Even as the supply chain for medical-grade items like face shields and gowns catches up, reducing the promo industry’s role, the market for reusable fabric face masks, hand sanitizer and other items is here to stay, he says. “Hand sanitizer was always a huge category, but now even more so,” he says. “I don’t believe the new normal will be wearing a face mask in public indefinitely, but there will be a place for them moving forward.”

Gilley also thinks demand for cloth masks will continue to grow, especially as companies turn to reusable options rather than provide new, single-use masks for employees each day. She’s seeing this already with customers in food and grocery delivery, retail and telecom. “It seems that our larger customers are starting to think through reopen and what that might require in terms of safety for their employees,” she says.

On the apparel side, suppliers have shifted and ramped up manufacturing to help meet demand for masks. Gildan has been making non-medical masks and isolation gowns at its Central American facilities, and is now considering adding masks to its long-term manufacturing plans, to the tune of 150 million per year. Delta Apparel ramped up production of cotton masks and expects to produce up to 10 million per week. Hanesbrands is set to produce 320 million masks and 20 million medical gowns. Next Level Apparel added adult and youth masks. Fanatics, adjacent to the promo industry, reconfigured its factories to make masks from material previously meant for baseball jerseys. Even Cap America, a company known for supplying promotional hats, has dramatically reconfigured its manufacturing to include masks.

“While we are still decorating thousands of caps every day, shifting a few facets of manufacturing to mask production has evolved from donating a few to our local first responders to selling seven to eight figures in units daily,” Mark Gammon, president and chief operating officer of Cap America, said in a LinkedIn post published in late April. “We had never even considered assembling a made in the USA mask one month ago, and I find myself in awe this morning realizing that the creativity of the staff has led us to now offering four options between domestic and overseas.”

We can also look at explosion of branded masks in the consumer marketplace. While companies that need PPE for essential workers or as part of their reopening plans are loading up on bulk purchases, other businesses are buying up masks as merchandise. Early on, we saw this mostly with smaller businesses—bands, restaurants, breweries, etc. But the market has since blown up to include the biggest brands out there.

Disney, for example, just added masks decorated in designs from its most popular properties, including Star Wars, Marvel, Pixar and more, available at its online store. Three of the four major U.S. professional sports leagues are now offering team-branded masks for sale. (Major League Baseball is the lone outlier.) There’s even a subscription service, called MaskClub, that launched in mid-April and partnered with Warner Bros., Sanrio and Hasbro to mail branded masks to subscribers. Proceeds support first responders.

It’s certainly possible, if not likely, that demand in this area will cool within the next few months as consumers add masks for personal use. But it’s also possible that, like any other piece of branded apparel that gets worn and washed often, consumers will buy multiple masks, or add new ones based on personal interests. This seems more likely given that CDC mask usage recommendations could carry on well into next year, if not longer, even as America starts to reopen.

“There are 330 million people in the U.S., and not nearly enough PPE to go around,” says Chong.

“There is a huge opportunity [here],” says Kronberger. “But I would recommend educating yourself on the procedures and products prior to marketing to your clients, because they will ask a lot of questions—and rightfully so.”

For distributors, answering those questions will be key to gaining or maintaining momentum in the PPE products category. As supply chains normalize, some of the issues covered earlier in this story will resolve themselves. But, by then, there may be fewer opportunities for sales. If distributors want in on the PPE market, now’s the time to start. And they’ll need to learn it quickly.

As in any product category (but especially with PPE), that means knowing the differences between products on the market, says Chong, and learning customer requirements for quality, timing, origin, materials and more. “Are you willing to pay more for USA-made and get it now, or do you want to wait and take your chances with customs?” he says.

McGuire says distributors should ask suppliers for the appropriate certifications per product. If suppliers can’t provide them, the risk is “extremely high” that the goods will be seized due to customs or compliance issues. He also recommended that distributors include disclaimers on lead time, availability and pricing in every quote. And he advised having an alternative source at the ready, when possible, to stay ahead of changes in the supply chain.

“The selling and supply cycle for PPE products changes from week to week and day to day based on various products,” says McGuire. “What is surprising this week may wane in demand next week. A diligent yet nimble approach to creating a stable of suppliers for a multitude of products is essential to quickly respond to the changing market demand for PPE products.”

Many suppliers are also requiring prepayments of 50 percent to 100 percent of the cost of the items at the time of order. That can be a problem for smaller distributors without access to as much capital as their larger competitors, especially with supply chain issues potentially holding up delivery and, therefore, payment from customers. That might necessitate asking customers to prepay if orders are large enough.

Above all, distributors that have so far found success selling PPE advised others to remember what this is all about. PPE is a financial lifeline for industry businesses able to sell it. For others, it’s a literal lifeline.

“This market is not for everyone,” says Kronberger. “We at Fully Promoted and United Franchise Group corporate are dedicated to helping the communities where our owners live, and the foremost thing we remember is that we are not looking to profit, but to help. If you have that mindset, you may even gain a new client or two out of this.”