The global pandemic has made healthcare workers resort to extreme measures to secure medical supplies.

One clinic director in Florida learned enough Chinese to cut a deal for safety masks and waited outside his facility past midnight for the truckload of goods to arrive. Others have procured “secret sources” to obtain personal protective equipment, or PPE, for their staff, sometimes dealing with “shady characters”.

According to Kaiser Health News, while hospitals in major centers have seen their crises dissipate, nursing homes, safety net clinics and outpatient facilities are bracing for a new wave of coronavirus patients without enough medical equipment and supplies to handle the expected tsunami.

ABC News reported that easing restrictions and public disregard for preventative measures may make the second wave of cases greater than the initial burst. But since the majority of most medical supplies — from isolation gowns to the filtration components of N95 masks— are manufactured in disease-torn China, the pandemic has created a tipping point where the supply cannot meet the demand, especially if the second wave hits.

Even nasal swabs for testing are in short supply, according to Kaiser Health News. A cardiologist in South Carolina couldn’t find basic hand sanitizer and turned to Amazon and Etsy to learn how to make his own. Dr. Paula Muto, a general surgeon in Massachusetts, has been struggling to find lidocaine and saline which are surgery staples, and said “all the doctors are competing to get this stuff.”

She told Kaiser Health News that her backup plan is to find a distributor who imports supplies from European countries.

“We’re already stocking up,” she said. “We’re going to make sure we’re at the top of the list for everything.”