While federal, state and local emergency preparedness workers are trying to address supply shortages of IV fluids due to recent natural disasters, fears about not being able to access the vital medical products are growing.
Hurricane Helene damaged Baxter International’s IV fluid manufacturing facility, which is located about 35 miles outside of Asheville, North Carolina. Baxter provided about 60% — or 1.5 million bags — of the nation’s IV fluid supply.
The company announced this week that it is increasing its current U.S. allocation levels of its highest demand IV fluids for direct customers from 40% to 60% and from 10% to 60% for its distributors.
Baxter’s executive vice president Heather Knight said the company expects to be at 90% to 100% production by the end of the year.
While Baxter works to address shortages – emergency preparedness experts are monitoring Hurricane Milton’s impact on the national IV fluid supply. The manufacturing facility for B. Braun, which supplies about a quarter of the nation’s IV fluid, is in Daytona Beach on Florida’s Atlantic coast.
The company closed the plant Wednesday morning and planned to resume operations Friday. In an online statement company officials said that they were “focused on protecting our people” while mitigating the storm’s impact on their supply of IV solutions.
B. Braun is coordinating with the federal government, specifically the Administration for Strategic Preparedness and Response (ASPR), to take steps to increase production of IV fluids at its plant in California.
The Virginia Department of Health’s Office of Emergency Preparedness is coordinating efforts to secure their IV fluid supply with its partners at ASPR and the Food and Drug Administration, which regulates IV fluid safety.
James Moss administers Virginia’s hospital preparedness program through the VDH. He says they are looking at long-term plans and determining how to best allocate IV fluids to minimize the impact of the shortage.
“Our primary concern is pushing out messaging for mitigation and conservation,” Moss said.
Earlier this week, many of Virginia’s hospital systems began implementing measures to preserve their existing supply, including using smaller IV bags when appropriate, encouraging oral hydration and switching medications to oral formulations if possible.
Moss says hospitals aren’t the only health care providers impacted by the shortfall in supply. Emergency medical service agencies, long-term care facilities and dialysis providers all rely on IV fluids to care for patients.
The American Association of Kidney Patients says it is unaware of any interruption in care so far, but patients have expressed growing concern about a possible supply disruption of peritoneal dialysis solutions and IV fluids.
Paul Conway, AAKP’s policy and global affairs chair, said many kidney patients are dealing with multiple comorbidities and conditions.
“You have a complex, medically vulnerable population that is very frontline when an issue like this emerges,” Conway said.
Conway understands the patient experience. He spent three years doing home dialysis while serving as one of Virginia’s Deputy Health Secretaries under Republican Gov. George Allen.
“When you’re dependent on that fluid, you’re conscious of the fact that it’s your life,” Conway said.
Patients experiencing kidney injury, disease or failure rely on dialysis treatment to help their body remove waste and extra fluids from their body. Dialysis, which can be done in a hospital, dialysis center or at home, also helps people regulate high blood pressure.
Quality Insights, a non-profit renal dialysis network that serves Virginia, West Virginia, Washington, D.C. and Maryland, said not all dialysis providers and patients have been affected by this product disruption.
Brandy Vinson, Quality Insights’ regional executive director said in an emailed statement, “supplies are being monitored closely by [patients’] dialysis facility, with plans in place if inventories fall below established thresholds.”
Moss said he has maintained near daily communication with the supplier.
Conway raised concerns about the IV fluid supply shortage from back-to-back hurricanes and the potential impact of future unknown disasters.
“What if you have a massive earthquake in California? What if you have a significant non-natural event? What is your ability then to keep producing and sustain?” Conway said.
The American Hospital Association submitted a letter to the Biden administration on Monday recognizing the work it had done to manage Hurricane Helene recovery efforts, but also called on the administration to “take immediate actions” to increase the supply of IV solutions.
“Patients across America are already feeling this impact, which will only deepen in the coming days and weeks unless much more is done to alleviate the situation and minimize the impact on patient care,” the group said in the statement.
The AAKP echoed the call for the administration to do more to address the supply shortage by encouraging better communication and a more coordinated federal response between the FDA, U.S. Health and Human Services, the Department of Homeland Security and the Department of Defense.
“The other thing to keep in mind here is you’re going into cold and flu season. COVID is still an issue for these high impact populations like kidney patients,” Conway said. “They are some of the most negatively impacted and most vulnerable still to COVID.”
UVA Health University Medical Center postponed elective surgeries to conserve IV fluid supplies. Non-urgent procedures were also postponed at UVA Health’s hospitals in Culpeper, Haymarket and Manassas.
In a statement UVA Health said, “as the area’s only Level I trauma hospital, the medical center is taking these measures to ensure care for its most critical patients.” The hospital is calling all impacted patients and says it plans to reschedule their procedures as soon as IV supplies become more readily available.
VDH officials said in a statement that local, regional, state and federal partners will continue to work to limit the disruption in the commonwealth.