As IV shortage continues after hurricane, U.S. invokes wartime power to speed recovery

The Biden administration says it has invoked the wartime powers of the Defense Production Act to speed rebuilding of a major American factory of intravenous fluids that was wrecked by Hurricane Helene last month. Damage to the plant in North Carolina has worsened a nationwide shortage of IV fluids, and hospitals say they are still postponing some surgeries and other procedures as a result. 

Some 60% of the nation’s IV supplies had relied on production from the plant, run by medical supplier Baxter, before it was damaged by the storm.

“Ensuring people have medical supplies they need is a top priority of the Administration. It’s exactly why we are working closely with Baxter to support cleanup and restoration of the facility, including invoking the Defense Production Act to help production resume as quickly as possible,” an official with the Department of Health and Human Services told CBS News on Tuesday.

A spokesperson for the federal Administration for Strategic Preparedness and Response said the federal government had wielded the act’s authorities to push Baxter to the front of the line for a contractor needed for construction in the plant. ASPR officials are now looking into other ways that the powers might be able to accelerate rebuilding or help other domestic manufacturers ramp up.

The Defense Production Act was previously used by the Trump and Biden administrations to boost manufacturing of items like test swabs, ventilators and vaccines during the COVID-19 pandemic.

While the factory remains offline, the Food and Drug Administration has greenlighted Baxter to import IV fluids from its other plants around the world. Officials say they are also backing plans to airlift more supplies into the U.S.

“It turns out, a huge part of my time has been taken up, including today, on very basic supply chain issues across every commodity that we regulate,” FDA Commissioner Robert Califf said earlier this month at a meeting of the agency’s science advisers.

Califf warned shortages were likely to worsen in the coming years, as many generic drugmakers are racing to cut costs amid growing threats to supply chains.

The FDA announced Friday that it had declared three more IV fluids in shortage, adding to an ongoing shortage of other IV supplies now worsened by the closed plant.

“We are seeing shortages and supply chain interruptions, often due to climate change or international strife. And it’s a very combustible mix,” Califf said.

Some hospitals still facing shortages

Baxter says the amount of IV fluids it has been supplying to customers has grown, though several hospitals told CBS News they still do not have enough. Baxter says it is aiming to be back to 100% of its highest demand products by the end of the year. 

“Although Baxter has increased allocations of some fluids, it has further restricted others. One-liter bags of 0.9% saline — our most commonly used fluids — are on back order, with no shipments expected for at least 3½ weeks,” Dr. Jonathan Stallkamp, chief medical officer of Pennsylvania’s Main Line Health, told CBS News in a statement Tuesday.

Stallkamp had previously told CBS News Philadelphia that the system had turned to conservation strategies like relying on Gatorade to hydrate some in the hospital, reserving IV fluids for only the neediest patients.

In Massachusetts, a spokesperson for Mass General Brigham said Tuesday that elective procedures are still being delayed “through at least Wednesday, October 16.” 

That health system has not yet seen an increase in limits on orders from Baxter, though they are awaiting “an additional one-time shipment this week to address urgent concerns.”

“We use in the area of hundreds of thousands of liters of these fluids across our entire system each month, and so even little bits of conservation make a big difference in terms of preserving our supply,” Dr. Paul Biddinger, chief preparedness and continuity officer for Mass General Brigham, told CBS News Boston on Monday.

The University of Virginia’s hospitals are now able to “proceed with most scheduled” elective procedures this week, a spokesperson said, but is still scaling back “procedures with high-volume irrigation fluid use” at the university’s main medical center.

“Any postponed surgeries will be rescheduled as soon as possible once the critical IV supplies become more available,” Eric Swensen, a UVA Health spokesperson, told CBS News.

Conserving IV supplies

Health officials in recent weeks have urged all hospitals to prepare to conserve IV fluids, even if they were not immediately facing a supply crunch. Some major health systems CBS News spoke with said they had avoided a shortfall, but were still carefully managing supplies.

The federal Veterans Health Administration, which operates the country’s largest integrated health system, said it had not identified any cancellations resulting from the shortage.

“VA is closely tracking inventory, shipments, cross-leveling supply between facilities when appropriate, and following general conservation guidance to maximum use of existing supplies,” Veterans Affairs press secretary Terrence Hayes said in a statement Tuesday.

Spokespeople for the Cleveland Clinic and Mount Sinai, which operate some of the country’s largest acute care hospitals, said they had not needed to cancel or postpone any procedures. 

The University of Minnesota’s M Health Fairview, which had told CBS News Minnesota last week that it had been forced to reschedule patients, said Tuesday that it has resumed “scheduling all services as usual” as of Friday.

Some hospitals caring for “vulnerable patient populations” are also getting stepped up supplies from Baxter, Children’s Minnesota hospital told CBS News in a statement.

However, the hospital is still taking “extra precautions” to conserve supplies, saying they have yet to receive “the full allocation” from Baxter as it recovers.

“While we have not yet delayed any procedures, this is a serious, fast-moving situation that requires real-time decision-making. Leaders across our organization are meeting daily to monitor the situation and take action,” Children’s Minnesota said.