This flu season continues to break records in terms of the number of people affected and the severity. Flu cases are up over 800 percent here in Southern Arizona, and deaths from the virus are on track to rival the 2009 swine flu pandemic.
Those who are young, old or dealing with chronic illnesses are the most susceptible to contracting influenza. But our neighbors who get the flu and end up in the hospital are actually victims of two recent catastrophes.
Four months before this flu menace, Hurricane Maria made landfall in Puerto Rico. When the storm wiped out reliable power and access to running water, it also devastated the island’s ability to produce saline intravenous bags. In fact, Puerto Rico produced 44 percent of the IV bags made in the United States, so hospitals and patients from Tucson to Tallahassee to Tacoma are now coping with the shortage.
About two weeks ago, the U.S. Food and Drug Administration announced that “having adequate supplies, especially during this severe flu season, is a critical matter of public health.”
The shortage encompasses small-size sterile IV saline bags, which had been supplied by Baxter International from its facility in Puerto Rico. That facility, thankfully, has been powered back up, but transportation infrastructure remains profoundly affected. The supply chain to and from the plant remains a real problem.
These saline bags are central to treating more than just the flu. They’re also used in the treatment of a range of seriously and critically ill patients in hospital, as well as patients who are receiving medications like chemotherapy or immunotherapy in the outpatient setting. Any treatment delay poses a serious threat to our sickest patients, whether they’re suffering from influenza or other ailments.
In my own hospital-based practice, I am seeing the effects of the shortage firsthand. These crucial IV fluids are now restricted to the central pharmacy so that distribution can be closely monitored.
That means that when doctors and nurses seek out urgently needed IV medications, there can be delays that we just wouldn’t experience in normal situations.
So you could say Hurricane Maria has now made landfall in Tucson. I am seeing its impact on patients daily.
It’s worth thinking about the root causes of this shortage.
In part because of rising water temperatures in the Gulf of Mexico, the Caribbean Sea and the world’s oceans, scientists say we will likely face more frequent and more intense natural weather disasters like Hurricane Maria — or Hurricane Harvey that hit Houston. When these destructive events occur, we face both direct and indirect costs.
A clear cost is the financial burden on U.S. taxpayers and to affected communities’ economies. Often that’s tens of billions of dollars added to the national debt. This stifles productivity, reduces our GDP and hurts our ability to compete globally.
But the IV shortage is a leading example of costs that aren’t apparent on first blush. And clearly it’s a cost that is being imposed on the entire nation, not just on Puerto Rico. With better public policies, it’s a toll that could have been reduced or avoided.
I think about that old phrase about the U.S. economy’s impact globally: “When America sneezes, the world catches a cold.”
But today it’s the flu, and it started with some bad symptoms in Puerto Rico.
We live in an increasingly interconnected world, and it can only help for us all to see the big picture, hear the needs of our communities, and take the actions necessary to protect our health and our environment. Otherwise, Maria won’t be the last coastal storm to hit right here at home.