The American Hospital Association is calling on the White House to help increase the supply of IV solutions after a massive Baxter International plant was taken offline by Hurricane Helene.
Baxter's Marion, N.C., facility — which produces 60% of the IV solutions used daily — was closed due to flooding caused by the hurricane late last month and it is uncertain when the plant will reopen.
Related: Baxter closes largest plant due to Hurricane Helene damage
"While we look forward to returning to full operations in the future, there are many components to the recovery process given the nature of sterile drug manufacturing," Baxter said in a statement Thursday. "We are working with the greatest urgency, but we do not yet have a timeline for when operations will be back up and running."
Some hospitals are already experiencing shortages, including Mass General Brigham, which said Thursday it would be receiving a reduced supply of IV fluids.
On Friday, systems across the country, ranging from Renton, Washington-based Providence and Nashville, Tennessee-based HCA Healthcare to Cleveland Clinic in Ohio and Providence, Rhode Island-based Lifespan said they were not experiencing shortages but were watching the situation closely.
“We’re not in a panic mode at this point but we’re watching it closely,” said Robert Garrett, CEO of Hackensack Meridian, on Friday.
Meanwhile, hospitals are employing conservation strategies that could include reusing a patient's IV bag if they required more than one bag. Greensboro, New Jersey-based Cone Health said it is trying to conserve its IV fluid supply by using substitutes or opting for oral medications when possible.
Hospitals with a more unique patient population, particularly children's hospitals, have seemed the most concerned about supply shortages, specifically regarding small IV solution bags, said Nancy Foster, the AHA's vice president of quality and patient safety.
"Children's hospitals tend to use the smaller bags," Foster said. "For some patients, you can choose to give them the medication orally and then make sure they're sufficiently hydrated by having them drink a lot of water. That's not true with a small child. So, hospitals that have a large pediatric population are really concerned about having access for those children."
In its letter, the AHA asked the administration to direct the Food and Drug Administration to declare a national shortage of IV solutions in order to give providers more flexibility, including by extending expiration dates on solutions, expediting approval processes and seeking international manufacturers.
The trade group also asked that the Health and Human Services Department declare the situation a public health emergency, which would allow for certain waivers of Medicare and Medicaid rules, and for the administration to employ the Defense Production Act, which could speed the manufacturing of the fluids and bags by other companies.
"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 AHA said in its letter.
Kyle MacKinnon, senior director of operational excellence at Premier, a group purchasing organization, said while there are other manufacturers who produce IV solutions in the U.S., including B. Braun, ICU Medical and Fresenius Kabi, but none of the companies has the capacity to match Baxter's production.
"What we know is that it would have to take all of [the remaining manufacturers] to step up and look at their production capacity to help mitigate this caliber of disruption," MacKinnon said. "And I don't know that all of them putting forth their total production capacity could even mitigate [the disruption.]"
On Monday, Vizient, a healthcare consultancy, released guidelines for conserving IV fluids in line with the American Society of Health-System Pharmacists, which includes opting for oral medications and dispensing some medications in syringes.