U.S. health care providers are racing to ration intravenous (IV) fluids after the country’s largest supplier was forced to halt production in the aftermath of Hurricane Helene.

The Baxter International North Cove facility in North Carolina, which is responsible for 60% of the nation’s IV fluid supply, was “significantly impacted” by storm damage, the company said Thursday.

Baxter’s mitigation plan, which includes reducing shipments as part of its recovery efforts, has hospitals nationwide scrambling to conserve their most basic lifeline.

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RWJBarnabas Health in New Jersey and Northwestern Medicine in Illinois are among the health care providers implementing conservation strategies for IV fluids, according to NBC News.

“It will be impossible to treat patients without IV fluids,” Dr. Peter Papadakos, critical care director at the University of Rochester Medical Center, said in an interview with Forbes.

From ambulances to operating rooms, IV fluids are indispensable. And with no clear timeline for when the Baxter plant will be back online, health care systems are bracing for what could become a critical shortage.

Leanne Petty, a radio broadcaster from Kernersville, North Carolina, is dismayed at the news, given that her family depends on IV fluids from Baxter.

“This 100% sucks! This is where my husband and many other people get their dialysis fluids. It’s literally a lifeline,” Ms. Petty posted on X. 

Baxter International announced the temporary shutdown of its North Cove plant, which produces not only IV fluids but also peritoneal dialysis solutions. The company cited a “significant impact” from the storm surge and flooding caused by Helene.

Baxter CEO Joe Almeida emphasized in a press release that the company would “spare no resource — human or financial—to restart operations” but noted the complexity of restoring sterile drug manufacturing. Despite their efforts, there is no confirmed timeline for when production will resume.

Baxter has implemented an allocation system on key products to manage the crisis, including saline and dextrose solutions, according to FastPharma. This system limits how much customers can order, aiming to prevent stockpiling and ensure equitable access to dwindling supplies.

But with so much of the U.S. dependent on the North Cove plant, the strain on the supply chain is already apparent.

The Food and Drug Administration said it has been closely monitoring the situation but has not yet declared an official shortage.

The agency also said it’s working with Baxter to increase production at other facilities and exploring alternative sources of IV fluids to help mitigate potential shortages. As of Monday, the FDA had not confirmed any official supply crisis.

Adding to the challenge is the damage to infrastructure in North Carolina. Bridges that provide access to the North Cove facility were destroyed by the storm, slowing down recovery efforts, according to Baxter’s press release.

The company has built a temporary bridge to support limited transfers, while the Army Corps of Engineers and North Carolina officials are working on a permanent bridge solution.

Baxter has deployed 500 remediation workers to the site, with plans to double that number in the coming weeks, but the recovery is still expected to take months.

The sudden shutdown of Baxter’s facility has drawn comparisons to a similar crisis last year when a tornado struck a Pfizer plant in North Carolina that produced about one-quarter of the drugmaker’s sterile injectables.

Both incidents are throwing a spotlight on the fragility of a health care supply chain that relies heavily on centralized production, according to some online commentators.

“We must do better when it comes to planning and foresight for availability of critical medical supplies affecting the survival of people living in the U.S. Lessons learned from prior natural disasters, including floods, hurricanes, tornados and ultimately COVID-19, should serve as a wake-up call,” wrote Dr. Robert Glatter, emergency physician at New York’s Lennox Hill Hospital, in an opinion piece for Forbes.

For now, hospitals across the U.S. are left balancing patient care with conservation efforts, knowing that if recovery at North Cove takes longer than expected, the nation could be facing a severe — and prolonged — IV fluid shortage.