Puerto Rico’s Hurricane Damage Strains US Medical Community

It’s been over 100 days since Hurricane Maria devastated Puerto Rico — and for most Americans, the natural disaster has been all but forgotten. Meanwhile, roughly half of the island’s 3.4 million residents are still without electricity. Many are still displaced from their homes and living in temporary housing and shelters — and rebuilding the territory’s impacted infrastructure is a task in which the continental US appears to have lost all interest.

Now, however, the fallout of the destruction is coming to the mainland, and it’s no longer something most Americans can ignore. Without proper aid to Puerto Rico, the health care system is falling into dangerous new shortages.

The issue first came to light in late December, when a man named Ben Boyer tweeted about his hospital experience, a statement that soon went viral:

My wife’s nurse had to stand for 30 mins & administer a drug slowly through a syringe because there are almost no IV bags in the continental US anymore. See, they were all manufactured in a Puerto Rican factory which still isn’t fixed. Meanwhile that stupid swollen prick golfs.

News reports soon showed exactly how real — and widespread — the problem was. According to the Boston Herald, hospitals have all been urged to evaluate who will need IV bags, seeking patients who can be switched to pills or other forms of medication in order to conserve what few bags remain.

The Herald reports:

Baxter International Inc. is the primary resource for the supplies, which are produced at its Puerto Rico location. The shortage, which has been seen in hospitals nationwide, also has [Massachusetts General Hospital] running low on larger bags that hydrate patients with saline solution. And the situation is only getting worse, [Dr. O’Neil Britton, chief medical officer and senior vice president at Massachusetts General Hospital] said. Various sizes of mini bags have run out, and those remaining are in ‘critically low’ supply. To try to conserve supplies, nurses are diluting the antibiotics manually, known as an ‘IV push’ but that is a time-consuming process. Doctors are also taking a closer look at who needs fluid antibiotics rather than the oral variety.

IV bags are at a dangerously low supply, but many drugs manufactured in Puerto Rico are drying up as well. According to InsightUS, a data-driven research news site, there may be as many as 101 drugs currently on the market that are manufactured in Puerto Rico, setting the US up for a potential looming drug shortage in the near future:

Thanks to a favorable US tax code provision enacted in 1976, major pharmaceutical companies like Pfizer, Amgen, Bristol-Myers Squibb, Lilly, and Johnson & Johnson have large factories located across the island of Puerto Rico. But post-Maria those multimillion dollar facilities face the same impossible conditions that their workers’ families also face at home: faltering electrical service, failing backup generators, trickling tap water, and unreliable transportation.

After analyzing current medications and finding 101 potentially vulnerable drugs, they concluded, “Included in the resulting list of 101 Puerto Rico–manufactured pharmaceuticals…are 9 of America’s top 20 bestselling drugs for 2016, including Humira (the #1 best-seller), Enbrel (#3), Remicade (#5), Januvia (#6), Lyrica (#8), Crestor (#9), Neulasta (#10), Xarelto (#14), and Eliquis (#16).”

Congress is currently at work to pass a new spending bill, and included in that should be funding to help rebuild Puerto Rico and address the ravages of Hurricane Maria. But first those funds have to be approved by a GOP Congress that wants to reduce government spending — unless it is on tax breaks for businesses and the rich — and could take ages to be distributed.

Meanwhile, the workforce in Puerto Rico is dwindling, as those who no longer have jobs or homes explore opportunities in the US to pick up low-wage work in communities that at least offer running water and electricity — far more than they currently have at home. Analysts suggest as many as 2,000 Puerto Ricans are leaving the country per day, with many heading to the states — a number that suggests even if the companies do rebuild, they may not have enough remaining employees to run them.

Hundreds of lives were lost in Puerto Rico, many of them caused by a US government that was too slow and too stingy in its aid. Now that the lives hanging in balance may be patients in the states themselves, will the government be any quicker to react?