Sometimes, you don't know what you've got 'til it's gone. Such is the case with saline, a pharmaceutical-grade salt water that is in short supply across the US. The reasons for the shortage appear to be numerous, one being that the simple solution, used to mix meds, clean wounds, and hydrate, is actually complex to manufacture given it must be fully sterile to be safely injected. Other complications: The FDA has been cracking down on manufacturing oversights that could compromise safety—and in terms of US manufacturers, there are only three, KTSU reports. The demand they experienced reportedly shot up in January when dehydrated patients flooded hospitals during the worse-than-expected flu season. Then, snow and ice storms in the Midwest delayed trucks hauling saline to the West.
One hospital materials manager in California tells NPR he was genuinely scared of running out altogether—which would have led to tough choices about who gets the solution first. For instance, dialysis requires about 4 liters of saline per patient per week; without it, toxins build in the blood, and can lead to death. Some hospitals are trying to maximize their stock by using smaller saline bags and water in cups where possible. Meanwhile, the shortage has already cost one hospital in Utah $150,000 in one month, after it had to reallocate staff to deal with "triaging and counting up saline bags and figuring out where to move different saline bags around the hospital." The price of saline is set through next year, but costs could as much as triple when those contracts expire, notes NPR. (And some patients are already charged a lot for it.)