Ultimately, saline is not part of the emergency drug stockpile, says Erin Fox, the senior director of the University of Utah’s drug information services, who tracks drug shortages for the American Society of Health-System Pharmacists. But, she argues, it probably should be, considering how such a shortage of the essential product has devastated the health care system.

“When we think about how hospitals absolutely require saline to run on any given day, and they need thousands and thousands of bags to do it, it seems odd that they don’t consider that supply chain,” Fox said, adding that protecting the supply chain should be a part of a national security conversation.

This is a particularly urgent matter as weather patterns become more severe, according to Nicolette Louissaint, the executive director of Healthcare Ready, a group that works to strengthen health care supply chains.

Take Hurricane Florence, which is currently ravaging North Carolina, home to many pharmaceutical manufacturing plants. While many of the companies have been on high alert, in part after seeing the effects of Maria, the U.S. could find itself right back in the throes of another shortage in a cycle that is seemingly unending, Louissaint warned.

How a weak supply chain hurts patients

Baxter’s main manufacturing plants for its IV bags were in Puerto Rico. When the company’s capabilities went down due to hurricane damage, the bags—already limited after an issue with quality at a B. Braun factory and a record flu season—were in even shorter supply.

Hospitals and medical establishments across the country made do with what they could get their hands on. And when they couldn’t use the regular bags, nurses or paramedics would have to use syringes to inject directly into a vein, or switch out IV-administered drugs for pills when possible.

“It became so critical that hospitals were actually giving patients liquid to drink as hydration, as they didn’t have enough of the bags to give,” Michael Ganio, the director of pharmacy practice and quality at the American Society of Health-System Pharmacists, told HuffPost.

Medical providers decried the shortages for endangering patients as medical personnel switched up common procedures—upping the risk of a life-threatening medical mistake.

“Anytime you deviate from standard medical practice, you risk an error,” Ganio explained.

Fox said the lack of IV bags led to “a large number of downriver shortages,” such as shortages of syringes, which medical workers had to increasingly rely on as an alternative.