In the Southeast United States, hurricanes and floods that have been occurring with more frequency and intensity have exposed the weak links in the country's medical supply chains. And as warmer oceans have supercharged these storms, the ongoing change in climate has strained a system built on single-site manufacturing, just-in-time inventories, and fragile last-mile links.

The U.S. medical supply chain is still trying to find the balance between cost and efficiency, while paying heed to resiliency, says Chris Luoma, the senior VP of strategy at health care supply chain software provider Global Healthcare Exchange.

When Hurricane Helene made landfall in late September 2024, it devastated swathes of Florida and Georgia. But the less-dramatic heavy rainfall and flooding in North Carolina had consequences that took months to play out, because medical supply company Baxter International was forced to close its North Cove plant in the state, which produces roughly 60% of the country's supply of IV fluids, as well as a sizable share of peritoneal dialysis (PD) solutions used to treat kidney failure. 

The North Cove plant was able to reopen two manufacturing lines by early November, although that accounted for just half of the facility's pre-Helene production of IV solutions. PD solution production wasn't able to come back online until early December, leaving hospitals across the country forced to delay treatments for new kidney patients, and make difficult decisions about prioritizing existing patients that needed dialysis the most. IV fluid shortages also forced many hospitals to delay elective procedures, and in many cases, even give patients water or Gatorade orally before starting an IV, as a way to ration stockpiles. 

The plant returned to full capacity by January 2025, but by then, the damage had been done. According to an April 2025 analysis published by the National Institute of Health (NIH), the shortages caused by the North Cove closure led to a "fundamental altering of the standard of care for dialysis patients," exposed critical vulnerabilities in the country's medical supply chains, and demonstrated the pressing need to plan around the growing impacts of climate change.

"If there is one lesson to be learned from Hurricane Helene, it is that climate change adaptation in health care policy should include an emphasis on decentralizing health care infrastructure," the study reads. 

According to the NIH, the rate of billion-dollar natural disasters in the U.S., adjusted for inflation, grew from an average of 3.3 events a year in the 1980s, to 27 annual events in 2024, with outsized impacts from tropical cyclones, hurricanes and storm surge flooding concentrated in the Southeast. It's not difficult to draw a straight line between that trend and climate change either, says Everstream Analytics chief meteorologist Jon Davis. As ocean temperatures have gotten warmer, storms have tapped into more energy, intensified faster and produced heavier rainfall, increasing the risk of rapid-strengthening hurricanes and catastrophic flooding across the Southeast.

When it comes to supply chain risks posed by a single point of failure, Florida has one of the heaviest concentrations of medical supply manufacturing in the U.S., and has suffered through four major hurricanes in the past three years. Davis describes how hurricanes can also have a cascading effect on supply chains across sectors, as people are forced to evacuate, businesses and production plants close, and transportation systems grind to a halt.

"It's air cargo, it's ports, it's roads, it's rail, and it's damage to infrastructure," he explains. "Then you have to fix it, and it can become a disruptive event for many months on end."

And while that can affect any number of industries that rely on the flow of goods through shipping hubs, health care delays can lead to far more dire consequences compared to other sectors, says Chris Luoma — actually life or death.

That said, Luoma says he believes the health care industry in the U.S. is in a better place today than it was in the aftermath of Hurricane Helene, while noting that it's still "not at the end of that journey." Using the lessons learned from Helene, the NIH issued a list of recommendations in its April 2025 analysis, including tax incentives for medical manufacturing in areas of low risk from extreme climate events, faster approval processes for alternative suppliers during emergencies, and a federal mandate to keep at least 30 days of strategic reserves of critical medical supplies.

Moving forward, Luoma adds, health care manufacturers will need to continue to gain a better understanding of the supplies that would have the greatest clinical impact in the event of a disruption, plan out alternative sourcing strategies or substitutions for those supplies before the next disaster hits, and collaborate with partners at each stage in the supply chain.

"It's about patient care and delivery continuity," he says. "You can't do this in a silo — business continuity in a supply chain requires all partners to lean in."