Yes, a Shortage of Salt Water

We've all seen it: You're on a highway that's moving at posted speeds or faster, and then suddenly it starts to slow down. It becomes stop-and-go, or maybe even grinds to a complete halt. You think, There must be an accident up ahead. And sometimes there is.

But other times, there wasn't anything. It just got slow for what appears to be no reason, or just because the number of cars got over a certain level relative to the space available. I'm sure a mathematician could explain it, but there's some kind of exaggeration of motion that happens. One car brakes for no reason, slowing the car behind it, and then it spreads until someone has to come to a sudden stop and then the flow completely breaks down.

The highway analogy came to mind on Sunday while I was listening to an NPR Weekend Edition story about the current shortage of sterile saline. Considered a drug even though it's just salt water, saline is regulated by the FDA for safety. Makes sense.

The factories that produce it are and have been running flat out, 24/7, without change, and the demand is not greater -- but for some reason, a shortage has developed.

A few recalls (because of contamination) are mentioned in the story, but it also says that they are not related to shortage. But how can anyone know that? If the supply and demand were close to perfectly matched, any disruption in supply could cause ripple effects that turn into shortages. And shutting down production to fix a safety problem clearly would affect supply.

The scary thing about the story was that the shortages may require the use of triage, particularly in dialysis centers. Each dialysis patient needs four liters a of saline a week to filter their blood. Some may not get the dialysis they need as soon as they need it if they're not "sick enough."

In response to the shortages, "Hospitals have developed new clinical protocols to conserve supplies during the shortage. Nurses at San Francisco General are using smaller saline bags when possible, and transitioning patients who still need hydration to drinking water from cups a little sooner than they did in the past."

Sounds like those are good ideas. I'm sure there's wasted saline that could be safely saved, somehow. And the FDA is also doing something that sounds pretty silly -- shipping saline from Norway and Spain across the great salt ocean.