WASHINGTON — The Food and Drug Administration’s biggest concern in Puerto Rico is access to electricity, Commissioner Scott Gottlieb said at a congressional hearing Tuesday morning.

“If [drug and device manufacturing plants] don’t return to the grid by the end of this year, we’re concerned we could face multiple potential shortages,” Gottlieb said. He added that the concern could be mitigated if companies temporarily shift more of their manufacturing operations off the island during the recovery process.

The FDA has not announced any shortages directly related to Hurricane Maria, but Gottlieb said that the agency is keeping close watch on 30 different drugs and 50 types of devices.


And connecting plants to the grid is only part of the solution — the grid also has to be repaired so that it is dependable. Gottlieb said that companies might prefer reliable generators — which most, if not all, companies are now using — to an unreliable grid.

The current status of the electricity grid in Puerto Rico is unclear. A government website said that power “generation” stood at 24.40 percent as of 6 a.m. Tuesday. STAT was unable to reach the island’s electricity authority by phone Monday to clarify what “generation” means.

According to the local newspaper El Nuevo Dia, even such statistics can rapidly change.

Last Thursday, the power authority was operating at about 20 percent percent of its capacity, the newspaper reportedBut service was cut in half that night due to a “breakdown on a transmission line.”

And the grid was in dire straits well before the hurricanes struck. According to a 2016 report prepared for the Puerto Rico Energy Commission, the electrical “transmission and distribution systems are falling apart quite literally: they are cracking, corroding, and collapsing.”

Drug and device manufacturing is by no means the only aspect of health infrastructure that depends on reliable electricity.

At the hearing, the Department of Health and Human Services’s assistant secretary for preparedness and response, Dr. Robert Kadlec, said that 40 percent of Puerto Rico’s hospitals are still operating off of the electrical grid. And even those might not have power all the time.


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Representative Jan Schakowsky (D-Ill.) asked Kadlec if that means the hospitals connected to the grid actually have power all the time.

She cited a photograph that had gone viral on social media, which purports to show surgeons performing a procedure while using cell phones as flashlights. It was posted on Twitter by the former governor of Puerto Rico Alejandro García Padilla. 


“Sometimes, there’s some reliability issues as it relates to transmission wires and distribution,” Kadlec said. He noted that even hospitals connected to the grid may have backup generators.

And Stephen Redd, the Center for Disease Control and Prevention’s director of the office of health preparedness, noted that there are not currently any operational laboratories on the island that can test for infectious diseases, and that restoring power is the first step to getting these labs up and running again.

Currently, samples that need to be tested are shipped off the island, Redd said.

This story has been updated to make clear that Gottlieb suggested a temporary shift of manufacturing operations off the island of Puerto Rico.

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