A tornado caused extensive damage to a Pfizer drug manufacturing facility in Rocky Mount, NC, on Wednesday, threatening critical supplies for hospitals across the country.

The company estimated that one-quarter of the injectable drugs it supplies to U.S. hospitals were made at the Rocky Mount property, including drugs used during surgeries and other procedures to help block pain, keep patients sedated and fight infections.

Although the company has yet to reveal the extent of the impact of the storm, video footage of the site and interviews with the Nash County sheriff and with people informed about the damage indicated that the tornado caused the worst damage at the company’s warehouse.

On Thursday, Pfizer declined to comment on the drugs affected or the proportion of its supply destroyed in the tornado, which could be significant given that many of these drugs required careful production and handling to ensure sterility.

It was also unclear how deeply the destruction would exacerbate an existing national drug shortage that reached 10 year maximum in recent months. Hospitals are on high alert because cheap generic products manufactured at the site, such as the sedative propofol, are already among the most shortage-prone on the market.

“From a healthcare practitioner’s point of view, I’m just holding my breath,” said Michael Ganio, senior director at the American Society of Health System Pharmacists.

The tornado tore through a 16-mile swath of the Rocky Mount area, about 50 miles east of Raleigh, at about 12:30 pm on Wednesday. It snapped trees at the base and tossed homes 20 yards from their foundations, according to a summary of the National Weather Service. The tornado reached wind speeds of up to 150 miles per hour before it tore away large chunks of the metal roof of a Pfizer building and overturned big-rig trucks in the parking lot. Sixteen people were injured, but no deaths were reported.

Several people said the tornado caused the most damage to a company warehouse; the impact on the factory — and its ability to continue producing drugs — is not yet clear, according to Mittal Sutaria, senior vice president of pharmacy contracts at Vizient, which provides contract medicine to hospitals.

She said Pfizer and the Food and Drug Administration had teams on site to assess the damage.

Dr. Sutaria, who said Vizient has been in contact with Pfizer, added that the Rocky Mount site made anesthesia products including propofol, used to sedate patients during surgery, as well as fentanyl and morphine, which are used in IVs for pain management. It also makes vancomycin, an antibiotic administered to fight severe infections, and muscle blockers including succinylcholine, also used in surgery.

Keith Stone, the sheriff of Nash County, where Rocky Mount is located, told local news reporters on Wednesday that a large part of the Pfizer building was splintered, the roof was crushed and as many as 50,000 pallets of medicine were destroyed.

About 100 vehicles were also damaged, including forklifts that were strewn across nearby railroad tracks, Sheriff Stone said in an interview Thursday. “It’s just amazing what can appear so quickly and have so much damage and disappear so quickly,” he said.

Steve Danehy, a spokesman for Pfizer, said Thursday that the company’s Rocky Mount team is “working hard to address and assess the situation,” but did not provide details. The company said its staff survived the tornado without serious injuries.

Pfizer is expected to report its findings to the Food and Drug Administration, which tracks deficiencies.

“We are following the situation closely as it develops and are working with the company to understand the extent of the damage and any potential impact on the nation’s drug supply,” said Chanapa Tantibanchachai, a spokesperson for the agency.

The Rocky Mount facility, established in 1968, employs 4,500 people and has 24 filling lines and 22 packing lines. Although not as large as Pfizer’s manufacturing complex in Kalamazoo, Mich., the North Carolina site contains 1.4 million square feet of manufacturing space. The medicines made at the site are also sent to Japan, Canada, Brazil and other countries.

The specific products made at the Pfizer plant – and the share of the market they comprise – are not typically public information. However, the company sells dozens of injectable itemsincluding IV antibiotics, anti-seizure drugs used in brain surgery and even an antidote to coral snake venom.

Many Pfizer drugs were already in short supply before the tornado: About 130 products marketed to hospitals were listed as “out of stock” and about 100 more were in “limited supply,” according to the company’s list. of 660 products.

Pfizer has another manufacturing plants in Kansas, New York, Massachusetts and Wisconsin where the company could eventually shift some production to ease any shortages resulting from the Rocky Mount destruction.

Soumi Saha, senior vice president of Premier, a company that provides contracting services for drugs to hospitals, said Pfizer had a strong track record of building in some redundancy so that products were manufactured in more than one location.

If the storm damage is limited to the warehouse and does not affect production schedules at the factories, that could mitigate potential shortages, she said.

Dr. Ganio recalled other drug addictions caused by disasters in production zones.

Hurricane Maria struck Puerto Rico in 2017, leaving hospitals scrambling for IV bags. Another happened last year when a region of China that was hit hard by Covid had a pause in the production of contrast dye for CT scans and other medical imaging. And in recent months, doctors have warned that survival rates for some cancer patients are in jeopardy due to a halt in production at a factory in India after the FDA cited serious quality lapses.

Given the alarming shortages that affect so many lives — and that have resulted in a hoarding of certain drugs and bartering between activists who trade and find scarce drugs for the most desperate — policy experts, lawmakers and federal officials have debated solutions in recent weeks.

On Thursday, Senate lawmakers passed a pandemic preparedness bill out of a key health committee. It had provisions aimed at ending shortages and increasing reporting by drugmakers to alert the FDA of circumstances that could lead to shortages so the agency could help eliminate them.

The bill would also require a report from the FDA within 90 days of the legislation on the agency’s ability to address deficiencies and whether it needs more help from lawmakers.

However, the natural occurrence of a tornado provided a stark reminder of the need to better manage shortages.

“This reinforces the need for resilience in our supply chain and a real focus on preparedness, not just for the next pandemic,” said Dr. Saha, “but for any unforeseen circumstance that creates shocks in our supply chain.”

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