Health Response Alliance – Situation Report
Puerto Rico Island-wide Power Outage
Date: April 16, 2025
Prepared by: Health Response Alliance
Status: Ongoing Event

Update as of April 18, 2025: Power has been restored to 99% of the island. Hospitals, water systems, and airports are operating as usual.

Overview

As of April 16, 2025, Puerto Rico is experiencing a full island-wide blackout affecting approximately 1.4 million electricity customers. The outage began at 12:40 p.m. local time, following a sudden and complete shutdown of all power generation plants. This marks the second total blackout in four months, underscoring long-standing vulnerabilities in Puerto Rico’s electric grid.

The disruption is affecting daily life across the island—halting transit systems, shutting down businesses, and placing additional strain on public services. Healthcare operations, water access, and other critical services are facing immediate operational challenges.

Source: Associated Press – April 16, 2025

Healthcare Access and Operations

Hospitals and Clinics

• Most hospitals have activated backup generators in accordance with standard emergency protocols. While large hospitals are generally well-equipped, fuel access and generator reliability can vary.

• Smaller clinics, outpatient facilities, and rural health centers—especially those without robust power backup systems—are likely experiencing partial or full service interruptions, a pattern consistent with previous outages like those during Hurricane Fiona in 2022.

• Dialysis centers and other outpatient services often face immediate operational strain during power outages due to shorter generator runtimes and limited staffing.

Source: KFF Health News – Puerto Rico’s Health Faces Prolonged Recovery, Commonwealth Fund – Healthcare Infrastructure Post-Maria

Patient Safety

• Individuals who rely on electrically powered home medical equipment—including ventilators, oxygen concentrators, and refrigeration for insulin—face elevated health risks.

• Disruptions to communications infrastructure have historically made coordination of EMS transport and emergency referrals more difficult.

• Community-based organizations are reportedly receiving increased requests for batteries and fuel—similar to trends observed after Hurricane Maria and during the 2021 Texas winter storm.

Source: NEJM – Excess Deaths after Hurricane Maria, Commonwealth Fund – Impact on Vulnerable Patients

Healthcare Supply Chain

• Puerto Rico is a key hub for pharmaceutical manufacturing. After Hurricane Maria, manufacturers invested heavily in backup energy systems to ensure uninterrupted operations. Today, many of these facilities—including Amgen’s plant in Juncos—are among the most energy-resilient in the region.

• Given the expected power restoration timeline of 48 to 72 hours, disruption to pharmaceutical manufacturing and distribution is expected to be minimal. Logistics networks may experience brief delays, but no significant interruptions are anticipated.

• During Maria, IV solution shortages arose primarily from transport disruptions rather than production shutdowns. Lessons learned from that period have since informed broader supply chain contingency planning.

Source: FDA – Drug Shortage Alert After Maria, Healthcare Ready – IV Solution Shortage Alert 2024

Public Health and Water Access

• Loss of power affects cold storage for medications and vaccines. Disruptions to refrigeration could result in spoilage, especially for temperature-sensitive products like insulin and pediatric vaccines.

• Approximately 78,000 residents are without running water due to electric pump failures, according to early estimates. This mirrors service losses during past blackouts and increases the risk of sanitation-related illness.

• Wastewater systems may be operating below capacity, elevating the risk of waterborne illnesses. Following Hurricane Maria, leptospirosis and other gastrointestinal diseases increased under similar conditions.

Source: CDC – Hurricane Maria Health Impact

The situation remains fluid, with ongoing assessments by public health and emergency management agencies. Health Response Alliance will continue to monitor and report on impacts to healthcare access and delivery as new information becomes available.