How old is your hospital’s generator?

Answer could be vital in an emergency.

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Note to readers: Prognosis will publish its final edition on Feb. 13. On March 5, a new weekly newsletter, Health Monitor, will replace Prognosis for paying Bloomberg subscribers. If you are a subscriber, no action is required. If you are not currently a Bloomberg subscriber, you will stop receiving Prognosis and will instead receive Bloomberg's flagship Morning Briefing Americas newsletter, which offers a broader look at the day's most important news. To continue receiving dedicated health coverage and access more subscriber-only newsletters, explore a Bloomberg.com subscription. Hi, it's John in New York. I was shocked by a recent report on aging hospital infrastructure, specifically generators that power life-saving equipment during an emergency. More on that in a moment, but first ...  Today's must-reads The FDA refused to review Moderna's application for an mRNA flu vaccine. Measles cases in South Carolina, the hardest-hit US state, have fallen as inoculation rates rise. Opinion: RFK Jr.'s vaccine skepticism Is entering a new phase. In the dark If the power goes out at a hospital, patients and doctors might be relying on backup generators that are 30, 40 or even 60 years old. That's the startling takeaway from a recent review of emergency power systems at hospitals in Los Angeles County. It's likely a similar story in the rest of the country, says Eric Cote, project director at a small nonprofit called Powered for Patients, which did the survey on behalf of the county. Cote has been working in disaster safety since after Hurricane Katrina, when power failures led to deaths at hospitals and nursing homes. The census of generators at hospitals in LA, done at the county's request, found that one-third were more than 30 years old, which Cote says is considered their useful life. A handful were more than 60 years old. The outdated equipment was more prevalent at hospitals that had only one backup generator, Cote said, heightening the risk. He likened the situation to a "a ticking time bomb," and said public health officials and emergency managers are largely unaware of the danger. Hospitals are required to test backup power systems monthly. But Cote said those tests may not replicate the real-world conditions they'll face in an emergency. How well a hospital responds to a power failure depends on more than just the age of the generator. Other components of the system and how it's set up make a difference, too, along with how well-prepared staff are to use it. Newer systems can fail when people aren't trained on the complexity of the technology, Cote said. LA hospitals regularly test check backup systems for reliability, and "generator age alone is not an indicator of safety or readiness," Adam Blackstone, a spokesperson for the Hospital Association of Southern California, said in an email. The medical centers coordinate with the county and can divert patients if needed. No rules force hospitals to replace generators just based on age, he said, "and upgrades involve significant planning and capital investment to ensure patient safety is not compromised." The cost to upgrade a hospital generator in California can range anywhere from $800,000 into the millions, said Salvatore Martorana, president of Global Power Group, which specializes in backup power systems. (The cost may be less in states with less stringent regulations and earthquake protection requirements.) LA County offered funding to some hospitals relying on aging generators to set up systems to monitor their power supply. Cote said some have also upgraded infrastructure to allow for swift connections to portable generators that many cities can deploy quickly. But Cote says the industry and regulators aren't doing enough. There's no central data on hospital generator failures, for one thing, making it hard to know the scope of the problem. He thinks they should be tracked and analyzed like airline crashes. For hospitals, the expense of upgrading a generator competes with other priorities – paying for staff and supplies, expanding buildings or purchasing new diagnostic equipment. And unlike some other investments, a new generator doesn't bring in more revenue. "These facilities are essentially making gambles that outdated equipment will continue chugging along," Cote said, "and we've seen plenty of examples where their calculations turn out to be wrong." — John Tozzi What we're reading Statins are not a major cause of side effects like depression, fatigue and headaches, the Independent reports. Ivermectin, an antiparasitic promoted without proof as a Covid treatment, is being studied by the US National Center Institute, KFF Health News reports. Doctors can't agree on how to diagnose Alzheimer's disease, the Wall Street Journal reports. Contact Prognosis Health questions? Have a tip that we should investigate? 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