Covid-19 hotspot hospitals run out of remedies

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Wolfe would like to share some of his remdesivir with doctors like Godofsky, as it is the only drug authorized by the United States Food and Drug Administration to treat Covid-19.

But as the coronavirus makes its way to the United States, with increases in some areas and a decline in others, there is no mechanism for hospitals to move the drug to where it is most needed. .

The federal government oversees the distribution of remdesivir, and Wolfe, Godofsky and other doctors say the system needs to be overhauled.

Godofsky says he feels “handcuffed” not being able to give his patients in Bradenton, Florida, remdesivir, a drug that can speed healing and possibly reduce the risk of death for patients.

“It’s very frustrating,” said Godofsky, an infectious disease specialist. “The patients are suffering and you just feel awful. “”It’s crazy,” said Wolfe, an infectious disease expert at Duke University Medical Center. “It’s really disturbing to see how it went. “

A spokesperson for the United States Department of Health and Human Services told CNN on Friday that in the coming week, remdesivir allocations to states “will focus on locations with recent large increases.”

The spokesperson has given quantities to ship to four hotspot states – Arizona, California, Florida and Texas – which are much smaller than the number of hospital patients in those states.

The spokesperson also said that the company hired to distribute the remdesivir would contact each hospital that received the drug to confirm that it still needed it.

The department “is committed to a fair and efficient distribution of the drug in order to reach as many patients as possible in all American states and territories”, according to the spokesman.

Distribution of remdesivir

In May, the FDA granted emergency authorization to remdesivir to hospitalized Covid-19 patients. Gilead Sciences, the company that makes the drug, initially donated it, but starting next week, hospitals must buy it.

It is hardly a successful drug. A study published in the New England Journal of Medicine shows that he shaves four days of a hospital stay.

Science by press release: When history precedes science

Gilead presented data at a medical conference on Friday that patients on remdesivir had a 7.6% death rate compared to a 12.5% ​​death rate for those who had not received drug. The analysis also showed that 74.4% of patients treated with remdesivir recovered within 14 days, compared to 59% of patients who did not receive remdesivir.

The data have not been published in a peer-reviewed medical journal, which makes them less reliable.

Although it is not a cure for Covid-19, doctors say that most of their hospital patients could benefit from remdesivir. Shipments to hotspot states in the coming week, however, don’t even come close.

As of July 10, Texas had 10,002 patients hospitalized with Covid-19, but the batch for Texas will have only enough remdesivir for approximately 3,507 patients; Florida had 6,974 patients, but only enough for 2,733; California had 7,896 patients, but only enough for 2,080; Arizona admitted 3,432 hospital patients, but enough for 2,080 patients, according to state and federal data.

HHS will make another shipment in two weeks.

More Evidence Remdesivir Helps Some Coronavirus Patients

The University of Texas Health Sciences Center at San Antonio has admitted more than 250 Covid patients since mid-June, but its last allotment of remdesivir was sufficient for only 53 patients, according to Dr. Thomas Patterson, chief of infectious diseases in the hospital.

“It is frustrating not being able to donate a drug that we think will benefit the bottom line,” said Patterson.

The Memorial Hermann healthcare system in Houston is almost out of remdesivir.

“Our estimates indicate that we have a few days left before we run out,” said a statement from Dr. Angela Shippy, chief medical officer and quality manager.

According to hospital CEO Kevin DiLallo, Manatee Memorial Hospital in Brandenton, Florida has a “small supply” of remdesivir to treat patients.

Finding a plan for a limited resource

On Friday, New York Governor Andrew Cuomo announced that his state would ship enough remdesivir to Florida to support 280 Covid-19 patients.

The HHS spokesperson said that once a hospital purchases remdesivir, “that hospital owns the drug and is free to handle it as it sees fit, which could include transfer or sale to others.” other hospitals inside or outside his state or territory ”.

But Dr. Michael Ison, an infectious disease specialist at Northwestern Medicine in Chicago, said that Illinois health officials have warned hospitals about the transportation of drugs by the state for legal reasons.

Even if they were able to ship where they wanted, doctors and hospitals should not make destination decisions, said Ison.

“What we don’t want is for someone to say, ‘Oh, I have a friend at Hospital X, so I’m going to send everything to them,'” he said.

Rather, Ison said the government should have a systematic way to see which hospitals have a surplus and which hospitals need it most and coordinate shipments accordingly.

“No one knows where the excesses and the gaps lie,” he said. “It is a limited and scarce national resource. There has to be a process to follow. ”

He added that there should be transparency in the process.

HHS spokesman Friday told CNN that the agency will use data from three systems to determine remdesivir allocations: the United States Center for Disease Control and Prevention’s healthcare security network; HHS Protect; and a private company called Teletracking.

The remdesivir is then allocated proportionally. “For example, if state A has 10% of the national total of patients admitted with COVID-19, state A gets 10% of remdesivir for a given week of distribution,” the spokesperson told CNN.

But the spokesperson did not explain exactly what data is used from the three sources and how proportionality is determined.

“There should be transparency on how remdesivir is made available and when it is available,” said Ison. “Without transparency, it makes people less trustworthy in the overall process. “

CNN’s Wes Bruer, Dana Vigue, John Bonifield, Gisela Crespo, Amanda Watts and Chuck Johnston contributed to this report.

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