When hospital leaders last week told the Pinellas County Commission how coronavirus cases are straining intensive care units and nursing staffs, they said they were finding some relief in one promising drug.
The problem is that officials from AdventHealth, BayCare and HCA have not been able to secure sufficient quantities of remdesivir, an experimental medicine that has reduced coronavirus recovery time in some trials.
On Monday, Pinellas County Commission Chair Pat Gerard wrote to Gov. Ron DeSantis, pleading with him for help in securing more supply, stating that “our local hospitals are in desperate need for more of the lifesaving drug remdesivir.”
“(Hospital leaders) continue to advise that the shortage of remdesivir along with the lack of medical personnel has created life and safety issues during this pandemic,” Gerard wrote.
Fred Piccolo, DeSantis’s chief spokesperson, said on Tuesday that a recent shipment of 30,000 vials of remdesivir brought Florida’s total received to more than 81,000 vials in July.
He said allocation to each hospital is based on their COVID-19 cases and that 38 local hospitals, including those in the Advent Health, BayCare and HCA systems, have received the drug.
Gerard’s letter said “we can not stress enough the need for remdesivir,” but she did not specify how many more vials would meet the demand. And in response to a question from the Tampa Bay Times asking how much more remdesivir BayCare needed, a hospital spokesperson responded only that “supply is tight.”
“The Governor has prioritized obtaining the largest remdesivir allocation he can,” Piccolo said in a statement. “Of course, we all would like every hospital to have more than they need or can use. However, hospitals continue to coordinate effectively to ensure the facilities most in need receive sufficient supply. Hospitals, doctors and patients can be assured that this Governor will never stop trying to get enough remdesivir for all in need.”
According to her letter dated Friday but sent to DeSantis on Monday, Gerard stated there were 67 patients in Pinellas County on ventilators and 106 in intensive care units due to COVID-19.
As of Tuesday, Pinellas County led the region in deaths with 397, largely because of outbreaks at elder-care facilities, which account for about 68 percent of the county’s deaths.
Although the number of new coronavirus deaths in Pinellas County has been going down over the past seven days, about 65 percent of deaths have occurred in the past four weeks — which Gerard called “a huge concern.”
She expressed worry over the county’s “much older population,” with 250 long term care facilities with 13,000 residents.
“Our medical professionals are doing all they can including using convalescent plasma but advise the demand for remdesivir is high,” Gerard wrote.
The Food and Drug Administration granted an emergency approval of remdesivir in early May, but initial distribution to hospitals across the country by its wholesale distributor, AmerisourceBergen, has been inconsistent.
In an interview with the Tampa Bay Times on Monday, Dr. Doug Ross, chief medical officer of AdventHealth Tampa, said because of limited supply, the hospital is using remdesivir only to treat patients requiring low-flow oxygen and no mechanical ventilation, following CDC guidelines.
Research has shown the drug to be less effective on patients requiring high oxygen and mechanical ventilation. But if there were more supply, Ross said the hospital would be able “to liberalize it to more patients.”
“The bottom line is, I don’t feel comfortable with what we have,” Ross said. “We could always use more.”
AdventHealth patients who received the drug in May, June and July experienced a reduction in hospital stays of two and a half days, compared to COVID-19 patients that went without remdesivir in March and April, Ross said.
Ross said the drug has been shown to decrease the viral load in lungs and decrease the inflammatory air response in the lungs, reducing recovery time. The hospital has also seen a reduction in mortality rate, but Ross could not entirely attribute that shift to remdesivir, as other treatments were being used simultaneously.
Ross said AdventHealth received the drug through AmerisourceBergen, but the allocation for each hospital is determined by the Florida Department of Health.
“The allotment changes, so it’s fairly unpredictable,” Ross said.
While addressing the Commission last week, which prompted Gerard’s letter to DeSantis, Dr. Angus Jameson, medical director for Pinellas County Emergency Medical Services and an emergency room physician, said emergency rooms are not full, but the pandemic is triggering increases in other medical conditions requiring life-saving support, like overdoses, putting pressure on the system.
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