Southwest Florida hospitals face shortage of COVID-19 drug remdesivir
Southwest Florida hospitals are running out of a drug used to treat patients with severe cases of COVID-19.
Meanwhile, Lee Health said it may restrict elective surgeries again, due to the rising number of cases.
Hospitals are exhausting their supply of the investigational drug, remdesivir, that’s shown to hasten recovery from COVID-19 by as much as four days.
The federal government no longer has state health departments receiving remdesivir for distribution. The change created a temporary lag in hospitals getting the drug directly from suppliers, according to the Florida Hospital Association
But shipments to hospitals directly should begin July 13, according to the hospital association.
“Ensuring access to remdesivir continues to be a top priority because it has shown promising results for accelerating patients’ recovery from advanced COVID-19,” Crystal Stickle, FHA interim president, said in a statement.
Lee Health has 53 patients on a five-day cycle of the drug, and for now, no new patients will get the medication.
“As we shift from the state supply to purchasing from a wholesaler, new treatments are paused for this week and will begin again early next week,” Lee Health said in a statement.
Physicians Regional Healthcare System in Collier County said it has “a limited supply of remdesivir and is working to acquire more,” according to spokeswoman Brittney Thoman.
The NCH Healthcare System reports some patients are taking remdesivir, but the system will run out soon.
The Naples-based hospital is considering alternative medical treatments being reviewed in scientific literature, Dr. David Lindner, medical director of the COVID-19 response team for NCH, said in an email. He did not elaborate.
“We also hope that we will be able to re-stock our supply (of remdesivir) as soon as possible,” Lindner said.
Florida is an epicenter for new daily infections and has added more than 162,000 cases since Phase 2 reopening began June 5.
On Wednesday, 9,989 new infections were reported, pushing the statewide total to 223,783 cases, according to the state Department of Health. The death toll stands at 3,889.
The public health agency does not report how many people have recovered.
In Lee County, there were 266 new positive tests Wednesday, bringing the total to 8,125. It is the 15th consecutive day Lee has added more than 100 new cases. An all-time high was 530 new cases July 4.
There have been 172 deaths related to the virus in Lee.
In Collier, there were 232 new infections Wednesday for a total of 5,433 cases, and 85 people have died.
Gov. Ron DeSantis has rejected requiring masks in public and the only roll-back to phased re-opening the state was an emergency order banning bars from selling alcohol on premises, which went into effect June 26.
Meanwhile, Walt Disney World in Orlando is scheduled to open Saturday and the state’s public schools have been ordered to open in August.
The three local hospital systems in the region say they can handle the current spike in patients with COVID-19. But Lee Health officials warned that could change quickly.
The publicly-operated Lee Health could run out of beds at the end of the month if tripling of admissions since last month doesn’t slow down, said Dr. Larry Antonucci, president and CEO of the 1,800-bed system.
“If the current trends of the last two weeks continue, it’s possible that Lee Health hospitals would be at full capacity by the end of the month,” Antonucci said in a statement.
Lee Health reported 316 patients with COVID-19 on Wednesday when a month ago it was 100 patients, he said.
The hospital system has 131 adult ICU beds among four campuses and 91% are occupied, according to a daily report. Of the 1,800 beds, 87% are occupied and 23% have COVID-19 patients.
Antonucci has been the most vocal of local hospital leaders to sound alarms the public must get beyond “coronavirus fatigue” and be diligent about social distancing and mask wearing to help reduce spread of the virus.
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NCH can add 95 more ICU or critical care beds combined at its two hospitals and some other rooms can be converted to low-acuity patients waiting for discharge.
“(The) ICU is not just a place but the people and supplies necessary to care for the sickest of the sick,” Lindner said.
The system has a pyramid plan to have the correct number of staff caring for patients, he added.
NCH reported 104 patients with COVID-19 on Wednesday. The daily census was nearly half that at 62 patients two weeks ago.
The hospital system is experiencing a degree of a surge now, Lindner said. How the situation is going forward depends on the community and whether residents embrace masking and appropriate behavior to significantly reduce the pandemic locally, he said.
Physicians Regional in Collier this week has fluctuated with around 45 patients in its COVID-19 units across both campuses, said Thoman.
The system has 28 ICU’s, which are not full, and the ability to manage 50 patients with critical care needs, she said.
“I am confident in the team’s preparedness and ability to handle a surge in our community if it happens,” Scott Lowe, CEO, said in a statement.
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The rising number of cases has caused Lee Health to activate a plan to manage capacity that could include scaling back elective surgeries based on an average of patient volume over three days.
For instance, the volume of elective surgeries would be scaled back by half if the hospitals are nearly full, or reach 97% occupancy.
DeSantis in March had issued an emergency order halting elective surgeries statewide, in part due to low supplies of safety equipment, and the ban was lifted in early May.
Some South Florida hospitals are already scaling back elective surgeries due to spikes in COVID-19 admissions.
Elective surgeries are critical for hospitals' finances. Due to elective surgeries being halted, coupled with costs caring for COVID-19 patients, Lee Health estimates $50 million to $75 million in losses this year.
In late June, Lee Health officials told medical staff that patients scheduled for elective surgeries need to be tested for COVID-19 and to cancel procedures when results are positive, according to an advisory to the medical staff in late June.
That’s a change from a policy of letting the surgeon decide if COVID-19 testing is needed and if post-surgery stays would be needed.
Physicians Regional said it is monitoring elective surgery and no changes are planned for now, Thoman said.
Hospitals are seeing a younger people with COVID-19 infection, compared to early in the pandemic, officials say. They say that could mean shorter hospital stays.
The median age of new positive tests in Collier is 38 and it is 41 in Lee, according to the state health department. The state median age for positive tests is 39.
“The severity of COVID-19 can vary greatly from patient to patient, but in general younger patients are at lower risk of complications,” Lee Health said.
The FHA says hospitals statewide are seeing more younger patients with lower acuity but that’s not always the case.
“We’ve seen young people develop serious symptoms and become hospitalized,” Stickle, the FHA president, said.
In terms of personal protective equipment, such as masks and ventilators, local hospitals say they are well stocked compared to when the pandemic started in spring when all hospitals were scrambling to stock up. Lee Health is working on having a standard three-month supply.
“We continue to have plenty of (personal protective equipment) to be able to safeguard our staff and patients,” according to NCH’s website. “We have planned for this and are positioned to manage the increased volume.”
Hospitals expanded their network of personal protective equipment suppliers and now are more focused on maintaining bed capacity, staffing, the availability of COVID-19 treatments and lab resources, Stickle said.
USA TODAY NETWORK - FLORIDA journalist Dan DeLuca contributed to this report.