Donated supply of key coronavirus drug dries up in Sacramento, Yolo amid surge
As the number of critically ill COVID-19 patients surges, Sacramento and Yolo counties have run out of their allotment of the only antiviral drug that has been proven effective in clinical trials against severe cases of the respiratory disease.
“We currently do not have remdesivir,” said Carolyn Jhajj, the interim public information officer for Yolo County, in an email response to The Sacramento Bee’s query. “We have requested an allocation from the state, but cannot estimate as to when it will be received since allocation is based on greatest need across the state.”
Because supplies of remdesivir are limited, the federal government is coordinating distribution of the medication to states, according to a May 20 advisory from Dr. Sonia Angell, the state public health officer and director. This is how the California Department of Public Health gets its stock.
Gilead, the company that manufacturers the broad-spectrum antiviral drug, donates the medication out of supplies that it does not need for research.
Federal officials said this month that they expect one more shipment from Gilead the week of June 29. While Gilead is making more, Dr. Robert Kadiec, an official with the U.S. Department of Health and Human Services told CNN that he was uncertain of how much will be available this summer and what the delivery timetable will be.
In May, as the first federal distributions made their way to medical providers, hospitals and doctors said they did not understand why some hospitals treating hundreds of COVID-19 patients were not receiving any of the donated drug. They demanded greater transparency regarding federal criteria for distribution.
Sacramento County officials said in an email to The Sacramento Bee that hospitals can request the drug directly from the company.
Charles Casey, a spokesman for UC Davis Health, said: “We are aware there are reported shortages of remdesivir. Since the UC Davis Medical Center is an academic medical center, we have access to remdesivir and a number of other treatments through the clinical trials we run to help validate new treatments for patients. We are currently able to treat patients with remdesivir if it is appropriate for their condition.”
The shortage of the drug comes as populous states such as California, Arizona, Florida and Texas are seeing big increases in hospitalizations. Late Friday evening, Sacramento County reported that 73 COVID-19 patients were in hospitals, 20 of them in intensive care units. Statewide, about 5,600 people are hospitalized as of Friday, nearly 1,600 in ICU’s.
In the May 20 advisory, Angell said the state was scheduled to get a shipment of the antiviral drug from the federal government on June 1 that would be about half the 15,800 doses that were shipped on May 16. That shipment, she wrote, was sufficient to treat 1,436-2,633 patients. A second shipment was expected in June, however, Angell noted.
“For each new allotment received from the federal government, CDPH will use the most recent hospital data for patients with confirmed COVID-19 to proportionately distribute remdesivir to the counties’ medical and health operational area coordinator,” Angell explained.
The operational area coordinators have instructions on how to dispense and track the number of doses given to hospitals. When considering how to distribute the drugs, for instance, they may:
▪ Distribute medication in five-day (six dose) courses to maximize the number of patients who can be treated (as opposed to 10 day courses).
▪ Distribute medication based on the proportion of laboratory-confirmed COVID-19.
▪ Distribute medication based on the proportion of laboratory-confirmed COVID-19 cases who meet established clinical criteria, including being within 10 days of symptom onset.
The coordinators are given flexibility to determine their own methodology, given differences in supply and demand across regions. Sacramento County officials said they had been allotted 372 doses so far.
