New Jersey hospitalizations from COVID-19, the number of patients in ICUs and the number of patients on ventilators all remain low. But there’s a new warning out about a possible shortage of a drug being used to treat COVID patients.

The American Society of Health-System Pharmacists is voicing concern about low supply levels of the anti-viral drug remdesivir, which is produced by an Egyptian generic drug manufacturer and licensed from patent-holder Gilead.

Mike Ganio, the senior director of pharmacy practice and quality for the society, said a review of the situation indicates “there is just not going to be enough remdesivir for every patient who qualifies to use it.”

While remdesivir is not a coronavirus cure, it has been shown in clinical trials to shorten hospital stays of hospital patients.

Remdesivir is an anti-viral drug, so it’s given as an injection. Patients receive a dose on the first day, and then lower ones on subsequent days, he said.

Ganio said while other drugs help the body cope with the effects brought on by the coronavirus, remdesivir is different.

“As an anti-viral it will directly attack the coronavirus,” he said. “Remdesivir actually has an activity against the virus itself.”

He said when the Food and Drug Administration issued an emergency use authorization for the anti-viral drug, it indicated remdesivir should be used for hospitalized patients who require some sort of supplemental oxygenation — but “if we treated every patient with remdesivir who met that criteria we would probably quickly run out.”

He said for that reason many hospitals have implemented critical criteria on top of the FDA guidance so remdesivir is only given to patients for whom it will do the most good, when oxygen support begins, before a patient is put on a ventilator.

He said the federal government is in charge of how much remdesivir is allocated to every state, so since New Jersey hasn’t had as many cases lately as states like Florida, Texas and California, "New Jersey probably hasn’t been receiving as much remdesivir as those states.”

He said while Jersey hospitals don’t need a lot of remdesivir right now, if there’s a sudden spike there could quickly be shortages.

“There’s patients who would obviously need the drug as the cases of COVID are increasing,” said Ganio.

To conserve supplies, he said, “we need to make sure that we’re using the drug appropriately, ethically, responsibly, so that we have (an adequate) supply.”

Ganio said early on, when the pandemic roared to life in March, New Jersey and New York hospitals had shortages of several important sedatives and analgesics that are used to help paralyzed patients put on ventilators, but various drug shortages have been a problem for the past 20 years.

“Pharmacists have become fairly skilled at managing these shortages, and in a situation with a drug like remdesivir to come together and establish these criteria," he said.

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