U.S. May Get More Ventilators But Run Out Of Medicine For COVID-19 Patients There have been dramatic spikes in demand for sedatives, pain medications, paralytics and other drugs that are crucial for patients who are on ventilators.
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U.S. May Get More Ventilators But Run Out Of Medicine For COVID-19 Patients

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U.S. May Get More Ventilators But Run Out Of Medicine For COVID-19 Patients

U.S. May Get More Ventilators But Run Out Of Medicine For COVID-19 Patients

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MARY LOUISE KELLY, HOST:

We've heard a lot about the critical shortage of protective gear for health care workers and about the urgent need for more ventilators to help keep patients with COVID-19 alive. Well, there is another shortage of grave concern. Hospitals are running out of the drugs those patients on ventilators require. NPR's Melissa Block has that story.

MELISSA BLOCK, BYLINE: For a patient in acute respiratory distress, being put on a ventilator can be lifesaving. It's also really unpleasant.

ALIX MORSE: It is deeply uncomfortable.

BLOCK: Alix Morse is a pulmonary critical care physician at Sturdy Memorial Hospital in Attleboro, Mass. She explains when patients are intubated, they're given strong sedatives and pain medicine and sometimes paralytic drugs. Without them...

MORSE: Most people will kind of reach for the tube and try to grab it and pull it out. They may fight against having it in their mouth. And if they're working against a breathing machine, it can actually damage their lungs.

BLOCK: Now, with the surge of COVID-19 patients on ventilators, hospitals are burning through their supplies of those essential medications. Some have run out of certain drugs entirely. Others are down to just a few days' supply. They're even having to ration the use of albuterol, the common drug used to treat asthma. Doctors say they've been urging patients to bring in their albuterol inhalers from home.

Dr. Morse has been watching her hospital's drug stocks dwindle and worrying about her patients.

MORSE: It's the human cost of being scared - maybe being aware on the breathing machine when you really shouldn't be. That really keeps me up at night.

BLOCK: The drug shortages are especially acute in a COVID-19 hot spot like Albany, Ga. That's where Shanti Akers works as a pulmonary critical care doctor at Phoebe Putney Memorial Hospital. They've seen their caseload of patients on ventilators soar from the typical 12 or 15 to as many as 46 at one time.

SHANTI AKERS: At present, we're running through anywhere up to 134 bags of fentanyl. Typically, pre-COVID, that would've lasted us two to three weeks. And now we're running through that quantity in simply a day.

BLOCK: Akers says the problem isn't just the overwhelming number of COVID-19 patients. They're also staying on ventilators much longer. Instead of a few days, it might be two weeks or more. And they require that much more medication.

AKERS: The nightmare really is that I won't have enough ventilators to treat them all at the same time. And even if I get them on a ventilator, I won't be adequately able to sedate them to know that they're safe. And my real worry is that a lot of people will die as a result of that.

DAN KISTNER: We have seen an increase in demand on pharmaceuticals that's unprecedented.

BLOCK: Dan Kistner manages the pharmacy program for Vizient, a group purchasing organization that negotiates lower prices with drug manufacturers. Vizient released data last week showing dramatic spikes in demand for the sedatives, pain meds and paralytics crucial for patients who are on ventilators. But while demand is soaring, Kistner says, the supply chain is lagging far behind. Here's one complicating factor.

KISTNER: Injectable drugs take a long time to make. For instance, there's a 21-day sterility period needed for all injectable drugs. And so it's not something simple that you can do overnight.

BLOCK: Which means, he says, if you ramp up production of ventilators but don't also get a jump on producing the necessary drugs, you've got a big problem.

KISTNER: We're going to build all these cars, but if we don't have the gas, they can't go anywhere.

BLOCK: Adding to the problem, there aren't that many companies that make these drugs, says Erin Fox, a pharmacist at University of Utah Health.

ERIN FOX: These hospital drugs are very, very cheap. It's just not a big profit-making arm for these companies.

BLOCK: Fox has tracked drug shortages for years. She says just as the Trump administration has put pressure on manufacturers to produce more ventilators, it's high time for them to exert the same pressure on drugmakers and ask...

FOX: What are you doing to ramp up supply? What are you doing to make sure that we have enough medicines to treat all the Americans who are sick?

BLOCK: Melissa Block, NPR News.

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