CORONA CRISIS RUNNING OUT FAST ... DRUGS TO SAVE VICTIMS
TOP medics warned last night that doctors are running out of drugs to treat the sickest coronavirus patients.
Three experts said there are supply issues with a crucial sedative for those desperately needing ventilation.
One consultant warned his hospital lacked enough propofol for the week amid a “nationwide shortage”. He said lives would inevitably be lost as intensive care beds would have to be rationed.
Royal College of Anaesthetists’ Prof William Harrop-griffiths, chairman of the clinical quality and research board, also warned of a shortage.
Doctors said reserves of painkiller fentanyl and circulation boosting drug noradrenaline, also called norepinephrine, both key to treating patients on ventilators, are drying up.
Experts said using less advanced drugs would mean patients take longer to recover, using up vital intensive care capacity as the health service is stretched to breaking point.
Their warnings come as the UK’S coronavirus death toll rocketed by 917 to 9,875, with an 11-year-old among the latest victims.
Rationed
Brave consultant anaesthetist Anthony Beaumont, 62, who has come out of retirement to help fight the virus, said: “We’re running out of drugs.
“Nobody saw this pandemic coming and to expect the health service to be ready for it is unfair. The infrastructure is just not up to it.”
Another frontline doctor, who asked not to be named, said: “These drugs are being rationed centrally by the Department of Health and Social Care.
“We have enough propofol for about five days. We will use older drugs like morphine and midazolam to sedate patients. The problem is they’ll take significantly longer to wake up.
“The normal length of stay in ITU [intensive care] for someone with pneumonia caused by flu is about five days, but we are up to 15 to 20 days with Covid patients.
“Essentially, this means another patient can’t be admitted for lifesaving treatment. It’s extremely worrying.”
This is the latest challenge for frontline medics. They are already faced with comforting dying patients who cannot spend their final hours with loved ones due to infection control measures.
Those on ventilators need to be kept asleep and medics prefer to use propofol. Anthony, who has returned to work at the ITU in Kent and Canterbury Hospital, explained: “Propofol is an extremely good drug because it’s effective, quick and devoid of side effects. It sends you into a nice sleep and has a good safety margin. When you’re in intensive care on a ventilator you need to be kept asleep so we give this drug continually via an infusion pump, usually in combination with an opiate like fentanyl.
“This combination keeps you out of pain and represses your respiratory drive. It’s a really good combination and one of the positives is that the patient wakes up very quickly as soon as the propofol is turned off.
“There is a shortage –this could mean that operating theatres will get first pick. If this happens, there are plans to use other drugs like midazolam with morphine. But midazolam is not as good as propofol because it can take hours, sometimes days, for people to wake up after taking that.
“It’s more commonly used for very unwell and unstable people and it can cause a reaction to blood pressure.
“And, of course, if it takes days for a patient to wake up, that means your occupancy will increase. There won’t be enough beds for other patients.”
There are currently over 16,000 people in UK hospitals with coronavirus – around a third of whom will require ITU treatment at some point. But the
Government’s chief scientific adviser Patrick Vallance said we may be weeks away from the peak of the outbreak, meaning demands for drugs like propofol could surge.
Global drug supply chains have been hit hard by the pandemic.
At the same time demand for propofol has skyrocketed due to the number of patients on ventilators.
Just 100ml of propofol costs around £20 and although the drug is produced by British firm Astrazeneca, a large volume is manufactured in China. Drug