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NGHS finds remdesivir useful as COVID-19 treatment, but future supply uncertain
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Staff don full PPE at the Northeast Georgia Medical Center in Gainesville while working May 15, 2020, on the COVID-19 area of the hospital. - photo by Scott Rogers

Northeast Georgia Medical Center doctors have been using the anti-viral drug remdesivir to treat COVID-19 patients since May, but the state may not be able to supply additional doses once supplies run out. 

“This medication works by reducing the virus’ ability to replicate and spread in the body,” Dr. Supriya Mannepalli, chair of NGMC’s Infection Prevention and Control committee, said in a statement. “I am usually fairly conservative in my evaluation of new drugs, but this one has truly impressed me and has been life-saving for many.” 

Mannepalli said NGMC started using the drug May 18, and as of July 7, 144 patients had begun a course of treatment with remdesivir at Northeast Georgia Health System’s four hospitals in Gainesville, Braselton, Winder and Dahlonega. 

Patients are being treated with steroids along with remdesivir. Mannepalli said some patients are also receiving convalescent plasma, antithrombolytics and Tocilizumab. 

Convalescent plasma is a type of blood donation collected from COVID-19 survivors that may contain antibodies that can fight the virus. Antithrombolytics prevent blood clotsTocilizumab is an anti-inflammatory drug. 

Mannepalli said the majority of the hospital’s remdesivir was supplied by Gilead Sciences, a pharmaceutical company, and was allocated to the health system by the Georgia Department of Public Health.

 But the hospital’s request for additional remdesivir has been denied. 

“The guidelines for distributing remdesivir to Georgia hospitals include the number of positive patients on ventilators, the number of patients being treated with extracorporeal membrane oxygenation (ECMO), the availability of remdesivir and how much hospitals have on hand from previous allocations,” DPH spokeswoman Nancy Nydam said in an email. “At the time of the last allocation, there were other hospitals who met these criteria over NGMC.” 

Nydam said DPH does not yet know when the next allocation of remdesivir will be, as federal guidelines will be changing and the state is waiting on details.  

At the level of current use, NGHS would run out of remdesivir in less than two weeks, although a recent increase in COVID-19 cases could affect that prediction, Mannepalli said.  

“We are pleased with the results we’ve seen with the treatment so far, and we would very much like to have more on hand to treat the increasing numbers of COVID-19 patients coming to our hospitals,” she said. 

Mannepalli said NGHS does not have any other antiviral medications for use in treating COVID-19. If the health system runs out of remdesivir, patients will be treated with steroids and Tocilizumab, she said. 

“As COVID-19 was just beginning to spread, our providers were using hydroxychloroquine to treat patients confirmed to have COVID-19, but we are not using it now,” she said. “…I have not looked at the data in detail, but in my experience, I cannot tell whether it helped patients or not.” 

On Friday, NGHS was treating 72 COVID-19 patients at its facilities.  

Remdesivir was authorized by the U.S. Food and Drug Administration on May 1 for treatment of hospitalized patients with confirmed or suspected COVID-19. A National Institutes of Health clinical trial had shown the drug shortened recovery time in some patients.  

The emergency authorization by the FDA allows remdesivir to be administered intravenously by health care providers to patients with severe disease, which is defined as “patients with low blood oxygen levels or needing oxygen therapy or more intensive breathing support such as a mechanical ventilator.”