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Remdesivir, the only drug with an emergency authorization from the FDA to treat coronavirus has come to Illinois. Also, more than 90% of the drug will be set aside for patients in Cook County.
However, there’s not enough remdesivir to go around, in Illinois or anywhere. Luckily, Illinois received 140 cases of remdesivir containing enough of the drug to treat approximately 700 people, or, around five patients per case.
As of May 10, there were 1,232 COVID-19 patients across the state in intensive care units, with 709 on ventilators. Furthermore, the number of cases in Illinois continues to rise.
When it comes to allocating the antiviral drug, there is frustration at the federal level, due to its limited supply. Illinois may feel similar frustration over the allocation of the experimental drug.
Illinois has allocated the first 140 cases of remdesivir to 14 hospitals around the state, with 127 cases reserved for hospitals in Cook County. The remaining 13 cases went to hospitals in Peoria, O’Fallon, Springfield and Rockford.
“It’s not possible for every hospital in Illinois to get a case of remdesivir,” Illinois Department of Public Health Director Dr. Ngozi Ezike wrote in a letter addressed to the state’s hospital chief medical officers.
Ezike said the Illinois Department of Public Health established a set of criteria to determine how to allocate the drug that state officials find equitable, data-driven and transparent.
The criteria prioritize hospitals with the most critically ill COVID-19 patients as well as to safety-net hospitals. Furthermore, hospitals treating communities of color receive preference. Unfortunately, Illinois’ Latino and black residents disproportionately account for most COVID-19 cases and deaths.
Rush University Medical Center in Chicago has received 34 cases, followed by Advocate Christ Medical Center in Oak Lawn, which received 25 cases.
The University of Chicago Medical Center and Northwestern Memorial Hospital each received 10 cases. Northshore Glenbrook Hospital, Advocate Lutheran General Hospital, AMITA Resurrection Medical Center Chicago, Mount Sinai Hospital, John H Stroger Jr. Hospital Cook County and Saint Anthony Hospital each received eight cases.
The Restore Illinois framework separates the state into four regions, coalesced from the state’s 11 Emergency Management System regions. All of the above hospitals are in the Northeast region and are all located in Cook County.
According to Ezike, 5% of the remdesivir has been allocated to North Central Illinois, while the Southern and Central regions will receive 2% each of the state’s initial allotment of remdesivir.
While hospitals in Cook County received 127 cases, the remaining 13 cases of the drug were allocated to four hospitals outside of Cook County; Swedish American Hospital in Rockford received four cases, while HSHS St. John’s Hospital in Springfield, OSF St. Francis Medical Center in Peoria and HSHS St. Elizabeth’s Hospital in O’Fallon each received three cases.
The drug was shipped to the hospitals by the case, following the advice of the Department of Health and Human Services, which warned against sending loose vials.
The Department of Health and Human Services allowed individual states to decided how to allocate the drug, since state and local health departments understand the community-level needs during the coronavirus response. These include the proper distribution of remdesivir, which is in limited supply.
Some residents and lawmakers of downstate Illinois are annoyed that despite low COVID-19 levels compared to Chicago’s, their churches and shops must also remain closed through May. Likewise, their restaurants must remain closed to dine-in customers until at least the end of June.
Governor Pritzker continues to maintain that the highly contagious coronavirus knows no boundaries, and that downstate regions don’t have Chicago’s robust hospital network. If there were a more serious outbreak, they would have difficulty handling it.
“Future shipments of remdesivir are expected to be available. Likewise, the future allocation will favor the hospitals that received the initial allocations,” Ezike said.
The Food and Drug Administration granted emergency use authorization for remdesivir to treat severe cases of COVID-19.
“While the information is limited concerning the safety and effectiveness of using remdesivir to treat hospitalized individuals with COVID-19, the drug has been shown in a clinical trial to shorten the recovery time in some patients,” according to an FDA press release. “It is reasonable to consider that remdesivir might be effective in treating COVID-19, and that, given there are no approved, alternative or adequate treatments, the known and possible benefits of this drug to treat this serious or life-threatening virus outweigh the known and potential risks of using the drug.”
The FDA has left it to individual hospitals to decide which patients are best suited for the treatment.
Remdesivir is administered intravenously, and is reserved for the treatment of severe cases of COVID-19. Severe cases are defined by the FDA as COVID-19 patients with low blood oxygen levels, including patients on ventilators.
Gilead Sciences, the manufacturer of remdesivir, has pledged to donate 607,000 vials of the drug, which will be distributed by the federal government.