Tuesday, January 25, 2022

Montreal hospitals threaten to run out of key COVID drugs

In Maisonneuve-Rosemont, the hospital has decided to tighten controls on the use of Tocilizumab, a powerful anti-inflammatory drug.

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Maisonneuve-Rosemont Hospital is at risk of running out of a life-saving COVID drug in its intensive care unit within the next 10 days, amid a continuing high number of ICU patients suffering from the pandemic disease, the Montreal Gazette has learned.

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The fifth wave, powered by Omicron, has not only called off some scheduled cancer and cardiac surgeries in Quebec, but has begun to deplete stocks of some COVID treatments, particularly those in Montreal’s overburdened adult hospital network. In addition, Quebec’s largest pediatric hospital, Ste-Justine, is reporting a 20 percent drop in its surgical volumes due to COVID hospitalizations among children.

In Maisonneuve-Rosemont, just east of the Olympic Stadium, the hospital has decided to tighten controls on the use of tocilizumab, a powerful anti-inflammatory drug. This expensive drug is also given to some cancer patients who are at risk of dying.

“Last week, we had very little, little left,” Dr. François Marquis, head of the ICU at Maisonneuve-Rosemont, said in an interview on Wednesday.

“We got more dosages this week. Every week the allocation is given by the government, but it is very likely that we will run out of this drug. Now, it is not the only one on the market. There are some drugs that do pretty much the same thing. But they are all kind (in short supply).”

“We still have a lot of Decadrone,” Marquis said, “so this is another anti-inflammatory drug that we’re giving. But when you move to the next stage, that next level of inflammation, especially in the ICU.” For patients on the go, who require a lot of flow oxygen or are headed for intubation, those are the types of patients where you want to give tocilizumab.”

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At McGill University Health Center, doctors are starting to run low on monoclonal antibodies for a certain group of COVID-positive immunocompromised patients. TVA Nouvelles reported Tuesday that Maisonneuve-Rosemont and two other Montreal hospitals were battling a COVID drug shortage that contains the drug Sarilumab, a treatment also given to people with severe rheumatoid arthritis.

Marquis said the capacity in his ICU is “quite tight” and “we have to be very careful about who is getting admitted and who is not. What is different from the other waves is that our business ( of patients).

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“During the second, third wave and fourth waves, it was more like young patients who would be in the ICU for weeks, months. Right now, I am touching the wood, but we see that patients have a low turnover, so they stay in the ICU for a few days and then they can go back to the ward. It’s probably thanks to vaccinations. ,

In contrast, Marquis said, Maisonneuve-Rosemont’s emergency room and ward are now under “real, insane pressure.” On Wednesday night, Maisonneuve Rosemont’s ER was filled to 133 percent of its capacity.

“This is where most (COVID) patients congregate,” he told the ER. “In the ICU, it is very tight. …we are at 100 per cent capacity, but we are not at the same place where we were in the first and second wave of the pandemic.

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Adding to the challenges facing Quebec’s adult hospitals is that they have fewer staffed beds than at the start of the pandemic due to increased absenteeism among healthcare workers. Health Minister Christian Dubey said on Tuesday that Quebec was scrambling to find 1,000 workers to send to hospitals, which he described as a “point of no return”.

Meanwhile in Ste-Justine, the pandemic is creating challenges for the pediatric staff as well. In one case, a COVID-negative child is scheduled for a bone-marrow transplant but has a parent who is COVID-positive, requiring restructuring in that patient’s care, spokeswoman Michel Dumais said.

On Tuesday, 22 patients were infected with COVID in Ste-Justine, but six were admitted solely because of the pandemic disease, while others tested positive at the hospital for other medical reasons.

[email protected]

twitter.com/Aaron_Derfel

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