Dr Balkrishna Adsul, the dean said, the hospital had never before faced such a shortage. Its 250-bed ICU is fully occupied. Adsul said he was hoping to get 15 vials from the BMC’s central purchase department by Sunday night, but if that doesn’t pan out, he will have to send out an SOS to KEM, Cooper and Sion hospitals.
He said there are enough stocks of tocilizumab, another drug used to treat Covid-19.
The crisis at the hospital couldn’t have come at a worse time. There’s a statewide shortage of remdesivir and the government recently issued fresh usage guidelines which allow even patients affected moderately by Covid-19 to be administered the antiviral drug, prompting fears of further shortfall and black-marketing. So far, the drug was only given to severely ill and critical patients.
Released by Dr TP Lahane, head of the Directorate of Medical Education and Research, on September 13, the guidelines said those moderately sick and who score above nine on the 15-point CT scan severity index can be given the jabs under strict supervision, provided their families’ consent is first taken.
But, the circular said, such intervention is best within 10 days of infection and should be limited to five days of usage. Doctors are worried that following these guidelines will do more harm than good, and will encourage hoarding as well as indiscriminate use of the drug.
The state government isn’t overlooking these concerns. On September 22, FDA Minister Rajendra Shingne said by the end of the month more than 1.5 lakh remdesivir injections would be made available and a special campaign would be launched against its black-marketing. In India, Cipla, Dr Reddy’s, Hetero, Mylan, Zydus Cadila and Jubilant have the licence to manufacture the drug. Each has the capacity to produce 1 lakh vials a month.
Three days after Shingne’s assurance, Health Minister Rajesh Tope said all Covid-19 hospitals will be directed to rationally use the drug.
But healthcare workers have warned that Mumbai is already too deep into the crisis. “Several hospitals have exhausted their stocks. Civic-run hospitals in satellite towns, too, are not getting fresh supplies. We are getting inquiries from several hospitals and individuals,” said Naief Memon, a healthcare consultant who is helping many hospitals source the drug.
He said the shortage has primarily been created because of low rate bids by some companies. “Other companies are not able to supply at those rates.” Last month, with more companies getting the approval to manufacture remdesivir, the price had dropped to Rs 2,626 per vial from over Rs 4000 when it was first produced in the country in July.
Jalil Parkar, senior pulmonologist at Lilavati Hospital, said while supply of remdesivir was always rationed for private hospitals, he was surprised that BMC-run facilities, too, are facing a dearth.
A doctor from a state-run Covid-19 hospital said healthcare centres monitored by the government and civic bodies not only have to grapple with the drug shortage but also a fund scarcity.
“Even when there are supplies, we do not have the money to buy them. We had recently suggested that a portion from the chief minister’s relief fund be set aside for the next few months to purchase remdesivir.”