The Virginia Department of Health has reported that Fauquier Hospital is one of 55 hospitals that received an allotment of the drug remdesivir, a drug being studied as a treatment for COVID-19. Fauquier Health CEO Chad Melton confirmed that a shipment arrived Wednesday morning (May 20).
Melton said the hospital was fortunate to receive a shipment in the lottery-style random allocation.
Gary Matthews, director of Pharmacy at Fauquier Health, said, “The remdesivir that Fauquier Health received was from Virginia’s share of a national donation by the drug manufacturer, Gilead, as authorized by the FDA’s ‘Emergency Use Authorization.’ " He said the shipment of medication came with "standard dosing protocols from the manufacturer and the VDH, that have been reviewed and adopted by our medical staff.”
Hospital officials preferred not to specify how may patients could be treated with the allotment they received.
Fauquier Health Chief Nursing Officer Christine Kress said Wednesday, “We are uncertain of when additional doses may arrive, as the supply is limited and is being prioritized for facilities in greatest need. The hospital is actively engaged and participating in the appropriate federal and state processes to ensure our eligibility to receive a fair allocation of remdesivir to treat patients with COVID-19.
"Based on the specific allocation formula in place – which takes into account the number of COVID-19 cases reported within our facility and also the prevalence of community spread – we can confirm as of today that we have received our first limited supply shipment of remdesivir." Kress emphasized that "the supply amount is based on appropriate allocations based on our prevalence of disease at the local level.”
She added, “We are actively collaborating with state and local officials to address the health needs of the community and utilizing best practice recommendations and advanced treatment options to treat patients with COVID-19. The use of remdesivir to treat COVID-19 patients will be dependent upon multiple factors, including severity of case and an established list of protocols and criteria. Treatment will ultimately be decided upon by the patient’s provider and care team.”
The following questions and answers about remdesivir were provided by the Virginia Department of Health on May 13:
What is remdesivir?
Gilead Sciences Inc., the pharmaceutical company that makes remdesivir, received an Emergency Use Authorization from the U.S. Food and Drug Administration on May 1 to allow the medication to be utilized by hospitalized COVID-19 patients with severe disease.
Why did the FDA authorize emergency use of remdesivir?
The National Institutes of Health and Gilead Sciences worked together to conduct a randomized controlled clinical trial of the investigational drug in hospitalized patients. Preliminary results suggested that remdesivir was associated with faster recovery, although the data was not sufficient to determine if the drug was associated with lower mortality. Preliminary results indicate that patients who received remdesivir had a 31% faster time to recovery than those who received a placebo. Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received a placebo.
Those who received the drug displayed a mortality rate of 8%, compared to those who received a placebo (11.6% mortality rate).
Which patients can receive remdesivir?
The emergency use authorization of this unapproved product is for the treatment of suspected or confirmed COVID-19 cases in adults or children hospitalized with severe disease.
Severe disease is defined as patients with a low oxygen saturation or requiring supplemental oxygen, a ventilator, or requiring extracorporeal membrane oxygenation. [An ECMO machine pumps blood from the body and oxygenates it – allowing the heart and lungs to rest – and then pumps it back into the body.]
How much remdesivir has Virginia received?
VDH received an allotment of 10 cases on Monday, May 11. Each case includes 40 vials of medication, with 100 mg of remdesivir in each vial. Ten cases of this medication equates to treatment for about 36 patients, using a 10-day course of this drug. A prior shipment of 33 cases of remdesivir, as determined by the White House Taskforce/U.S. Health and Human Services, was provided to Inova Health System in a separate package.
[Another shipment of remdesivir was reported by the VDH on May 19. This is the distribution through which Fauquier Hospital received its share of the drug. The total allotment included 96 cases of the drug, enough to treat 350 to 400 patients, according to the Virginia Mercury.]
The VDH Division of Pharmacy Services was responsible for receiving, storing, and distributing the remdesivir, along with any future shipments of the drug. The distribution plan takes into account community-level needs and the limited supply, with input from the Virginia Emergency Support Team Unified Command, Virginia Hospital and Healthcare Association (VHHA) and the governor’s office.
The distribution of the initial remdesivir to acute care hospitals was determined by a random selection model (lottery system) based on confirmed COVID-19 positive patients and a hospital’s ability to support the clinical use of remdesivir.
There are ongoing clinical trials evaluating the effectiveness of remdesivir in treating COVID-19. Various Virginia hospitals are participating. For more information, visit clinicaltrials.gov.
A spreadsheet detailing the hospitals who were scheduled to receive remdesivir is here.