Cut off in mid-treatment: Israel running out of lifesaving COVID drug remdesivir

As COVID-19 cases surge, a drug that is emerging as Israel’s new weapon against the virus is running low, and at least two hospitals are unable to get hold of it.

Remdesivir, developed in the US and delivered to Israel before much of the rest of the world, has wowed many doctors in recent weeks in its ability to reduce the impact of COVID-19 in serious patients.

The drug is “quite amazing,” as is another increasingly popular medicine dexamethasone, said Michael Halberthal, general director of Rambam Health Care Campus in Haifa, saying both are helping doctors manage the second coronavirus wave better than the first.

The US-based company that has developed remdesivir, Gilead Sciences, announced on Friday that the latest results from ongoing clinical trials suggest that patients who are given the drug have a 62 percent reduction in the risk of mortality compared to others. Gilead also concluded that those who recover do so more quickly.

Michael Halberthal, director-general of Rambam Health Care Campus (courtesy of Rambam Health Care Campus)

But Israel’s remdesivir stock is depleting, to the point that a Rambam patient who was mid-treatment had his supply cut off.

Rambam’s spokesman David Ratner told The Times of Israel: “We have a patient in serious condition who is ventilated and he received one course for a few days. When Rambam asked for a second course for him we were told [there is] no more remdesivir in Israel.”

The Health Ministry manages remdesivir stocks, and transfers them to hospitals as needed.

Asher Shalmon, head of the ministry’s international relations, told The Times of Israel: “I don’t know if we’ve run out, but there is a shortage.”

He said that the government is “negotiating with the company” and also trying to use “diplomatic connections” to procure the drug.

This development comes as Israel is in the thick of a COVID-19 second wave. According to official figures, Israel’s active infections are at an all-time high of 18,940, including 1,148 new cases recorded Saturday. With the latest rise, the number of active cases has overtaken the number of Israelis who have recovered from the virus, which stood at 18,915.

A drill at Rambam Health Care Campus to transform the underground car park into an emergency hospital for large numbers of coronavirus patients (courtesy of Rambam Health Care Campus)

Some hospitals are feeling the impact before others.

Eyal Leshem, a senior doctor at Sheba Medical Center in Ramat Gan, said his hospital is unable to source any remdesivir. However, a spokeswoman at Shaare Zedek Medical Center in Jerusalem said her institution hasn’t had any requests rejected.

Supplies of remdesivir globally are very limited, but a month ago Israel’s government accepted a shipment from Gilead Sciences, and described the transfer of an unknown quantity of the drug as a “donation.”

Last week remdesivir became the first drug authorized by the European Union to treat COVID-19, two months after being given an Emergency Use Authorization in the United States. Gilead’s test data released on Friday suggested that 74.4% of remdesivir-treated patients recovered by day 14, versus 59% of patients who didn’t receive the drug.

Meanwhile, doctors are increasingly interested in dexamethasone, a drug in plentiful supply that is generally used to reduce inflammation in arthritis and other diseases. A non-peer-reviewed study last month suggested that given to the most seriously ill COVID-19 patients in hospitals, it reduces death rates by about a third.

The abundance of dexamethasone does not compensate for the remdesivir shortages, however, as the two drugs are used differently in the treatment of COVID-19, and are occasionally administered together.

A vial of remdesivir is pictured during a press conference about the start of a study with the anti-viral drug at the University Hospital Eppendorf (UKE) in Hamburg, Germany, April 8, 2020. (Ulrich Perrey / POOL / AFP)

Doctors in Israel say that these drugs help to explain why, amid the sharp increase in hospitalizations and serious cases, patients are faring better in treatment than they did in the first wave.

Both Halberthal and Leshem said hospitals are reaping the benefits of these drugs, as well as more staff experience in dealing with coronavirus and a lower average age of virus patients.

Leshem said of the drugs: “We use them on our patients who are characterized as moderate to severe, so about a third to half of hospitalized patients.”  The medicines “shorten the severe phase,” he reported.

Times of Israel staff contributed to this report