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Professor Șerban Bubenek, president of the Romanian Society of Anesthesia and Intensive Care, told the Digi24 Evening Journal that there is no transparency in Romania about how Remdesivir, essential in the treatment of very serious cases of Covid-19, is assigned. . Professor Bubenek says that, in a simple calculation, around 1,900 people in intensive care units did not receive Remdesivir, but there is no data on how many of them died from coronavirus. It also says that “Romania does not receive this medicine for its needs” but also that the medical staff is insufficient to manage an epidemic out of control and concludes, drawing attention at the same time, that “the pandemic will be, in the absence of a vaccine, defeated and restrained, if it can be restrained, only by an absolutely normal and responsible behavior of a citizen of the XXI century ”.
“On March 23, a treatment protocol was issued, approved by the Ministry of Health, where together with hydroxychloroquine and caletra, Remdesivir was also indicated for patients admitted to intensive care with severe conditions, intubated, ventilated. Meanwhile, another protocol emerged on August 7: this time Remdesivir treatment is extended, earlier treatment is introduced, from the onset of symptoms, of course, based on clinical studies that have shown that as soon as possible introduced in Remdesivir treatment the better the results, the patient does not necessarily need to be intubated and ventilated, it is enough to have symptoms, to have a tendency to hypoxemia.
During this time we, that is, the Romanian Society of Intensive Care and the Commission of the Ministry of Health of Anesthesia and Intensive Care, addressed a memorandum on May 19 to the Ministry of Health indicating that order 489 established a program for these patients carried out carried out by a working group. Consisting solely of colleagues from other specialties, that is, infectious diseases and epidemiologists, will cause a lot of confusion, what has happened.
In the first period of the pandemic we had signs that these funds, of course, that were so generously made available to the Ministry of Health for patients in certain intensive care units and here we are not referring to hospital wards for major infectious diseases. , Bucharest Cluj, Timișoara, Craiova, etc. We refer to the intensive care units that were not in the infectious disease hospitals and that cared for these patients, at that time they also faced the problem of the supply of hydroxychloroquine.
With Remdesivir the same problem arises, we report it and try to see if there is a clear and transparent mechanism to allocate these resources in the first place. Of course, after my speech in which I drew attention to this, the only positive and transparent reaction that I salute with all my heart is today’s reaction from Professor Rafila who told us that so far they have been treated in Romania. , 2,500 patients with Remdesivir. We do not know how many in intensive care, we do not know how many out of intensive care, we do not know how many with early treatment. If we take into account and know that only in Intensive Care in these months 4400 patients passed, 2500 received them, the rest is a mathematical conclusion.
The problem is not that Romania has not made efforts, the problem is that we have not been transparent enough, nor do I, personally, know how this drug is allocated, how it actually reaches hospitals and because there is a wider range, today, patients who need, of course, people in Romania who can read and can read and who are patients or their children are patients or their relatives, they started asking questions, making phone calls, our colleagues have pointed this out and I think it’s very good discuss transparency.
We do not know if only those who received died or did not die. We currently do not have these data, but there are certainly a number of patients who have not received them. It is not necessarily someone’s fault because Romania was assigned a number of, as I understand from this statement, 25,000 vials during this period. Approximately 10 ampoules per patient, so what Professor Rafila said is perfectly verified, 2500 patients.
The problem is that we must tell the people, the citizens, that it is not enough that we have made an effort to have almost 2,000 fans today. Let us have almost 4,000 sufficiently equipped intensive care beds. Because we have two major problems: one is the problem of staffing, 1100 anesthetists and resuscitators in Romania that we are starting to spread through all kinds of modular hospitals, and the second bad news is that this medicine Romania does not receive when it is necessary. who has them. Perhaps then the population, those who deny the existence of the virus, deny the need for simple protection measures, would understand in what danger they put themselves, in what danger they put their families, in what danger they put their loved ones and they would think of two. or if he walked down the street without a mask and if he went to a party with 300 participants, ”said Professor Bubenek.
Regarding the way Remdesivir reaches Romania but also its availability, Professor Bubenek stated:
“The company that produces it in America (Remdesivir – ed.) Has two methods that make it reach other states, one is a compassionate program for pregnant women and children over 12 years old and a quick access form through the Ministry of Health, a fee. I suspect that the Ministry of Health knows this very well, but the biggest problem that arises today is that this company just announced today that it will no longer deliver the medicine in this way to the states of the world and that they will have to pay a price. decided by that company, which may, at some point, be prohibitive. There is also talk that there would not be enough doses, and it certainly is not, for all the citizens of the planet who need it.
So here the self-protection measures that we have to take become even more important and I am surprised that the citizens of Romania, although they received from the highest level, from the President of Romania, countless times the best message, the most correct message – three measures : mask, wash and disinfect and maintain social distance, stubbornly believe that this pandemic will be overcome by the medical system in the hospital. Not! The pandemic will be, in the absence of a vaccine, defeated and stopped, if it can be stopped, only through absolutely normal and responsible behavior of a citizen of the XXI century ”.
National access to Remdesivir is becoming problematic. Romania already faces insufficient number of doses
The antiviral drug Remdesivir, which is essential for treating people with severe Covid-19, may become inaccessible outside of the United States. The US company that produces it has announced that it will market this drug only directly to US hospitals and not through the US Department of Health. The decision comes in the context in which the company considered that the United States government distributed the drug in a transparent way.
The representative of Romania to the WHO, Professor Alexandru Rafila warned that, in this situation, we should start thinking about how to handle ourselves. According to Alexandru Rafila, the treatment schemes provided by the European Commission now include 2,500 patients. But, if the sale of the drug is completely liberalized, based only on who offers more and faster, Alexandru Rafila believes that there will be competition between countries.
“There are already more than 2,500 patients included in the treatment schemes provided by the European Commission, and after the third installment is delivered, we will probably have to start thinking about doing it ourselves. There will be competition between countries. One is to benefit from a centralized mechanism in which the European Union has another negotiating power and that is why I say that the discussions in the direction of this drug must be addressed in time, ”said Alexandru Rafila.
“We tried to do some separate steps, precisely because we have a lot of patients with moderate or severe forms and we need Remdesivir. (…) And when it happened in the recent past that it was not Remdesivir, we took action anyway and managed to get it out of other units, ”said Adrian Marinescu, infectious disease physician at the Matei Balş Institute.
“We had doses of Remdesivir in the country, we also received them in the hospital last week, but it is insufficient for what we would need and unfortunately, as a recommendation, administration only in severe forms of disease deprives patients of having forms. and who would benefit from this treatment if they received it when needed, “said Andreea Moldovan, epidemiologist, medical director of the Hospital for Infectious Diseases in Brașov.
The doctor says that the doses of Remdesivir recently received by the Matei Balş Institute in the Capital are only enough for 35 patients. He believes that Romania could, in the context of the accelerated increase in the number of cases and serious cases, to a crisis situation in the purchase of medicines, similar to the one we faced at the beginning of the pandemic in relation to the acquisition. of masks and protective equipment.
“Let’s also think about the 200 doses that Matei Balş received. Basically, there are drugs that reach 35 patients, no more, which is insufficient given that they would be treated for five days, the minimum duration of treatment with Remdesivir. I say this only to realize that this amount does not actually represent an extremely high benefit or overabundance of therapy, but instead there are only a few patients who will benefit from this treatment. It is not a problem related to Brașov, Bucharest or Romania, but unfortunately it is an international problem, because it is obvious that as the number of cases increases now, the need for this drug also increases, “said the medical director of the Hospital for Infectious Diseases. in Brașov.
Publisher: Adrian Dumitru
