Montreal hospitals at risk of running out of key COVID drugs

In Maisonneuve-Rosemont, the hospital has decided to tighten control over the use of a powerful anti-inflammatory drug, tocilizumab.

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

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The Omicron-driven fifth wave has not only led to some scheduled heart and cancer surgeries being postponed in Quebec, but is also beginning to deplete stocks of some COVID treatments, especially in Montreal’s overburdened network of adult hospitals. Additionally, Quebec’s largest pediatric hospital, Ste-Justine, is reporting a 20 percent drop in its surgical volumes due to an increase in COVID hospitalizations of children.

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

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

“We received more doses this week. Each and every week, the government gives the allowance, but it is entirely possible that we will run out of this drug. Now, it is not the only one on the market. There are some medications that can do much the same thing. But they are all kinds of (rare).”

“We still have tons of Decadron,” added Marquis, “so this is another anti-inflammatory drug that we’re giving. But when you go to the next step, to the next level of inflammation, especially for patients coming into the ICU who require very high flow oxygen or who are going to intubation, those are the types of patients you want to give tocilizumab to.” .

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At the McGill University Health Center, doctors are beginning to run out of monoclonal antibodies for a certain group of immunocompromised COVID-positive patients. TVA Nouvelles reported Tuesday that Maisonneuve-Rosemont and two other Montreal hospitals were dealing with a shortage of COVID medications that includes the drug Sarilumab, a treatment also given to those with severe rheumatoid arthritis.

Marquis said that capacity in his ICU is “pretty limited” and “we have to be very careful who gets in and who doesn’t. What is different from the other waves is that we have a higher turnover (of patients). During the first wave, people either died outright or stayed a long time.

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“During the second, third and fourth waves, they were more like younger patients who would stay in the ICU for weeks, even months. Right now, I’m knocking on wood, but what we see is that patients have a shorter rotation, so they stay in the ICU for a few days and then they can go back to the ward. That’s probably thanks to vaccination.”

In contrast, Marquis noted, the ER and wards at Maisonneuve-Rosemont are now under “real, crazy pressure.” On Wednesday night, the Maisonneuve Rosemont emergency room was filled to 133 percent capacity.

“This is where most (COVID) patients end up piling up,” he explained of the ER. “In the ICU, it is very tight. … We are at 100 percent capacity, but we are not in the same place that we were in the first and second wave” of the pandemic.

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Adding to the challenges facing Quebec adult hospitals is that they have fewer staffed beds than at the start of the pandemic due to rising absenteeism among health care workers. Health Minister Christian Dubé said Tuesday that Quebec is struggling to find 1,000 workers to send to hospitals to avoid reaching what he described as the “point of no return.”

Meanwhile, at Ste-Justine, the pandemic is also posing challenges for the pediatric staff. In one case, a COVID-negative child is scheduled for a bone marrow transplant, but has a COVID-positive parent, requiring a reorganization in that patient’s care, spokesman Michel Dumais said.

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

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Reference-montrealgazette.com

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