31st March 2020 – Hospitals are rapidly running out of essential drugs for treating COVID patients in intensive care units. In the absence of European collaboration to ensure a steady supply of these drugs, front line COVID hospitals may no longer be able to provide adequate intensive care in one to two weeks from now.

The European University Hospital Alliance (EUHA), already called upon national governments and the EU to keep borders open for the supply of medical goods earlier this month. We now, and even more urgently, call upon our regional, national and the European authorities to intensify collaboration and coordination for the supply of medical goods and in particular for the supply of essential drugs for intensive care patients.

We are all aware and thankful for the rapid reaction, the courageous and far-reaching measures that regional and national authorities have taken to slow the spread of the virus and to ensure a sufficient supply of medical goods. However, the situation has now evolved to the point that international collaboration and coordination is absolutely needed.

A survey of EUHA members revealed that on top of the need for personal protective equipment and ventilators, the most urgent need now is for the drugs that are necessary for intensive care patients. The existing hospital stocks of muscle relaxants, sedatives and pain-killing drugs are consumed rapidly and with insufficient or non-existing resupply have now become the limiting factor in the care for COVID patients. Our members assume that, at the current rate of consumption, their stocks will be empty in a couple of days in the hardest hit hospitals and in two weeks’ time in those with the biggest stocks. Although we have no exact data, we are convinced that the situation is not better in most of the other hospitals in all of our countries. This has already led some hospitals to buy alternative drugs or dosages from those they are used to. It is extremely worrying that overworked and often less experienced nurses and doctors-in-training, drafted in to fill the gaps, have to use products and dosages that they are not used to.

Some authorities have reacted by closing their borders to the export – but not the import – of these drugs. Understandable as this may be to safeguard rapidly decreasing stocks, it will have an adverse effect if it prevents these drugs being exported to cross-border hospitals in need of those drugs. The availability of drugs depends on international distribution networks with specific drugs (including generic drugs) only manufactured at a few sites worldwide. No single country in Europe has the production facilities to provide all of the drugs (or PPE, or ventilators) needed. Moreover, if as a result of ongoing studies, specific drugs may be shown to be active against the corona virus, a coordinated response is again essential to ensure the drug is available to those that need it most and to maximize the benefit. A coordinated European action will be of vital importance in view of the fast approaching and worldwide search for these drugs, which will follow the rapid increase of COVID cases in other parts of the world.

This is why we call upon our authorities to initiate effective collaboration and coordination for the production and distribution of these essential drugs at a European level.

 

This statement is supported by:

Allgemeines Krankenhaus der Stadt Wien – Medizinische Universität Wien; Vienna, Austria

Dipl.-Ing. Herwig Wetzlinger, CEO General Hospital of Vienna
Prof Oswald Wagner, Head of the department of Laboratory Medicine, Vice-President for Clinical Affairs; Medical University of Vienna
Prof Gabriela Kornek, Chief Medical Officer
Prof Klaus Markstaller, Head of the department of Anaesthesia, Intensive Care Medicine and Pain Medicine
Prof Markus Zeitlinger, Head of the department of Clinical Pharmacology
Mag. pharm. Martina Anditsch, Head of the Hospital Pharmacy

Charité – Universitätsmedizin Berlin; Berlin, Germany

Prof Dr Heyo Kroemer, CEO
Prof Dr Ulrich Frei, Chief Medical Officer
Dr Miriam Stegemann, Infectology Specialist

Erasmus MC; Rotterdam, the Netherlands

Prof Dr Ernst Kuipers, CEO
Prof Dr Hans van Leeuwen, Dean and vice-chair executive board
Prof Dr Diederik Gommers, Head of the Intensive Care Unit
Prof Dr Hugo van der Kuy, Head of the Hospital Pharmacy /Clinical pharmacologist

Karolinska University Hospital; Stockholm, Sweden

Dr Björn Zoëga, CEO
Dr Annika Tibell, Director for Research and Education and Deputy CEO
Dr Torbjörn Söderström, Chief Medical Officer

Ospedale San Raffaele; Milan, Italy

Ing Elena Bottinelli, CEO
Anna Flavia d’Amelio Einaudi, Managing Director Vita-Salute San Raffaele University
Ing Federico Esposti, Chief Transformation Officer

Vall d’Hebron Barcelona Hospital Campus; Barcelona, Spain

Dr Albert Salazar Soler, CEO
Dr Joan Comella Carnicé, Director Vall d’Hebron Institute of Research
Dr Maria Queralt Gorgas, Head of the Hospital Pharmacy
Dr Ricard Ferrer, Head of the Intensive Care Unit

Assistance Publique – Hôpitaux de Paris; Paris, France

Martin Hirsch, CEO AP-HP
Prof Rémi Salomon, Medical Director
Prof Bruno Riou, President of the Conference of Deans of Medicine Faculties, Ile-de-France Area
Prof Catherine Paugam Burtz & Marc Samama, Deputy President and President of AP-HP College of Anaesthesia –  Critical Care
Prof Antoine Vieillard Baron, President of College of Intensive Care Medicine, Ile-de-France Area
Prof Jean-Louis Beaudeux, Dean of the Faculty of Pharmacy, Université de Paris
Prof Marc Pallardy, Dean of the Faculty of Pharmacy, Université de Paris – Saclay

And with further support from:

Prof Patrice Diot, President of the French National Conference of Deans of Medicine Faculties
Prof Bernard Muller, President of the French National Conference of Deans of Pharmacy Faculties
Prof François-René Pruvot, President of the French National Conference of University Hospitals Medical Directors
Dr Thierry Godeau, President of the French National Conference of Hospitals Medical Directors
Catherine Geindre, President of the French National Conference of Universitary Hospitals CEOs
Francis Saint Hubert, President of the French National Conference of General Hospitals CEOs

King’s Health Partners; London, the United Kingdom

Dr Ian Abbs, CEO and CMO Guy’s and St Thomas’ NHS Foundation Trust
Prof Sir Robert Lechler, Senior Vice President/Provost (Health), King’s College London, and Executive Director of King’s Health Partners

The University Hospitals Leuven; Leuven, Belgium

Prof Dr Wim Robberecht, CEO
Prof Dr Gert van Assche, Chief Medical Officer
Prof Dr Geert Meyfroidt, Intensivist
Prof Dr Eric van Wijngaerden, Head of Internal Medicine