NHS doctors are told to RATION Covid-19 treatment remdesivir amid global scramble for drug after US hospitals bought up most of the world's supply
The NHS is already rationing remdesivir, a key drug for treating coronavirus patients, because it is in short supply after the US bought up global stocks in the summer.
Doctors have been told not to give the drugs to the most seriously ill patients and to save it for those who have the 'greatest capacity to benefit'.
The instruction comes early on in the UK's second wave as the number of people being admitted to hospital with Covid-19 is only 10 per cent as high as it was during the peak, and after officials said they were stockpiling the drug.
NHS hospitals around the country were yesterday issued an alert titled 'supply disruption' which warned of an 'increased demand against available supply', which told doctors to be more selective about to whom they give the drug.
The Department of Health denies there is a shortage of the drug, claiming there 'remain plenty of supplies', but said it was being used up faster and more stocks couldn't be delivered until the end of October. It is not clear how much of the medicine the UK has bought.
The American drug, which costs around £2,400 per course ($3,120), was found in trials to reduce Covid-19 patients' recovery times from 15 to 11 days. Doctors are yet to find evidence that it can reduce mortality rates.
The US, where remdesivir manufacturer Gilead is based, was criticised in June for buying up the entire global supply of the drug meaning no new orders could be placed for the three months following. As well as this, Gilead donated 1.5million doses of it for clinical trials around the world, further depleting supplies.
Britain is not alone in feeling the impact of the stocking issue, however, and hospitals in the US and India are struggling to get hold of the drug, too.

American antiviral drug remdesivir has been rationed in NHS hospitals, after shortages were also reported in the US. It can reduce Covid-19 patients' recovery times. (Stock)

The decision comes as the rate of daily hospitalisations in the UK almost doubles within a week
Hospitals were advised to ration use of the drug in an emergency alert and were told the restrictions were likely to remain in place until at least the end of this month.
The alert ordered staff to deny remdesivir to the most seriously ill patients, including those on ventilators, demanding it should only be given to people with the 'greatest capacity for benefit'.
It said: 'Due to increased demand against available supply, clinicians are now asked to apply the full eligibility criteria ... last published on 3rd September 2020...
'Clinicians are also asked to adhere to a standard treatment course of 5 days.'
It says that for people to be eligible for remdesivir they should be in hospital with Covid-19 and pneumonia but not using a ventilator.
When the drug was first given emergency clearance for use with coronavirus patients, the NHS said it could be used for adults and people aged 12 years and over.
Health officials also said it should be given for up to 10 days to help stave off the worst symptoms of coronavirus.
But an advisory note says that in times of 'limited supply' patients will only receive the drug if they have 'the greatest capacity for benefit'.
Guidance explains it will only be available to 'patients in the early stages of respiratory failure' should there be a shortage.
A Department of Health spokesperson said the UK was expecting more deliveries of remdesivir at the end of this month, implying that if current stocks run out they can't be replaced for a month.
The Department said: 'We are aware of a rise in the use of remdesivir in line with an increase in Covid-19 hospital cases.
'While there remain plenty of remdesivir supplies, we have asked the NHS to temporarily prioritise patients to ensure those most likely to benefit can access it.
'Patients are also receiving other approved treatments, for example dexamethasone or hydrocortisone, which have been proven to save lives and are in good supply.
'The UK is leading the way on research to find and fast-track more potential treatments, including through the landmark RECOVERY trial which brought lifesaving treatment dexamethasone to NHS patients.'
The alert comes after it emerged in June that the US had bought up three months' worth of Gilead's entire supply of remdesivir.
Scientists hit out at the nation's decision to hoard all of the drug for its own medics and said other countries were left wanting.
The US Department of Health and Human Services (HSS) revealed it had secured more than 500,00 treatment courses of remdesivir for American hospitals, whiich was the global supply for July, and 90 per cent of all stocks for August and September.
The US president faced accusations of 'undermining' the global coronavirus fight by splashing the cash on one of only two drugs known to treat Covid-19 that are available on the NHS.
Dr Andrew Hill, from Liverpool University, told The Guardian at the time: 'They've got access to most of the drug supply so there's nothing for Europe.'
The Government's Business minister Nadhim Zahawi was among those who criticised the decision of Britain's closest ally, telling them it was 'much better to work together'.
Now, hospitals in the US have also warned of a shortage of the urgently-needed drug at the beginning of last month.
A report by the country's Food and Drug Administration (FDA) found 38 hospitals have experienced critical shortages since July.
They also noted there was patchy and inconsistent supply of the drug from its manufacturer Gilead.
Hospitals in Ohio received more courses of the drug than those in Georgia, even though the latter was battling with three times more coronavirus patients.
Rochelle Walensky, chief of infectious diseases at a hospital in Boston, said at a press conference last month: 'We do not have enough remdesivir nationally.
'Currently it's the only antiviral against Covid-19. It can shorten the time to recovery and stave off ICU-level disease. I'm very worried about the fall and winter surge.'
The chief of disease at the University of Texas, Tom Patterson, has also warned that they only had enough remdesivir to treat a third of patients at the height of the pandemic.
Indian hospitals are suffering too because of manufacturing failures.
There are companies in India other than Gilead that have licences to produce their own versions of the drug but they have been struggling to increase production, the Economic Times reports.
The Maharashtra region of India, which is the worst affected by Covid-19, has struggled to get supplies of remdesivir into its hospitals.
One hospital chief in the area said: 'We are finding it difficult to get the drug when we are looking to reorder.
'Earlier we would get the supply within a gap of five days, now it is taking 10 days.'
The Trump administration has faced mounting criticism for failing to address the shortage by licensing other companies to make the drug after Gilead acknowledged in June 'there is no assurance that we will be able to meet global supply needs for remdesivir'.
Hospitalisation rates in the UK have risen almost three-fold since the beginning of last month, although hospitals still reportedly have plenty of capacity.
There were 132 people admitted to hospital on September 1, which had risen to 323 by September 27, the latest date for which data is available.
The number of patients on ventilators with Covid-19 also currently stands at 332, a tenth of the 3,228 who were using them at the height of the pandemic on April 11.
Hospital admissions have leapt 58 per cent, according to the seven-day rolling average, with 13 per cent of all those in hospital being on ventilators.
Calculations reveal this number is up 79 per cent week on week at present, amid mounting concerns it could rise still higher due to a spike in cases.

The drug is manufactured by Gilead, which has been unable to make enough to meet demand

Drug is manufactured by Gilead, which has warned it will not be able to keep up with global demand. (Stock image of their head office in California)
Remdesivir had originally been developed to treat Ebola, but trials later revealed it could also assist coronavirus patients.
Doctors in Wuhan revealed in February, writing in the prestigious medical journal Nature, that the drug is 'highly effective' in the control of infections.
In March a US woman made a full recovery after being critically ill with Covid-19 when she received the drug.
Within a day doctors recorded a drop in the quantity of virus in her body as her condition began to improved. They first administered the drug to her 36 hours after she was admitted to hospital.
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