Intensive care units across the U.K. are facing drug shortages after dramatic increases in demand brought on by the coronavirus pandemic. Doctors report they are forced to use alternatives to their first-choice treatments, affecting the quality of care being provided to patients with COVID-19. Hospitals in London, Birmingham, and the northwest of England have been heavily impacted by the shortages.
In response to the shortages, the British government has banned the export of 33 essential drugs and ordered a “parallel export” ban on 196 drugs. Parallel exporting occurs when medications purchased in the U.K. are sold in a European Union member state or other European nation.
Some of the drugs in short supply include propofol, a sedative given to patients on ventilators; fentanyl and alfentanil, two opioid painkillers used as sedatives in intensive care; and noradrenaline and clonidine, used to treat life-threatening drops in blood pressure. A notice from the National Health Service, the U.K.’s publicly-funded health care system, to hospitals also warned of limited supplies of atracurium, cisatracurium, and rocuronium, which are muscle relaxants used during intubation.
Health-care workers across the U.K. say they have had to use alternative treatments when providing care to the sickest patients in the ICU due to the shortages, including drugs that are less effective or carry more severe side effects. The redirection of drugs to treat patients with COVID-19 is also having ripple effects on the treatment of other diseases. For instance, supplies of diamorphine, often used for cancer pain, are falling as the drug is being used to reduce breathlessness in patients with the coronavirus.
Most of the drugs on the export ban are used in intensive care, but other drugs in high demand have been added to the list, including insulin and paracetamol (acetaminophen). Ministers have also banned the export of at least three drugs being tested to treat COVID-19, including ritonavir/lopinavir, an HIV antiviral, and hydroxychloroquine and chloroquine, used for the treatment and prevention of malaria.