In Ludhiana, patients’ kin scramble to source out-of-stock tocilizumab injections
Ludhiana district, which had already been reeling under shortage of Covid vaccines, is in for another challenge — unavailability of tocilizumab, a drug which according to studies might reduce the risk of invasive mechanical ventilation or death in patients with severe infection.
To top it all, hospitals are expressing helplessness and asking the attendants of patients to arrange the medicine. The sudden dearth of drug has led to a mad rush among the patients’ relatives as those ‘not so resourceful’ are frantically calling their friends and looking for some ‘influential contact’ to source the medicine. Social media platforms are flooded with distress messages and requests for tocilizumab.
Rishi Sood, a drug trader, said, “There already is an acute shortage of beds for Covid patients. If one becomes available, then the relatives have to run from pillar to post to arrange medicines such as tocilizumab. The drug is currently not available.”
It is not the first time that the city hospitals are facing a tocilizumab crunch. In August last year too, when the Covid cases had begun to peak, the drug marketed by a Swiss multinational pharmaceutical company as Actemra was sold in the black market for nearly ₹40,000.
GS Chawla, general secretary of the Chemist Association of Punjab, has claimed that there is an acute shortage of remdesivir, while tocilizumab is not available across the country as its salt is sourced from abroad while the medicine is being manufactured in India. “The government has taken the distribution of the medicine under its control and it is being allocated to the hospitals as per the requirement,” he added.
‘In this war-like situation, we are on the frontline without ammunition’
Dr Rajoo Singh Chhina, director, gastroenterology, Fortis Hospital, Ludhiana, and technical adviser, United Nations Industrial Development Organization (UNIDO), blamed hoarding for the current crisis.
“There is no stock available in the hospitals and we keep hearing stories of how a handful of people are putting lives at stake by hoarding the medicine. It is a war-like situation and unfortunately, we are on the frontline without ammunition. The crises have been created due to unnecessary hoarding, perhaps for petty monetary gains. People should act responsibly and help each other. It is the only way we can win over the virus,” said Dr Chhina.
Dr Amit Gulrez, deputy medical superintendent, CMCH, also said the stocks of tocilizumab have dried up. “There are patients who need tocilizumab, but we have been told that it is not available anywhere. The injection is used to treat Covid patients when they fail to respond to any other treatment in a critical stage and are in respiratory distress.”
However, senior cardiologist Dr Bishav Mohan, who is a member of the Covid taskforce of the state, said new findings and treatment protocols have suggested alternative treatments if tocilizumab is unavailable.
“So we have to look for an alternative. But at the same time, concerted effort should be made to spread awareness among people to stop hoarding life-saving drugs,” he added.
SMO Dr Hitinder Kaur said while there is adequate stock of remdesivir, tocilizumab is not available for long. She said the medicine was earlier used for treating rheumatoid arthritis, which is now being used for critically ill Covid patients.
Punjab’s nodal officer for Covid-19 Dr Rajesh Bhaskar said the state government has floated tenders and within a few days, tocilizumab will be available.
District receives 40,000 vaccines to replenish stock
Meanwhile, the Ludhiana health department received 40,000 vaccines on Thursday to replenish its stocks.
On running out of its vaccine stock, the Ludhiana health department had suspended the vaccine supply to private hospitals in the district till further orders on April 20.
Sharing details, district immunisation officer Dr Puneet Juneja said they have received 40,000 Covishield vaccines on Thursday from Chandigarh for the smooth conduct of vaccination process.
He said that the current batch of vaccines will be used only at the government-run centres.
After running out of both Covidshield and Covaxin vaccines, the supply to 85 private hospitals in the district, which were also inoculating people, was stopped.
Manpower crises hit civil hospital
With 80 patients admitted to the Ludhiana civil hospital’s Covid ward, 52 of them on oxygen and 14 on ventilator support on Thursday, the facility is staring at serious manpower crises.
The issue of staff scarcity came to the fore after SDM (East) Dr Baljinder Singh Dhillon expressed concern over the shortage of nurses and attendants at the civil hospital and asked for urgent recruitment of 20 paramedical staffers.
SMO and Covid unit in-charge of the hospital, Dr Hitinder Kaur, said, “We have adequate staff to run the health services in mother and child hospital and emergency services, but the sudden rise in the number of Covid patients has mounted extra pressure on us.”
“Currently, the staffers are working in three shifts. We have arranged staff from other government hospitals and primary health centres, but that is not enough. For ICU duties, we need to have three times the existing staff strength,” she added.
Bhupinder Kaur, nursing in-charge of the civil hospital, said besides the staff shortage, there were other challenges as well. “Sometimes, the nursing staffers get infected or their family members contract virus and then they cannot perform duty for the next 17 days. Like other hospitals, we are also battling with such issues,” she said.
Lately, 50 paramedical staffers had been performing duties in three shifts in Covid emergency, triage, trauma, male isolation, female isolation, and ICU of the hospital. Out of them, five employees were found suffering from Covid.
On Thursday, one paramedical staffer was available for four wards, while two nursing staff members were present in the ICU.