Joliet hospital to use new 3-drug treatment for COVID-19, can't obtain remdesivir at this time

AMITA Health Saint Joseph Medical Center in Joliet has already ordered the medicines for a new triple drug therapy for patients hospitalized with COVID-19.

The wait to receive these drugs shouldn't be long either.

“We’re going to try to get that going this week,” said Dr. John Walsh, hospital medical director and pulmonologist.

On the other hand, although the FDA approved the antiviral remdesivir for emergency use in the treatment of COVID-19 on May 2, St. Joseph's won’t be able to offer it to COVID-19 for some time, Walsh said.

A study published in The Lancet this weekend suggests that a combination of interferon beta-1b, lopinavir–ritonavir and ribavirin may reduce symptoms in patients with mild to moderate COVID-19.

Kim Waterman, media relations manager for Northwestern Medicine, said Northwestern is not using this therapy yet.

Interferon beta-1b is a drug that suppresses the immune system and is used in the treatment of multiple sclerosis. The other two medications — lopinavir-ritonavir and ribavirin – are both antivirals.

Lopinavir – ritonavir has been used to treat HIV infection. Ribavirin has been used to treat hepatitis C and severe lung infections caused by respiratory syncytial virus.

Walsh said the study he read came from Hong Kong. The triple drug therapy was used on patients "who weren’t very sick."

“As a matter of fact, they were often patients that were sent home from the ER department,” Walsh said.

Still, this triple drug therapy seems to “rapidly reduce the viral load," he said, which he feels is promising in the quest to fight this virus.

“It offers us an option to intervene earlier than we typically have done,” Walsh said.

Other treatments, such as Actemra (tocilizumab) to reduce cytokine storm (an exaggerated inflammatory response to the virus) and convalescent plasma, which passes antibodies from the blood plasma recovered COVID-19 patients to those who are currently fight it, are are for patients who are extremely ill.

“This therapy we’re talking about would be given to patients early in the disease, within the first week or so, and with minimal symptoms,” Walsh said.

The plan at St. Joe's is to treat patients who are within a week of the onset of symptoms and also require hospitalization.

As far as remdesivir goes, Walsh said it “looks promising” in the sense that the antiviral doesn’t appear to reduce mortality rates and can reduce the hospital stay on average from 14 days to 11.

Unfortunately, Gilead Sciences, a research-based biopharmaceutical company that produces the remdesivir, didn’t choose Will County for its initial 1.4 million tablets, Walsh said.

“The company gave control to the federal government and they had to choose where it would be sent,” Walsh said. “And we just didn’t get chosen.”

The state sent about 90% of its supply received from the federal government to Cook County.

Walsh said remdesivir should be available locally “somewhere down the road.”

“We just don’t know how long down the road as it has to be manufactured and distributed,” Walsh said. “But it’s probably many weeks, if not months, away.”

In the meantime, St. Joe's is continuing to “prone” patients – positioning them on their stomachs throughout the night – even if they are on ventilators – to take pressure off their lungs.

Even patients who are being treated for COVID-19 at home should lie prone, Walsh said, including patients with pneumonia caused by the virus.

“If you have a diagnosis of COVID-19 on nasal swab, you should be sleeping on your stomach,” Walsh said.

The remainder of the time, patients should switch from time to time from lying on their right side to lying on their left.

“We give them handouts in English and Spanish at the hospital,” Walsh said. “Every two hours, they should rotate.”