Berks County Medical Society Medical Record Summer 2020 - 12

Coronavirus Chronicles: Berks Responds
Interview with Debra Powell, MD, Chief, Division of Infectious Disease, Medical Director
for Infection Prevention, Tower Health Medical Group, Reading Hospital
continued from page 11

MR: It was widely recognized that limited resources to treat patients
and protect staff were issues that the care team faced. How were
these issues addressed?
When the outbreak was noticed abroad, we started to
prepare. We ordered additional PPE, however, every other
hospital was ordering more and the supply chain could not
support the demand. So instead of receiving our whole order, we
were shipped a fraction of the orders. Additionally many of our
supplies come from China and their factories were closed due to
the outbreak, which led to further shortages. We had to adapt by
implementing extended use with limited reuse of masks per the
CDC protocol. We also investigated decontamination of N95
masks using vaporous hydrogen peroxide to extend the supply.
We also had discussions on prioritizing scarce resources based
on designated criteria. We were very fortunate that we did not
face the disease burden that was seen in New York City and our
ICUs had sufficient beds and the health system had sufficient
ventilators.
MR: With regards to treatments including a variety of anecdotal
reports of medications used as well as the more recent evidence for
the antiviral remdesivir, did you utilize any of these and find any
particularly useful? Also would you comment on the efficacy of
convalescent plasma available from recovered COVID-19 patients?
We have used experimental treatments including convalescent
plasma, remdesivir and tocilizumab. We are participating in
the Mayo Convalescent Plasma program. The COVID positive
patients must meet criteria for enrollment and once approved,
receipt of the plasma is coordinated with the local blood centers.
The ordering provider is required to submit outcome data to
Mayo Clinic and this information will be compiled to determine
the effectiveness of the treatment. To date, Mayo has coordinated
the administration of over 17,000 units of plasma to patients
across the US.
Gilead Sciences, Inc. donated 1.5 million doses of remdesivir
to the US Department of Health and Human Services for
distribution on May 3 after the drug received Emergency Use
Authorization. Since then we have received a supply distributed
by the PA State Health Department. I was asked to participate
on the Hospital Association of Pennsylvania Remdesivir
Panel to provide guidance to the state for fair distribution
of the medication and have requested outcome data post
administration. We have seen anecdotal positive results with
the addition of remdesivir. To date we have administered the
medication to 13 patients at Reading Hospital and preliminary
feedback from the Pulmonary Critical Care physicians have
been encouraging. This medication is recommended for COVID
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Berks County Medical Society Medical Record Summer 2020

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