Infectious diseases consultants have warned of the risk of a major patient safety issue regarding the Health Service Executive’s plans for providing new treatments against Covid-19.
The Infectious Diseases Society of Ireland accuses the HSE of acting prematurely on plans to provide antivirals and monoclonal antibodies to patients at risk of serious Covid-19 illness.
In a letter to senior HSE officials, the society claims the HSE told GPs pathways had already been formalised and agreed for the delivery of the new treatments “when that was not the case”.
Hospital Report
The letter also complains about the “inappropriate sharing” of personal phone numbers of clinicians and the listing of contact numbers for sites that remain “unmanned and unaware” that the initiative is to commence “immediately”.
HSE chief clinical officer Dr Colm Henry wrote to GPs on February 18th saying a number of new therapeutic agents to treat Covid-19 were "available or becoming available". Dr Henry warned that while supplies to Ireland appeared adequate, continuing stewardship would be needed to ensure treatment was targeted on those most likely to benefit.
Responding, the society welcomed the plans to roll out the new treatments but added that it had patient safety concerns. Because some of the therapies had to be administered within a short time of a person falling ill, access to PCR testing was “crucial”, it said, so resources would have to be made available outside of hospital pathways to ensure they were tested as quickly as possible.
Inaccurate
According to the society, many sites lack the resources to deliver the service in the manner announced by the HSE. “We are striving to address this issue as a matter of urgency. It is, however, inaccurate to inform community colleagues that a service exists out of hours and at weekends when this is currently not the case.
“This could pose a major patient safety issue. Additional resources will be required at several sites to deliver this service safely in the manner in which the correspondence has intimated.”
The infectious diseases doctors say many high-risk patients are already well-known to hospital specialist teams, which can liaise with colleagues to organise treatment with the monoclonal antibody sotrovimab.
They call for “clearer and more timely communication” with the society and other medical colleagues tasked with providing the new service. “Now is the time to develop robust, scalable and sustainable pathways, properly resourced so that as other therapies come on line, these pathways can be maintained.”
About 150 doses of sotrovimab have been administered to high-priority patients in hospitals after a first delivery arrived in Ireland in late January, the HSE said. A second delivery is due later this month.
“We have also made provision for referral of patients requiring this treatment to be referred to hospital to avail of such treatment by GPs on an interim basis pending the establishment of a permanent community pathway.”
Deliveries of the antiviral Paxlovid are expected in March, though exact supply dates are not available.
According to the HSE, a Covid-19 therapeutics advisory group, chaired by the two leads of the HSE national infectious diseases programme, provides recommendations on the use of all medications to tackle the virus.
