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The need for on-demand access to medical technologies when treating COVID-19 patients

Maria DeVita, MD
Conditions
November 8, 2020
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It’s well known that New York City was hit hard by the COVID-19 pandemic in the spring, having been the epicenter of U.S. cases for several weeks.

As I write this, more than 245,000 of my fellow New Yorkers have been stricken, and an estimated one in ten of them have died. In fact, the COVID-19 mortality rate here reached such heights it was projected one New Yorker was dying every two minutes.

As a frontline physician, I’ve witnessed how COVID-19 patients can present life-threatening issues at the snap of a finger. Complications that need immediate attention can pour in quickly, and when they do, there’s nothing more important than ensuring providers have life-saving technologies available to treat complications and improve survival rate.

We’ve seen how shortages of medical technologies result in unnecessary deaths. The New York Times powerfully reported that a critical shortage of dialyzers this spring led to many tragic, avoidable deaths. Situations such as these highlight the importance of policy efforts made to ensure these shortages don’t happen.

Two congressional committees recently called on the United States International Trade Commission (USITC) to investigate the COVID-19 related supply chain challenges and submit their findings to Congress. USITC agreed and is creating a report that will help Congress make critical policymaking decisions that would improve access to U.S.-sourced medical devices.

In my experience treating COVID-19 patients, I can attest to the benefit of U.S.-sourced therapies. One example is ultrafiltration for the treatment of hypervolemia, a common COVID-19 complication. Simply put, this condition is the result of too much fluid in the body and particularly within the vascular space as a result of cardiac or renal dysfunction. Unless it is addressed, COVID-19 patients face a much higher risk of dying due to weakened blood vessels, fluid in their lungs, respiratory failure, kidney injury and failure, septic shock, and multi-system organ failure. In other words, it’s a swift and silent train wreck.

Ultrafiltration gently and effectively removes fluid to stabilize patients and frees up much-needed equipment and supplies for those suffering kidney failure, such as dialyzers. This approach also reduces exposure to the virus when compared with dialysis since it allows for a 4:1 patient to nurse ratio.

This therapy can be particularly helpful in heart failure (HF) patients. Recent data demonstrated significant reductions in HF rehospitalizations and improvement in renal function response when their congestion was treated with ultrafiltration. Avoiding rehospitalization is always a priority, but avoiding it during a pandemic is even more paramount.

COVID-19 wreaks havoc on multiple areas of the body, and myself and my fellow frontline workers across the globe have been forced to quickly identify what tools work best in our quest to keep our patients alive.

While we’re working to identify which technologies can improve our patients’ outcomes, it’s encouraging that policy work is being done to ensure we can access the technology that allows us to provide life-saving care. We can’t do it alone.

As we anticipate a potential surge of cases in the coming months, we must be prepared with the proper PPE, medications, and medical technologies that will result in less devastation than what we experienced this spring. When it comes to pandemics, that means we’re intentional about establishing, nurturing, and supporting domestic manufacturers who can provide U.S. hospitals with the resources they need.

Maria DeVita is a nephrologist.

Image credit: Shutterstock.com

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