At Methodist’s flagship hospital in central Houston, Rosa V. Hernandez, 72, a patient in the intensive care unit, has pneumonia so severe that if she had fallen sick several months ago, she would probably have been put on a ventilator and made unconscious.
But doctors, based on the experiences of physicians in New York and elsewhere, are avoiding ventilators when possible and are maintaining Ms. Hernandez on a high flow of oxygen through a nasal tube. She is on the maximum setting, but can talk to the clinical team and exchange text messages with her daughter, who is also a Methodist inpatient with the coronavirus.
“I took it seriously,” Ms. Hernandez said of the virus. But she joined a small party of eight people for her granddaughter’s birthday, a decision she now described with regret. “Just a birthday cake. What’s a birthday cake without health?”
She is getting remdesivir, an antiviral that was tested in clinical trials in New York and Houston, among other cities, and a new experimental drug.
Methodist was part of two remdesivir trials. But because the research has ended, it and other hospitals now depend on allotments of the drug from the state. As virus cases increased, the supplies ran short, said Katherine Perez, an infectious-disease specialist at the hospital. “In Houston, every hospital that’s gotten the drug, everyone’s just kind of used it up,” she said.
The hospital received 1,000 vials, its largest batch ever, a little over a week ago. Within four days, all the patients who could be treated with it had been selected, and pharmacists were awaiting another shipment.
A new chance to test remdesivir in a clinical trial in combination with another drug may provide some relief. As cases rise, Methodist researchers are being flooded with offers to participate in studies, with about 10 to 12 new opportunities a week being vetted centrally. Without solid research, “your option is to do a bunch of unproven, potentially harmful, potentially futile, interventions to very sick people who are depending on you,” said Dr. H. Dirk Sostman, president of Methodist’s academic medicine institute.