The Health Ministry has instructed medical staff in hospitals and Health Maintenance Organizations to prepare for the possible use of medications to combat the coronavirus that have not yet been approved as treatments against the disease.
The ministry’s medical directorate has instructed hospital directors and medical division heads in HMOs to stock up on medicines that are still in the research stage.
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“Information on possible treatments is now in the process of being created and researched. Organized research and publications are expected to arrive later. However, the Israeli health system must equip itself with medications now in order to treat patients with COVID-19,” states a document signed by Dr. Vered Ezra, the head of the ministry’s medical administration.
The ministry said the treatment of coronavirus patients in a moderate or more severe condition should be carried out under the instructions of a doctor who is a specialist in infectious diseases, according to the clinical state of the patient. As of now, no treatment is designated for patients in good condition, except to treat their symptoms.
The ministry’s instructions say that for patients in moderate condition, it is proposed that physicians use the drug chloroquine, which was originally intended for use in treating malaria. Some evidence exists that it could be effective against the coronavirus – in addition to supportive treatment. “At this stage, it is possible to prepare what is needed in the lead up to treatment in the case of the deterioration of the situation – for example to prepare forms for compassionate use,” the Health Ministry wrote.
As for coronavirus patients in serious condition, the ministry proposed – in addition to treating respiratory failure and supportive treatment – using the drug Remdesivir, which was used in the case of Patient 16. The 38-year-old bus driver from East Jerusalem was in serious condition and the drug improved his situation dramatically, so much so that he was in good condition after the treatment.
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The drug can only be obtained, for now, with approval for compassionate use from the manufacturer, Gilead Sciences. If Remdesivir is not available, the ministry recommended considering the use of antiretroviral medicine Kaletra instead.
The drug is a combination of lopinavir and ritonavir and is manufactured by American biopharmaceutical firm AbbVie, but Attorney General Avichai Mendelblit recently approved the use of a generic version of the drug to treat coronavirus patients in Israel. The ministry also suggested the use of chloroquine or a combination of the drugs.
They said that at this stage the instructions are only to acquire the medicines and make necessary preparations – they are not making a medical recommendation to use these drugs.
“As of now, there is no established information concerning the various medications and the initial information for formulating this document has been gathered from a number of sources. This document should not be treated as a Health Ministry recommendation or instruction,” the document states.