For example, albuterol, used for wheezing illnesses like asthma, is already experiencing a national shortage. Hospitals with high volumes of critically ill patients are also reporting shortages of basic standbys like midazolam and propofol — drugs needed to induce and maintain sleepiness and comfort while on a ventilator. Without those medications, being on a mechanical ventilator can be agonizingly uncomfortable.
With the peak demand on health care systems projected in just a few weeks, we need to increase our supply of multiple medicines now. Efforts started today will be too late for many hospitals to practice at usual standards of care; further, availability of medications outside of the hospital will also be in short supply.
This effort starts with the Food and Drug Administration, which can either be a bottleneck or a facilitator during this crisis. Many of the shortages are going to be generic drugs, where unlike the rest of the world, we have only a limited number of authorized versions available. The FDA must institute a 24-hour turnaround for approving the importation of generic drugs that are in short supply from established manufacturers in other countries. Such an ultra-fast approval time has already been used in this pandemic, for approval to start using plasma from patients recovering from COVID-19 to help very ill patients. The FDA can also institute reciprocal approval for selected generic drugs manufactured in other countries.