Pandemic conditions in Greek children’s hospitals – Shortage of essential drugs

Pictures… of a pandemic are unfolding in the Greek pediatric hospitals (public and private), fighting a multitude of respiratory viruses that are striking the community. The violent – as described by the pediatricians themselves – symptoms they cause in young patients, whose immunity had been dormant because of the years of lockdowns, result in endless queues at emergency rooms, while at the same time significant shortages of first-line medicines line are recorded in pharmacies.

Certain fever reducing syrups, cough medicines and antibiotics are the preparations eagerly sought by parents, who are often forced to visit one pharmacy after another in order to find the medicine recommended by the pediatrician.

Under these developments, the Minister of Health Thanos Plevris sent an ultimatum on Friday in the event that it is found that the pharmacies... are empty due to parallel exports. More specifically, the minister asked the National Pharmaceutical Organization (EOF) to call on all pharmaceutical warehouses to immediately declare the stocks they have of the missing drugs that are on the market and consequently their export is prohibited.

The minister also underlined that in the event that they do not do so or declare false quantities, in addition to the criminal sanctions against them, the procedures for the immediate revocation of their operating license will be initiated quickly.

The message from the market

Industry representatives, however, point to the lack of raw materials due to the pandemic as well as the energy crisis as part of the problem that has arisen, with the result that the preparation of prescriptions takes place with a significant delay – a fact that is not an exclusively Greek phenomenon.

It is indicative that a few days ago a related publication was hosted in the “Wall Street Journal”, with the pediatrician of the Necker – Enfants Malades hospital in Paris, Remi Salomon, expressing intense anxiety as it is said that the shortages will be maintained for the next three to four months.

In fact, under these developments, a group of doctors in France – as mentioned in the same report – is working on new guidelines that recommend smaller doses of antibiotics for supply management.

Meanwhile, in our country, complaints about reduced supply from a portion of multinational companies are also being investigated. “We are still waiting, and we expect that this will happen soon, the results of the relevant controls announced by the Ministry of Health”, notes the president of the Panhellenic Association of Pharmacies Irini Markakis.

At the same time, the demand for antiviral drugs (Tamiflu) against the serious symptoms that seasonal flu can cause is also increasing. And although, according to the representatives of the pharmacies, the quantities that have been received are sufficient, they do not rule out that in the future there will be arrhythmias in the market as their prescription started this year prematurely and dynamically.

8 hour wait

“The situation we are experiencing is unprecedented”, the pediatrician and vice-president of the Association of Independent Pediatricians of Attica Anna Pardali told “NEA” newspaper, describing pandemic conditions.

More specifically and according to the representatives of public hospital workers (POEDIN), more than 700 young patients come to the emergency rooms of the “Agia Sophia” and “Aglaia Kyriakou” Children’s Hospitals. Indicatively, it is reported that on Saturday night the wait even reached 8 hours, while the pressure on the Penteli Children’s Center is gradually increasing, resulting in unprecedented queues forming there as well.

However, according to A. Pardalis, the situation in private pediatric clinics is the same, with bed occupancy reaching 100%. And since many hospitalizations are due to the flu, more and more pediatricians are giving antiviral medicines as a precaution.

“The widespread administration of Tamiflu compared to the past is due to the fact that the flu this year causes a high fever lasting 5 or even more days, while at the same time it manifests itself quite violently. In other words, it is accompanied by severe coughing up to vomiting, even in children who have a low fever. In some cases, the symptoms are similar to the picture of laryngitis and generally lead to exhaustion and dehydration, as a result of which hospitalization is deemed necessary, especially for small children.”

Apart from the flu, however, the syncytial virus (RSV) is today the most common reason for the admission of young patients. Furthermore, according to the specialist, strong circulation is also recorded in adenoviruses – that is, high fever, malaise and vomiting, as a result of which parents turn to the pediatrician or pile up in the emergency room queues.

Covid-19 on the rise

In addition, Ms. Pardalis warns that the Covid-19 infection seems to be on the rise. “Indeed, lately we have been noticing several infections, i.e. children who are sick with flu and coronavirus at the same time. And although the pandemic virus does not appear to cause severe symptoms, it is clinically suspected to make children vulnerable to future infections. At the moment, however, we are not sure whether the high infection rate is due to the exposure of the child population to other viruses or whether Covid has set the stage.”

She, however, is concerned about one more fact: “Influenza is a special infection that lowers the immunity of minors – and this is known and confirmed. But immune weakening often leads to respiratory infections – as is the case with pneumococcus.”

Meanwhile, scientists warn that next month is expected to be even more difficult, pointing out that the high morbidity of the child population will fatally affect the adult population as well. The National Public Health Organization (EODY) has already announced a 40% increase in flu-related cases, with the forecasts being ominous.