LONDON (AP) — Nine leading European university hospitals are warning they will run out of essential medicines needed for COVID-19 patients in intensive care in less than two weeks as they are increasingly crushed by the pandemic.

The European University Hospital Alliance said that without countries cooperating to ensure a steady supply of these drugs, doctors and nurses might no longer be able to provide adequate intensive care for people critically ill with the new coronavirus.

In a statement published this week and sent to national governments, the group said that aside from the need for protective gear and ventilators, “the most urgent need now is for the drugs that are necessary for intensive care patients.” They wrote that existing stocks of muscle relaxants, sedatives and painkillers were likely to run out in two days at the hardest-hit hospitals, and in two weeks at others.

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Last week, Italy’s national pharmaceutical agency issued a formal alarm to regional health authorities that the recent jump in demand for some medicines had depleted supplies. The agency set up a special email address for the regional authorities to report any difficulties finding certain drugs.

The shortage of such critical medicines has led some hospitals to buy alternative drugs or to try giving patients different dosages.

“It is extremely worrying that overworked and often less-experienced nurses and doctors-in-training, drafted to fill the gaps, have to use products and dosages that they are not used to,” the group wrote, on behalf of hospitals in Austria, Britain, France, Germany, Italy, the Netherlands, Belgium, Sweden and Spain.

A team of experts for the hospitals authority in Paris last week drew up a list of suggested workarounds for emergency units to employ to try to ward off what it identified as a “strong risk” of some sedatives and painkillers running out. The experts said that for each prescription, medics should ask themselves whether a drug is really necessary and if doses can be reduced, as well as consider alternative drugs.

The European hospital alliance noted that some governments had reacted to the shortages by refusing to export drugs elsewhere, and warned this would prevent drugs from reaching hospitals in dire need of the medicines.

“No single country in Europe has the production facilities to provide all the drugs (or protective gear or ventilators) needed,” the group wrote, pointing out that some countries had shut their borders to exporting such drugs but not importing them. “Coordinated European action will be of vital importance.”

Last week, the World Health Organization said there were “extreme pressures” at all levels of the medical supply chain, from raw materials to production, distribution and delivery.

“The world was not ready for a pandemic (and) we did not have the stockpiles in place,” Dr. Mike Ryan, the U.N. health agency’s emergencies chief, said.

Ryan said WHO was working with other agencies and negotiating with G20 nations on how to quickly scale up production of essential medical supplies and ensure equitable distribution.

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John Leicester in Paris and Nicole Winfield in Rome contributed to this report.