The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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COVID-19 has had an enormous impact on the US health care system. As we emerge from the acute impacts of the pandemic, some long-established norms of the health care journey are being reconsidered. In particular, the delivery and payment models for nursing and palliative care are being reconsidered in reaction to the harm caused when nursing home residents were separated from their families during the peak of the pandemic and the emerging need for ongoing care for patients with long COVID. Shifts toward in-home care and insurance coverage without a hospice requirement will greatly change the experience of patients and those who care for them.

The current US administration is looking at partnering with dollar stores and fast-food restaurants to reach both the vaccine-hesitant and those who live far from current vaccination sites. A recent study found that more than 90% of the US population would be within 5 miles of a vaccination site if Dollar General stores were added to the network.

As global cases rise, vaccine uptake levels increase to 58.9% of US adults receiving at least 1 dose, and US public health constraints are relaxed, there is still a need for new testing programs and better treatment options for younger patients (see Topics to Watch).

Remestemcel-L (Ryoncil) to Treat Moderate to Severe COVID-19 Acute Respiratory Distress Syndrome

At a Glance

  • Remestemcel-L (Ryoncil) is an investigational cell therapy consisting of donor-derived mesenchymal stems cell for treating ventilated patients with moderate to severe COVID-19 acute respiratory distress syndrome (ARDS).
  • Remestemcel-L purportedly modulates the body’s immune response to offset the cytokine storm by suppressing pro-inflammatory cytokine production, increasing anti-inflammatory cytokine production, and facilitating the release of naturally occurring anti-inflammatory cells to involved tissues.
  • Remestemcel-L was granted Fast Track designation by the US Food and Drug Administration (FDA) and is in phase 3 development in ventilator-dependent COVID-19 patients. In December 2020, a Data Safety Monitoring Board determined that the trial was unlikely to meet its primary end point of reducing mortality and recommended that the trial stop enrollment.
  • In April 2021, remestemcel-L’s manufacturer released 60-day results from the 223 patients enrolled before the trial was halted. In a prespecified subgroup of patients younger than 65 years, remestemcel-L reduced the risk of death by 46%, and among patients younger than 65 who were also taking dexamethasone, remestemcel-L reduced the risk of death by 75%. The number of days hospitalized was reduced and the number of days off mechanical ventilation was increased.
  • The manufacturer announced plans to discuss next steps with the FDA.

Say Yes! COVID Test Initiative to Reduce the Spread of COVID-19

At a Glance

  • The ​Say Yes! COVID​ Test Initiative is a cooperative effort among local, state, and federal health authorities to evaluate whether frequent self-administered testing can limit the spread of COVID-19 in communities.
  • Federal agencies are providing about 2 million rapid antigen COVID-19 tests to as many as 160 000 residents of Pitt County, North Carolina, and Hamilton County, Tennessee​. Up to 2 unvaccinated members of each participating household, those with the most public contact, will give themselves a COVID-19 test 3 times a week for about 1 month.
  • A digital assistant will guide the participants through the testing process and give reminders​.
  • The initiative seeks to determine the effects of frequent self-testing on the knowledge, attitude, and behaviors of people regarding hygiene practices and vaccination, as well as the effects of frequent testing on infection and death rates.  

Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: May 19, 2021

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