Briefing

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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In 2020, a bright spot in the pandemic was that it was having a lesser impact on children than might have been expected from a respiratory virus. That no longer seems to be the case. National data from June 26 through August 14, 2021, show a 10-fold increase in weekly hospitalization rates among children aged 0 to 4 years. And, in the week prior to September 23, nearly 207 000 children had a new case of COVID-19 in states where the American Academy of Pediatrics and the Children’s Hospital Association collected data.

Many, including epidemiologist Larry Brilliant, warn that the pandemic cannot end until children younger than 12 years are vaccinated. That future is around the corner now, because Pfizer has announced positive top-line results from its COVID-19 vaccine trial in children from 5 to <12 years of age. Pfizer has submitted the data to the US Food and Drug Administration (FDA) and said it would soon request Emergency Use Authorization (EUA) from the FDA for use in this younger age group. Pfizer is also expected to have immune response and safety data for children 2 to <5 years of age and children 6 months to <2 years of age before the end of the year.

The return to school by kindergartners through 12th grade students has prompted the Centers for Disease Control and Prevention (CDC) to study the effectiveness of masking to prevent COVID-19 spread in classrooms. One comparison of schools from 2 Arizona counties showed that schools without mask requirements were 3.5 times more likely to have COVID-19 outbreaks as were those with mask requirements. A recent ECRI clinical evidence assessment also concluded that SARS-CoV-2 transmission among students is relatively rare in schools that implement masking as part of a bundle with other mitigation strategies.

All of this might affect the mental health of our children. See Topics to Watch for a trend in screening programs that aim to identify kids who are at-risk for mental health conditions.

Increased Routine Pediatric Mental Health Screening in Schools to Mitigate Mental Health Effects of the COVID-19 Pandemic

At a Glance

 

  • The expansion of routine mental health screening programs for all children in elementary and secondary schools might help address the ongoing mental health effects of the COVID-19 pandemic for children and adolescents.
  • Although schools routinely screen children for physical health, universal mental health screening has not been widely or consistently implemented, primarily because of time, resources, and costs.
  • Proactively identifying students who are at risk of developing mental health issues and increasing access to care might improve mental health and academic performance.
  • Multiple states are reporting an increase in mental health services offered in schools, funded in part by the Elementary and Secondary School Emergency Relief Fund, part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Molnupiravir Post-Exposure Prophylaxis for COVID-19

At a Glance

  • Molnupiravir is an investigational oral nucleoside analogue prodrug that is being developed as a post-exposure prophylaxis for patients living with someone with confirmed COVID-19.
  • Molnupiravir purportedly is converted in the body to a cytidine analogue that is incorporated into viral RNA during replication to create a large error rate, resulting in nonfunctional virus.
  • Its developers have begun a phase 3, randomized, placebo-controlled trial enrolling 1332 participants living with someone infected with COVID-19. The trial’s estimated primary completion date is in April 2022.
  • An interim analysis of the phase 3 MOVe-OUT trial in at-risk adults with mild-to-moderate COVID-19 found that molnupiravir reduced the risk of hospitalization or death by approximately 50% through Day 29.
  • The company announced plans to submit an application for an EUA to the FDA as soon as possible for treating mild to moderate COVID-19. The US government agreed to purchase 1.7 million courses of molnupiravir from the manufacturer for $700 per course.

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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]
or by mail to: Patient-Centered Outcomes Research Institute, 1828 L Street, NW, Suite 900, Washington, DC 20036.


Posted: October 6, 2021

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