COVID-19 Daily: Remdesivir Authorization, Pay Parity for Telehealth

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center .

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

Remdesivir Emergency Use Authorization

The US Food and Drug Administration (FDA) Friday issued an emergency use authorization for the drug remdesivir to treat suspected or laboratory-confirmed COVID-19 in adults and children hospitalized with severe disease. The emergency use authorization is not the same as an FDA approval, and may be revised or revoked. 

In its press release, FDA acknowledged that there is limited information available about remdesivir’s safety and effectiveness for this use, but cited the findings of a National Institute of Allergy and Infectious Diseases-sponsored trial, announced earlier this week, that patients who received remdesivir had a shorter recovery time than patients who received placebo.

Pay Parity for Telehealth Services

Physicians who are conducting telephone visits during the COVID-19 pandemic will be paid at a higher rate more closely aligned with rates for face-to-face visits, officials at the Centers for Medicare & Medicaid Services announced Thursday. Rates for telephone visits will increase from $14-$41 per visit to about $46-$110, and the pay increase is retroactive to March 1, 2020.

Telemedicine use grew quickly in the early days of the pandemic in the US, new data indicate. For the week ending March 20th, telemedicine visits grew about 400% compared to the week before, according to data from the IQVIA Institute for Human Data Science. But this initial growth spurt has since slowed down. The week ending April 10th saw an 18% increase in telehealth visits compared to the week before. These stats reflect the claims in IQVIA’s database, and are not projected to represent the entire US population.

Primary Care Physicians Reshuffle Their Lives

Prior to the COVID-19 pandemic, Robert Hopkins Jr., MD, spent part of his time seeing patients in the main hospital of the University of Arkansas Medical Sciences College of Medicine in Little Rock, but most of it in an outpatient clinic. 

Now, the clinic is conducting 80%-90% of patient visits by video conferencing or telephone, and he and some colleagues have been redeployed to assist with the hospital’s surge unit for the inpatient facility. He also pitches in at a drive-through COVID-19 screening clinic. Hopkins and other primary care physicians shared their experiences with MDedge News

“I’m trying to keep an eye out on my team members – physicians, nurses, medical assistants, and folks at the front desk – trying to make sure that people are getting rest, trying to make sure that people are not overcommitting,” Hopkins said. “Because if we’re not all working together and working for the long term, we’re going to be in trouble. This is not going to be a sprint; this is going to be a marathon for us to get through.”

Yale’s Treatment Protocol 

Yale New Haven Health System has updated its treatment algorithm for COVID-19 patients several times since the virus first hit Connecticut weeks ago, MDedge News reports

Hydroxychloroquine is first-line, based on in-vitro data that show potent inhibition of the virus and a possibility for clinical benefit. Newer iterations of the algorithm have physicians watching patients’ QTc intervals more closely and prioritizing reading ECGs from patients with confirmed or suspected COVID-19.

Much of what’s being done at Yale and elsewhere is empiric because there are simply not much data to rely on. “We are trying to do the best we can” in “the haze of battle, says a Yale cardiologist who is helping to coordinate the health system’s response to COVID-19. “People really came together quickly to develop this. One hopes we never have to go through anything like this again.”

Virtual March for Masks

A coalition of Yale resident physicians and other medical providers calling themselves “NeedMasksToday” is holding a virtual march on Saturday, May 2, to draw attention to frontline healthcare workers’ need for adequate personal protective equipment (PPE) and advocate for the White House to invoke the Defense Production Act to manufacture and equitably distribute masks and other PPE.

In Memoriam

As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk of infection. Hundreds throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

Ellie Kincaid is Medscape’s associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine.

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