[BostonCard]

 My understanding is remdesivir isn't going to many patients who aren't already in the ICU, and lots of patients were already getting steroids even before the dexamethasone study results were publicized (and only showed a mild improvement in any case.)

Ironically, that seems to be where remdisivir is least effective.  I think it makes more of a difference early.

BC

I think it is a supply issue.

Agreed.  But my colleagues and I were musing that there will be a tendency to give less severe patients dexamethasone (even though it is less effective) because it is easy and cheap, while they will give more severe patients remdisivir (even though it is less effective) because of lack  of availability and the fact that it has to be given IV.

If you really thought this through, you would give high risk patients (those >65, those with risk factors) remdisivir, and you would do so early.  You would wait to give patients dexamethasone until they were starting to crash.

BC

[BostonCard]

 My understanding is remdesivir isn't going to many patients who aren't already in the ICU, and lots of patients were already getting steroids even before the dexamethasone study results were publicized (and only showed a mild improvement in any case.)

Ironically, that seems to be where remdisivir is least effective.  I think it makes more of a difference early.

BC

I think it is a supply issue.

Agreed.  But my colleagues and I were musing that there will be a tendency to give less severe patients dexamethasone (even though it is less effective) because it is easy and cheap, while they will give more severe patients remdisivir (even though it is less effective) because of lack  of availability and the fact that it has to be given IV.

If you really thought this through, you would give high risk patients (those >65, those with risk factors) remdisivir, and you would do so early.  You would wait to give patients dexamethasone until they were starting to crash.

BC