In the July 17th update, the National Institute of Health (NIH) made recommendations to triage the use of remdesivir when supply is limited. The recommendations state to prioritize remdesivir in hospitalized COVID-19 patients who require supplemental oxygen but are not mechanically ventilated or on extracorporeal membrane oxygenation (ECMO). [1], [2]

In the July 24 update (today), the NIH further clarified on the mode of oxygen delivery. If the mode of oxygen delivery involves high-flow oxygen, noninvasive or invasive mechanical ventilation, or ECMO; then the NIH offers no recommendation for use of remdesivir in COVID-19 patients who require supplemental oxygen. This recommendation is due to limited evidence and uncertainty whether patients will clinically benefit from use of remdesivir at this stage. COVID-19 patients requiring supplemental oxygen not involving high-flow oxygen, noninvasive or invasive mechanical ventilation, or ECMO are recommended to receive remdesivir for 5 days or until hospital discharge. [1], [2]