Text Box 3.

Allocation Among Patients Within a Facility

• Clinical criteria for allocation are based on patient need (risk of serious morbidity or mortality without the medication) and likelihood of benefit defined as recovery to hospital discharge. • Highest priority: patients on advanced respiratory support (high-flow nasal cannula, continuous positive airway pressure [CPAP] therapy, bilevel positive airway pressure [BiPAP] therapy) or patients with 3 out of 4 characteristics: < 94% oxygen saturation on room air; respiratory rate > 30; lung infiltrates on imaging; using supplemental oxygen. • Second priority: patients who have been mechanically ventilated for ≤ 5 days or on ECMO for ≤ 5 days. • When patients are otherwise of equal priority within a group and there is not sufficient drug for all patients in this group, a random process should be used to allocate. • Patients who are imminently dying or terminally ill with life expectancy < 6 months should not be prioritized for access. • Children and pregnant women are not included because of availability of remdesivir through the FDA’s compassionate-use program.