Explore the results of our latest COVID-19 Barometer study Close Sermo Newsroom About Blog Log in Sign up NEWSROOM COVID-19 Press Releases News Articles Press COVID-19 Press Releases Methodology November 17, 2021 New Data Suggests More Doctors Spending Time Addressing COVID-19 Vaccine Misinformation As Compared To Six Months Ago September 14, 2021 10% or less of children 12+ are breakthrough Covid cases July 20, 2021 If doctors could give Covid vaccine, innoculation would rise May 20, 2021 Efforts to stop COVID-19 undermined by vaccine fears March 16, 2021 Doctors see increase in patients who are unhoused/in poverty January 26, 2021 Doctors say mental health issues will be the biggest issue December 2, 2020 3 out of 4 doctors say COVID immunity is long way off September 24, 2020 92% of doctors tell patients not to wait to get the flu shot June 23, 2020 Physicians believe 2nd wave of COVID-19 is likely to occur June 11, 2020 No unified approach for Covid-19 treatment landscape June 4, 2020 Doctors discuss Pediatric Multisystem Inflammatory Syndrome May 29, 2020 Oxygen therapy delays intubation, but aerosolizes Covid May 21, 2020 67% of doctors say Remdesivir should be administered earlier May 14, 2020 Physicians see false negative tests and Covid re-infections May 7, 2020 COVID-19 treatment trends over 6 weeks and 33,700 interviews May 4, 2020 Experienced COVID treaters say COVID is an “oxygen failure” May 1, 2020 Korea, China, Japan report lowest COVID cases in doctors April 27, 2020 52% of US physicians say country has reached outbreak peak April 23, 2020 Sermo reports jury is still out on Remdesivir effectivenes April 22, 2020 2/3 of U.S. physicians say COVID-19 testing is subpar April 17, 2020 1/4 of doctors say HCPs should take hydroxychloroquine April 15, 2020 Doctors report on using Hydroxychloroquine and Azithromycin April 13, 2020 Insight into do-not-resuscitate protocol for COVID patients April 9, 2020 Zinc and vitamins c, d recommended to treat/prevent COVID April 8, 2020 Sermo reports on Hydroxychloroquine, plasma and Remdesivir April 2, 2020 Sermo doctors reveal global COVID treatment patterns March 27, 2020 Data from physicians in 30 countries provide COVID insight New Data Suggests More Doctors Spending Time Addressing COVID-19 Vaccine Misinformation As Compared To Six Months Ago November 17, 2021 Latest Sermo COVID-19 Real Time Barometer Shows Nearly 18% More Doctors Say They Are Hearing Vaccine Misinformation from Patients, But 22% More are Confronting Fewer Vaccine Side Effect Concerns New York, NY — November 17, 2021 — Sermo’s most recent COVID-19 Real Time Barometer surveyed 3,050 physicians across 26 countries and showed that while more physicians are hearing fewer concerns from patients about the side effects of the vaccine now (59%) compared to six months ago (72%), more physicians are reporting patients are coming to them with vaccine misinformation vs. six months ago. Specifically, in our June study (n=3,050 physicians, 24 countries), 45% of doctors said their patients shared misinformation expressing concerns about one or more of the following vs. 53% in our most recent poll: The vaccine modifies your DNA The vaccine causing infertility The COVID-19 vaccine contains a microchip Getting the vaccine gives you COVID-19 “We’re seeing an interesting contrast between what doctors told us recently about the vaccine, and what they told us just six months ago,” said Peter Kirk, Sermo CEO. “This just underscores the value of the COVID-19 Real Time Barometer…as physicians are seeing and learning so much everyday, it’s important that we continue to track insights over time that have the potential to impact how we are able to manage the spread of the pandemic.” Sermo, the global physician insights leader, launched their COVID-19 Real Time Barometer — an ongoing observational study of physicians’ experiences and perspectives on the impact of the COVID-19 pandemic — in March of 2020. To date, 84,000+ physicians from 31 countries have participated, providing more than 1,200,000 answers on timely and important COVID topics. “When the pandemic first hit last March, we knew that the 1.3MM HCPs on the Sermo platform — many of whom were on the frontlines — were going to be a critical tool in helping the world understand the impact of COVID-19 and how we might best fight it,” said Peter Kirk, Sermo CEO. “So we created the COVID-19 Real Time Barometer to not only better understand the real-time impact of the pandemic, but to give physicians a platform to voice their experiences, concerns and needs.” The latest study also shows that now that the FDA has approved the practice, 46% of doctors will encourage their vaccinated patients to get a booster shot even if it’s from a different manufacturer, and 47% of doctors surveyed believe their patients will request the same brand for vaccine boosters. Some additional findings from the survey include: 62% of physicians agree Pfizer will be the brand of booster shot most requested by their patients. Doctors are consistent in their belief that patients are more reluctant to vaccinate their children than themselves (59% now vs. 56% in June 2021). There was a slight increase in physicians concerned that the biggest hidden consequence of COVID-19 will be long-term financial impact to the healthcare system (57% now vs. 50% in January 2021). 87% of doctors say that depression and other mental health issues remain the biggest non-COVID-19 related public health concern. To learn more about the COVID-19 Real Time Barometer and its findings, click here. About Sermo Sermo turns physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company provides physicians with a social platform and unique community that fosters impactful peer-to-peer collaboration & discussions about issues that are important to them and their patients. Sermo offers on demand access to physicians via a suite of proprietary technology to provide business intelligence that benefits pharmaceutical, healthcare partners, and the medical community at large. To learn more, visit www.sermo.com Media Contact: Alexander Petti pr@sermo.com Share: Facebook LinkedIn Twitter 10% or less of children 12+ are breakthrough Covid cases September 14, 2021 Sermo’s COVID-19 Real Time Barometer survey suggests children ages 5-12 are at highest risk, with fatigue as the main long-COVID symptom. New York, NY – September 14, 2021 – Almost seventy-five percent of physicians have seen an increase in COVID cases among children, mostly due to the Delta variant, with 45% of physicians seeing the greatest increase among children aged 5-12 years, a new global survey of 1,528 physicians finds. In Sermo’s most recent COVID-19 Real Time Barometer survey, most physicians reported that they have not seen long-COVID or long-haul cases among children, however, a substantial 26% did say they have seen pediatric long-haulers, with the most common symptom manifesting as fatigue (63%) followed by headaches (47%), cold-like symptoms (44%), respiratory (43%) and loss of sense of smell / taste (40%). Long-haulers are patients who experience persistent symptoms after the typical course of the disease. Most doctors surveyed said that long-COVID symptoms last about 1-4 weeks (36%) or 5-6 weeks (21%). Sixty-five percent also reported that symptoms are milder and 34% said they do not linger as much in children as they do in adults, but nevertheless, 36% of physicians surveyed are somewhat concerned about the long-term health problems children may face. The Need to Vaccinate Children Sermo’s previous COVID-19 Real Time Barometer showed 65% of physicians believe that vaccinating children is essential for long-term control of COVID, but 55% of physicians also say their patients are more reluctant to vaccinate their children than themselves due to lack of long-term safety data and fear of adverse effects or allergic reactions. Sermo’s latest COVID-19 Real Time Barometer showed 42% of physicians said 10% or less of their pediatric patients were vaccinated and still caught COVID. Close to 50% of physicians said that in their experience, it’s too soon to tell if having had COVID offers any immunity to the Delta variant. “While there is mounting pressure from organizations like the American Academy of Pediatrics for the FDA to consider authorizing emergency use of COVID-19 vaccines in children under 12, the most at-risk group,” said Peter Kirk, CEO Sermo, “our survey also indicates getting children vaccinated is the next barrier for long-term control of COVID. Our survey reveals parents are more reluctant to vaccinate their children than themselves. With the Delta variant causing devastation, and another new worrying variant Mu on the horizon, the need to educate parents about children’s vaccinations is greater than ever.” About the COVID-19 Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 80,000 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan, and Australia. Full results are available at sermo.com. About Sermo Sermo turns physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company provides physicians with a social platform and unique community that fosters impactful peer-to-peer collaboration & discussions about issues that are important to them and their patients. Sermo offers on demand access to physicians via a suite of proprietary technology to provide business intelligence that benefits pharmaceutical, healthcare partners, and the medical community at large. To learn more, visit www.sermo.com Media Contact: Alexander Petti pr@sermo.com Share: Facebook LinkedIn Twitter If doctors could give Covid vaccine, innoculation would rise July 20, 2021 Sermo’s COVID-19 Real Time Barometer survey suggests patients would be more open to vaccine if received from a physician they know and trust New York, NY – July 20, 2021 – With variants on the rise and the continued need for vaccinations, a new global survey of physicians finds that many doctors believe that they may be the key to boosting vaccination rates as they are an important source of information, comfort, and reassurance for COVID-19 vaccine-reluctant patients. In Sermo’s most recent COVID-19 Real Time Barometer survey, nearly 70% of physicians said that if they could administer the vaccine to reluctant patients themselves, they believe patients would feel more comfortable about getting vaccinated. Additionally, nearly half of physicians surveyed said that their ability to discuss the benefits of vaccination and answer patient’s questions during appointments could help increase patients’ willingness to get vaccinated. The Need to Vaccinate Children Sermo’s COVID-19 Real Time Barometer also showed 65% of physicians believe that vaccinating children is essential for long-term control of COVID, but 55% of physicians also say their patients are more reluctant to vaccinate their children than themselves due to lack of long-term safety data and fear of adverse effects or allergic reactions. Opportunities to Increase Vaccination Rates Exist Of the 3,329 physicians around the world who responded to the survey, 60% of physicians believe a one-dose vial that can be administered at the physicians’ office during appointments would be beneficial in continuing to administer vaccinations. A whopping 81% believe that pediatricians and family doctors are in the best position to vaccinate children. Surveyed physicians believe that resources and information should be created to educate their patient base and parents about the importance of getting vaccinated. Needed resources include a risk/benefit analysis, quick answers to tough questions, as well as safety and efficacy data. “Our survey reveals that physicians worldwide feel strongly that they can and perhaps, should, play a very important role in driving COVID vaccination uptake,” said Peter Kirk, CEO Sermo. “The trust they have built with their patients, combined with the ability to counsel, answer questions, ease concerns and provide assurances could help patients overcome their hesitancy to be vaccinated. Allowing physicians to vaccinate their own patients has the potential to increase vaccine rates.” About the COVID-19 Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 70,000 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan, and Australia. Full results are available at sermo.com. About Sermo Sermo turns physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company provides physicians with a social platform and unique community that fosters impactful peer-to-peer collaboration & discussions about issues that are important to them and their patients. Sermo offers on demand access to physicians via a suite of proprietary technology to provide business intelligence that benefits pharmaceutical, healthcare partners, and the medical community at large. To learn more, visit www.sermo.com Media Contact: Alexander Petti pr@sermo.com Share: Facebook LinkedIn Twitter NEW YORK, NY Efforts to stop COVID-19 undermined by vaccine fears May 20, 2021 Insights from Sermo’s COVID-19 Real Time Barometer Survey point toward disease becoming endemic and need for more effective patient education New York, NY – May, 20 2021 – As the rate of people receiving COVID-19 vaccinations has slowed, a new survey of physicians has revealed that doctors are working hard to combat vaccine hesitancy, even among those who have already received their first dose. More than 72% of physicians surveyed said that patients continue to voice concerns over vaccine side effects. Still, others have reported ongoing misinformation discouraging people from getting vaccines. In addition, close to 30% of physicians reported encountering patients who have skipped their second dose due to unpleasant side effects of the first dose, or concerns over side effects. Sermo’s COVID-19 Real Time Barometer also showed over half of physicians report their patients have requested a specific vaccine with a clear preference for the Pfizer-BioNTech vaccine, as 78% of physicians indicated it’s the most requested and Moderna following at a distant second (7%). In Europe, almost 93% of physicians reported Pfizer-BioNTech was the most requested. Physician Views on COVID-19 Vaccines Fielded May 4 – May 8, 2021, over 3,000 physicians around the world provided feedback, of which close to 40% have treated between 10-100 patients with COVID. The survey found most physicians are currently not optimistic that COVID-19 will be eradicated with 75% of physicians believing COVID-19 vaccine boosters will be required annually, and of that, 35% believing their patients will likely see it as similar to the annual flu jab. This may be attributed to the ongoing vaccine hesitancy physicians reported. In addition to worries over side effects, physicians reported that they have also heard ongoing concerns about safety and efficacy (60%) or erroneous or misinformation, such as you don’t need a vaccine if you had COVID-19 (32%), the vaccine modifies your DNA (29%) or the vaccine contains a microchip (15%). Physicians are countering the vaccination resistance mostly by discussing the risk benefit profile (80%) and the impact COVID-19 can have on others (61%), while 14% are connecting patients to community resources, such as peer engagement, but not finding success. “I am burned out with efforts to convince patients to get vaccinated,” said Charles LaTendresse MD, Family Medicine, U.S. “I try to get their reasoning for not getting the vaccine, but I can’t buy into what I hear.” he added. “Our survey reveals that while sharing effective vaccinations and therapies worldwide is vital, it is not enough,” said Peter Kirk, CEO Sermo. “There is a tremendous urgency to counter misinformation and disinformation, and share which messages and approaches have been successful in convincing people to get vaccinated.” COVID-19 and Neurological / Mental Impact Data is continuing to emerge on the long-term implications of COVID-19, including the development of neurological or mental disorders, a topic extensively discussed at the recent American Academy of Neurology virtual meeting this year. While almost half of physicians thought it’s too soon to tell, a significant number of physicians (30%) believe COVID-19 is a neurotropic disease that can cross the blood-brain barrier and cause direct damage to the brain, rather than a respiratory illness that can have neurological side effects. In addition, 30% reported the pandemic has helped patients with social anxiety disorder / social phobia, and depression / mood disorders (29%) that may arise from avoidance of social situations and other in-person encounters by allowing more time for self-reflection and personal development. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 70,000 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan, and Australia. Full results are available at sermo.com. About Sermo Sermo turns physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company provides physicians with a social platform and unique community that fosters impactful peer-to-peer collaboration & discussions about issues that are important to them and their patients. Sermo offers on demand access to physicians via a suite of proprietary technology to provide business intelligence that benefits pharmaceutical, healthcare partners, and the medical community at large. To learn more, visit www.sermo.com Media Contact: pr@sermo.com Share: Facebook LinkedIn Twitter NEW YORK, NY Doctors see increase in patients who are unhoused/in poverty March 16, 2021 Physician Insights from Sermo’s COVID-19 Real Time Barometer Survey Reveal Hidden Health Impact of Pandemic-Driven Poverty New York – March 16, 2021 – One year after COVID-19 triggered a lockdown, economic downturn and devastating global unemployment, a Sermo survey of 2,696 physicians around the world revealed that an increasing number of patients are dealing with homelessness and an inability to afford treatments/medicines, raising concerns on the long-term health consequences beyond coronavirus. Sermo’s COVID-19 Real Time Barometer also found that a large number of physicians report they are treating people for stress related to the pandemic, and are finding their own stress to be increasing. Economic Impact of COVID-19 Fielded Feb. 25, 2021-March 1, 2021, Study 17 found that more than half (53%) of respondents reported seeing an increase over the past year in the number of patients who are unhoused or in poverty and are unable to afford treatment/prescriptions (56%). Physicians also reported that food insecurity/malnutrition (53%) and an increase in substance use and abuse (52%) were health issues resulting from the rising level of poverty. Additionally, 55% surveyed reported they have seen an increase in patients moving or changing physicians because they have lost their job and/or their house over the past year. “Regardless of country and whether they have a nationalized health system, physicians are witnessing dire health consequences due to the economic fall-out caused by COVID-19,” said Peter Kirk, CEO of Sermo. “A chief concern is the long-term impact on people’s health and wellness that isn’t directly related to the pandemic once the worst of the COVID-19 storm has passed.” In the U.S., three out of four (73%) physicians noted that patients have forgone necessary treatments or appointments because they have lost their health insurance and/or were concerned over the cost. More than 60% of these same respondents reported medications for diabetes and high blood pressure — diseases that disproportionately affect low-income households — were most often skipped. One out of four (24%) felt maternal health was one of the biggest health issues associated with homelessness. COVID-19 Impact on Health Systems Physicians surveyed recognized the impact of COVID-19 on the entire healthcare continuum. Worldwide 56% believed there will be an increased strain on health systems from medical emergencies because of delaying access to healthcare. In the U.S., 57% of physicians recommended a free medical clinic when they discovered a patient is unhoused or in poverty — at a time when many of these health clinics are already at capacity. Stress and the Pandemic The study also found that 81% of physicians have treated patients suffering from stress related to the pandemic, and 79% reveal that they personally have found their stress levels to be increased over the last year. Their recommendations — both for their patients and personally — are to utilize a variety of coping strategies, including exercise (74% and 73%, respectively), meditation (45% and 42%) and even scream therapy (9% and 6%). About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 70,000 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Full results are available at sermo.com. About Sermo Sermo turns physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company provides physicians with a social platform and unique community that fosters impactful peer-to-peer collaboration & discussions about issues that are important to them and their patients. Sermo offers on demand access to physicians via a suite of proprietary technology to provide business intelligence that benefits pharmaceutical, healthcare partners and the medical community at large. To learn more, visit www.sermo.com Media Contact: pr@sermo.com Share: Facebook LinkedIn Twitter NEW YORK, NY Doctors say mental health issues will be the biggest issue January 26, 2021 Two out of Three Do Not Believe or Are Unsure Whether the U.S. and World Will Return to Normal Following Vaccine Rollout One year after the first COVID-19 case in the U.S., Sermo surveyed physicians around the world as part of its COVID-19 Real Time Barometer, revealing that 86% of doctors around the world believe that mental health issues and depression will be the biggest non-COVID-19 public health issue after the pandemic. Other areas of concern for the coming year are an increase in violence (34%), increase in spousal or child abuse (27%), increase in suicides (26%) and an increase in opioid abuse (21%). The effects of COVID-19 Fielded Jan. 8, 2021-Jan. 13, 2021, Study 16 of Sermo’s COVID-19 Real Time Barometer included insights from 3,334 physicians across 24 countries. The study also revealed that the majority of physicians (53%) believe the long-term side effects of COVID-19 will be the biggest COVID-related public health issue over the next year. In addition, almost two out of three do not believe or are unsure whether the U.S. and the world will be able to return to normal after the vaccine is rolled out. The survey also revealed that 63% believe the general public will need an annual vaccine to protect against COVID, while 64% said they are very concerned/concerned that a new COVID virus is on the horizon. Of those who participated in the survey, 53% believe the next pandemic will arrive in 5 or more years. What have we learned after one year of COVID-19? Study 16 also asked physicians about the biggest lessons learned during the first year of the pandemic, revealing unified beliefs about: Preparedness — We needed to be more unified and better coordinate federal and global response to the pandemic Health System Fragility — Worldwide, healthcare is seen as an area for cost cutting rather than investment, which has resulted in it being easily susceptible to a health crisis Public Education — We must focus more on educating about the importance of hygiene, prevention and vaccines without devolving into political turmoil “I have learned resilience,” said Dr. Christopher Michos, emergency medicine physician in Bridgeport, Conn. “I have witnessed from my colleagues, our nurses, our techs and the truly unsung heroes, the maintenance and cleaning staff of my hospital. Every day, without a second thought, we are out there. It is war and we are the soldiers trying to save our patients, not knowing as we enter the battlefield, if the next exposure will be the bullet that will kill us.” What do we still have to learn after one year of COVID-19? Physicians surveyed are also concerned about the lessons still to learn about the pandemic, including where the virus originated, how it is transmitted, why certain groups are more at risk of severe infection, what the long-term effects of the virus could be, as well as how long the vaccine will last. Additional findings from Study 16 include: 73% are very concerned/concerned that COVID-19 variants will spread in their region 48% are concerned that pulmonary compromise will be a significant COVID-19-related public health issue in the coming year; 27% are concerned about blood clots and other cardiovascular issues, and 22% are concerned about the neurological side effects and multisystem inflammatory syndrome in children and adults (MIS-C, MIS-A) 78% are concerned about the long-term impact to the world economy; 50% believe the long-term impact to the healthcare system will be among the largest hidden consequences of the pandemic “The biggest lesson from the pandemic is to help each other,” said Dr. Lisa Nassif, a pediatric neurologist in Houston, Texas. “I just opened my private practice during the start of the pandemic. I wasn’t able to buy PPE because of the shortage. I had colleagues give me masks and face shields. Once I obtained PPE, I shared what I obtained, as well. Without coming together, we wouldn’t make it through this awful time.” About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 68,000 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Full results are available at sermo.com. About Sermo Sermo is the world leader in turning physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million HCPs across 150 countries, the company offers a unique physician-first online community that allows clinicians to communicate about issues that are important to them and their patients. Sermo uses a suite of proprietary, technology-enabled tools, so that they are able to cultivate a deep understanding of healthcare provider perceptions that can benefit pharmaceutical, healthcare partners and the medical community at large. To learn more, visit https://www.sermo.com/business/. Media Contact: Lora Grassilli 646.932.3735 lora@rjcomms.com Share: Facebook LinkedIn Twitter NEW YORK, NY 3 out of 4 doctors say COVID immunity is long way off December 2, 2020 Majority of Physicians Say Healthcare Workers Should Receive First Vaccinations in Line With CDC Panel’s Recommendations New York – December 2, 2020 – Study 15 in Sermo’s COVID-19 Real Time Barometer of nearly 4,000 global doctors revealed that 74 percent of physicians believe it will take at least 7 months to achieve community immunity with the new vaccines. Sixty percent of the almost 4,000 physicians who participated said they believed it would take at least 10 months or longer, while 23 percent said it would take at least 18 months. The long runway to community immunity could be driven by barriers physicians believe will hinder adoption of the vaccine. 81 percent of physicians believed that concerns over vaccine safety or potential side effects could keep people from agreeing to take the vaccine. 46 percent indicated that people may not want the vaccine because they believe they won’t get the illness or that symptoms will be mild, while 39 percent said they thought people may not take the vaccine because they don’t like people or the government telling them what to do. The findings come as the U.S. Food and Drug Administration is considering whether to grant emergency use authorization to the first two vaccines developed to protect against COVID-19. The survey, conducted between Nov. 20 and 24, included responses from physicians in 25 countries. In a follow-on Dec. 1 poll among 212 physicians on Sermo’s global social platform, doctors believe healthcare workers should be the first to get the vaccine once it becomes available followed by other frontline workers. This is in alignment with recommendations made the same day by the U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP), which decided that health workers and residents of long-term care facilities should receive the vaccine first. ACIP’s recommendation will need to be approved by the director of the CDC before it becomes official policy. “We need the hospital personnel to go first because they care for the sick and we cannot afford to lose them,” said Dr. Anne Kiltinen, an anesthesiologist practicing in New York. “And when I say hospital personnel, I mean the nursing staff and hospital personnel, not me. I am a senior attending and my contact with patients is limited, so I can wait. We also need public information campaigns. We’ve seen that some patients are concerned about safety and effectiveness.” The Real Time Barometer also found that the majority of physicians believe that during this critical time, it is imperative that the U.S. participate in the World Health Organization. Of all respondents, 68 percent said that it was very important and 16 percent said it was somewhat important for the U.S. to be part of the global organization. Most physicians were also anticipating that their communities would endure another lockdown soon, with 37 percent saying it was very likely and 40 percent saying it was somewhat likely. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 60,800 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Full results are available at sermo.com. About Sermo Sermo is the world leader in turning physician experience, expertise, and observations into actionable insights for the global healthcare community. Engaging with more than 1.3 million physicians across 150 countries, the company offers a unique physician-first online community that allows clinicians to communicate about issues that are important to them and their patients. Sermo uses a suite of proprietary, technology-enabled tools, so that they are able to cultivate a deep understanding of healthcare provider perceptions that can benefit pharmaceutical, healthcare partners and the medical community at large. To learn more, visit https://www.sermo.com/business/. For more information, visit sermo.com. Media Contact: Lora Grassilli 646.932.3735 lora@rjcomms.com Share: Facebook LinkedIn Twitter NEW YORK, NY 92% of doctors tell patients not to wait to get the flu shot September 24, 2020 Nearly 7 out of 10 US Physicians Also Say Pandemic Apt to Significantly Impact Travel This Holiday Season New York – September 24, 2020 – Week 14 of Sermo’s COVID-19 Real Time Barometer survey revealed that 92 percent of physicians in the United States are recommending that patients get their annual flu shot as soon as possible in light of the COVID-19 pandemic. In New York and California, the number of physicians recommending a flu shot immediately jumps to 96 percent and 94 percent, respectively. While the U.S. Centers for Disease Control and Prevention traditionally recommends patients receive a flu shot by the end of October to help combat the virus during flu season, almost all (85%) of the 2,400+ Sermo doctors surveyed from September 17-20 across 31 countries are encouraging their patients to receive a flu shot immediately. “Each year, the flu sickens millions and hospitalizes hundreds of thousands of people during the fall and winter months. The elderly are especially hard hit every year,” said Peter Kirk, Sermo CEO. “While physicians always recommend flu shots, the fact that almost all are recommending that patients receive a vaccine sooner rather than later shows just how concerned they are about the potential for flu to deplete valuable resources in the middle of this historic pandemic.” The survey also found that physicians, like everyone else, are already planning on either eliminating or sharply curtailing travel plans during the holiday season because of COVID-19. Worldwide, 68 percent of physicians said that their holiday travel plans are ‘significantly impacted’ by the pandemic. Overall, in the U.S., 66 percent of physicians said they didn’t plan to travel with their families, but those numbers jumped to 83 percent and 70 percent in New York and California, respectively. Other findings from the survey include: As many as 65 percent of physicians worldwide indicated that they had ordered a COVID-19 test for a patient while 42 percent said they have treated a patient for COVID-19. In the U.S., 70 percent of physicians have ordered a COVID-19 test while 44 percent said they have treated a patient for the illness. In New York, the numbers increase to 76 percent and 47 percent, respectively. In California, the percentage of physicians ordering tests mirror those nationwide. The numbers follow the belief physicians have that a second surge of COVID-19 cases is on the horizon. Globally, 93 percent of physicians expect a second wave of cases as the Northern Hemisphere enters the fall and winter months, and people spend more time indoors. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted over 60,800 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Full results are available at sermo.com. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1.3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Lora Grassilli 646.932.3737 lora@rjcomms.com Share: Facebook LinkedIn Twitter NEW YORK, NY Physicians believe 2nd wave of COVID-19 is likely to occur June 23, 2020 Survey Shows Nearly Half (44%) of U.S. Doctors Believe Fewer Patients will be Infected during a Second Wave Compared to the First New York – June 23, 2020 – Sermo’s COVID-19 Real Time Barometer survey, conducted with nearly 4,000 physicians across 31 countries from June 10-12, reveals 81% of physicians in the United States believe a second wave of COVID-19 – defined as “a sharp increase in cases after achieving extended periods of low growth rates” – is likely to occur. Sixty-two percent of physicians in other countries, such as France, Korea and Australia, feel a second wave is likely. Complete survey data and methodology can be found here. “I feel certain there will be a second wave of COVID-19 infections, hospitalizations and deaths, particularly in areas that have overly relaxed social distancing and mask wearing in a rushed attempt to return to ‘normalcy’,” said David Karpf, MD, endocrinologist at Stanford Health Care. Some Sermo members expressed concern a second wave could occur in the late fall or winter and be compounded by influenza, common respiratory viruses and other seasonal viruses. When asked about preparedness for a second wave, only one-third (34%) of global physicians reported they expect their state or region of their country would be prepared, and a quarter (26%) are not confident lessons learned would be fully applied to a second spike. Are we prepared locally? In California, where new cases are increasing, 87% of doctors surveyed feel a second wave is likely, yet only 39% are highly confident their state will fully apply past learnings. In Illinois, where strict guidelines have been in place since mid-March and residents are preparing to enter phase 4 later this week, 75% of doctors feel a second wave is likely. Only 10% of Illinois physicians surveyed are extremely confident the state will fully apply what was learned in wave one to wave two. In New York, once the epicenter of the outbreak, 76% of doctors surveyed expect to experience a second wave, and more than half (51%) have confidence in how people would handle it. How are physicians holding up? The return to some level of normalcy is a complex process that requires balancing the risk of infection and transmission with the physical and mental effects of isolating, canceling summer camps, shuttering schools, continuing the work from home practice, and more. As the general public has experienced an increase in anxiety over finances, health, safety, relationships and other issues, physicians are enduring their own professional stressors. Among physicians who have experienced more stress than usual in the past week, Sermo found: 63% attributed the increase to implementing new processes to see patients in the office. 58% attributed it to financial concerns (whereas 38% of doctors in the rest of the world feel their increased stress is due to finances). 36% attributed it to uncertainty about how to treat COVID-19. “Our data reflects the voice of physicians worldwide, and in this recent wave, we hear their concern about possible peaks, second waves and preparedness,” said Peter Kirk, Sermo CEO. “Physicians stress the importance of remaining vigilant against the coronavirus otherwise many countries will find themselves back to square one.” About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted 55,280 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1.3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Beth Richman 312-806-8999 Bethrichman1@gmail.com Share: Facebook LinkedIn Twitter NEW YORK, NY No unified approach for Covid-19 treatment landscape June 11, 2020 Global Treatment Patterns Reveal Steady Decline in Hydroxychloroquine Usage and Consistent Increase in Remdesivir Usage in ICU Setting New York – June 11, 2020 – Since late March, healthcare data collection company and social platform for doctors, Sermo, has been surveying physicians worldwide about their experiences and perceptions related to the COVID-19 pandemic. As part of Sermo’s COVID-19 Real Time Barometer, more than 51,300 surveys completed by physicians across 31 countries have reported their treatment strategies and opinions on safety and efficacy to provide a longitudinal view of frontline treatment patterns. Sermo has found doctors are navigating the treatment landscape with uncertainty and minimal confidence in future developments. When asked about the progress made by the scientific and medical communities in managing COVID-19, only 7% of physicians rated them as doing an “excellent” job developing new drugs and only 10% felt they are doing an “excellent” job developing new treatment regimens. Through an analysis of seven weeks of data (April 14 to May 26), Sermo has identified COVID-19 treatment trends: Globally, there has been a consistent decline in hydroxychloroquine usage (61% to 34%) and a steady increase in remdesivir usage (15% to 30%), yet many physicians feel neither drug is “highly effective” in treating COVID-19. With critical COVID-19 patients in an ICU setting, the treatment strategies doctors worldwide have consistently and most often used include: oxygen (69%), anti-coagulants (51%), steroids (45%) and remdesivir (45%). In the U.S., hydroxychloroquine usage for COVID-19 decreased significantly from 56% to 23% over a seven week period. Usage in other countries has also declined; hydroxychloroquine usage dipped from 63% to 41%. Increased confidence in remdesivir and a better understanding of who benefits most from the drug have helped drive usage; 62% of U.S. physicians surveyed reported using remdesivir in the ICU during the week of May 26. In contrast, 8% of U.S. doctors treating mild or moderate cases in a community setting were turning to this medication. “Through our Barometer, we have consistently gathered a significant sample of physician observations about the impact of the coronavirus pandemic,” explained Peter Kirk, Sermo CEO. “The physicians’ attitudes and behaviors shared over the past few months are being reinforced now as clinical and industry data begin to emerge. It’s important to recognize that as states continue to ease restrictions and we experience a possible second wave, our healthcare professionals still need better treatments they believe are safe and effective for COVID-19 and can be applied universally.” When the novel coronavirus outbreak began, there weren’t any drugs clinically proven to be safe and effective for COVID-19, as it was a new disease. Although research studies are underway, this remains true. Sermo surveys show doctors are getting the most relevant COVID-19 information from medical societies, government agencies, physician networks and colleagues. In the absence of approved drugs for COVID-19, this input is helping inform their treatment strategies. Although U.S. healthcare professionals now have a reliable resource in the National Institutes of Health’s treatment guidelines, these do not provide many new prevention or treatment options. “I have not had problems with hydroxychloroquine in 38 years of practice, but of course, I have been using it to treat inflammatory conditions, such as rheumatoid arthritis and systemic lupus erythematosus, not COVID-19.” said Thomas Namey, MD, rheumatologist in Knoxville, Tennessee. “I believe the drug will not benefit COVID-19 patients, but it may have significant benefits when used in a prophylactic measure.” About the COVID-19 Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience of treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, Sermo has conducted 51,300 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. For more information about the Real Time Barometer, including results and methodology, visit sermo.com. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Angela Crawford 201-417-9157 Azito35@gmail.com Share: Facebook LinkedIn Twitter NEW YORK, NY Doctors discuss Pediatric Multisystem Inflammatory Syndrome June 4, 2020 New York – June 4, 2020 – In Week 10 (May 22 to May 24) of Sermo’s COVID-19 Real Time Barometer, an ongoing opinion survey of thousands of physicians worldwide, respondents shared experiences treating multisystem inflammatory syndrome in children (MIS-C). According to the Barometer, in the past three months, 12% of physicians (N = 4,154) saw at least one child age 12 and under with suspected MIS-C, and among those doctors (N = 506), nearly half (49%) saw young patients with possible MIS-C in just the past week. Complete data published to date and study methodology can be found here. According to the U.S. Centers for Disease Control and Prevention, with MIS-C, different body parts, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, can become inflamed. Although the cause is unknown, it is believed many children with MIS-C had coronavirus or had been exposed to someone with COVID-19. Suspected cases of MIS-C should be referred immediately to a tertiary care center. “Our survey shows physicians in the United Kingdom, China, Germany, and other parts of the world have been seeing a higher frequency of MIS-C than we have in the U.S.,” said Peter Kirk, CEO of Sermo. Based on experiences in other countries, it’s possible we could see a surge among American children, particularly as activities reopen and families return to socializing. Recently the CDC provided the following diagnostic criteria for MIS-C: fever of at least 100.4 degrees for at least 24 hours; confirmed evidence of inflammation; need for hospitalization; problems with at least two organs (i.e., lungs, heart or kidneys); and no alternative plausible diagnoses. The patient also must test positive for the coronavirus or its antibodies, or have been exposed to COVID-19 within the last four weeks. Other reported symptoms include vomiting, upset stomach, red eyes, diarrhea, swollen lymph nodes and a rash. Most children diagnosed with the condition have improved with medical care; however, according to the survey, doctors are using a wide range of treatments to manage MIS-C, with no one particular approach being substantially more common. Also, few are utilizing common treatments for adult COVID-19 patients, such as Remdesivir and plasma. MIS-C can be serious, even deadly. Sermo found 41% of physicians who had seen young MIS-C patients reported they progressed to life threatening symptoms. Furthermore, 29% of these same physicians have seen young patients die. Physicians are noting the condition with higher frequency in certain U.S. cities, and state health departments are slowly documenting an increase in MIS-C cases. Children should continue wearing masks, practice social distancing, and interact with peers outside, whenever possible, and parents should be on the lookout for signs of infection, such as fever, inflammation and exposure to people who have COVID-19. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience of treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, 51,300 interviews with doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia, have participated in the Barometer. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Angela Crawford 201-417-9157 Azito35@gmail.com Share: Facebook LinkedIn Twitter NEW YORK, NY Oxygen therapy delays intubation, but aerosolizes Covid May 29, 2020 34% of COVID-19 treating physicians still believe ventilators are used too rapidly according to their hospital protocols New York – May 29, 2020 – Week 9 (May 17 to 19) results from Sermo’s COVID-19 Real Time Barometer with 4,193 physicians reveal COVID-19 treatment patterns among frontline physicians. In total, Sermo’s Barometer study includes over 49,000 survey interviews in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Complete data published to date and study methodology can be found here. Universal medical guidelines on COVID-19 and ventilation strategies have not been written or widely adopted yet. Despite the learning that early intubation was often unnecessary and potentially lethal to patients (with ventilator-related mortality rates documented up to 88%)1, many hospitals still have not changed their protocols. One possible reason is that the overwhelming majority of physicians believe non-invasive oxygen therapies put hospital staff and other patients at risk by aerosolizing the virus. Initially, physicians treated COVID-19 as they would any other virus-induced pneumonia. Patients quickly developed breathing difficulties, treatment protocols were created on the fly, and rapid intubation was encouraged based on older guidelines. Panicked, governments purchased a surplus of very expensive ventilators and the U.S. president invoked the Defense Production Act to compel automotive companies to manufacture ventilators. This week (week 9) in Sermo’s COVID-19 Real Time Barometer, 72% of all doctors (base= 4193) and 80% of hospital physicians treating COVID-19 (base= 764) believe non-invasive ventilation aerosolizes the virus and increases the risk of infection to themselves, other healthcare professionals and patients. Non-invasive oxygenation devices are inexpensive and widely available. They include heated high flow oxygen delivered via a face mask or nasal cannulas, sleep apnea machines such as continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP). CPAPs and BiPAPs work via a tube into a face mask, as opposed to invasive ventilation, which includes a tube placed deep in a patient’s throat while they are sedated, posing a much higher risk to the patient. “At the outset of the pandemic, there were worldwide concerns about a shortage of ventilators. Non-invasive oxygen therapies, like CPAP and BiPAPs were and still are associated with an increased risk of virus transmission, and therefore many hospitals are still moving directly to invasive ventilation. If properly protected, physicians shouldn’t fear using these devices and should absolutely delay ventilation,” said Dr. Mark Rumbak, Professor of Medicine, Pulmonary, Critical Care and Sleep Medicine, University of South Florida. According to a recent study, non-invasive ventilation techniques were proven to be droplet (not aerosol)-generating procedures, producing droplets of > 10 µm in size. Due to their large mass, most fall onto local surfaces within 1 meter. Gradually, the medical community began to see marked differences in the pathophysiology of the disease versus other known virus pneumonias, and in patient response. Physicians made a startling observation; many COVID-19 patients had blood oxygen levels so low they should have been either dead, gasping for air, or experiencing racing heartbeats from the lack of oxygen. Eventually, the medical community learned patients could tolerate these lower levels of oxygen. “Oxygen blood levels have typically driven decisions about breathing support and intubation, but with COVID-19 they might be misleading. Additionally, many physicians are realizing respiratory failure of COVID-19 should be treated differently from routine Acute Respiratory Distress Syndrome (ARDS). It’s imperative to communicate that more patients could receive simpler, noninvasive oxygen support. These strategies should be used in the beginning of breathing difficulties and can even be used for the duration of the illness,” said Dr. Rumbak. However, many physicians feel ventilators are still being used too quickly by their hospitals. In a May 4 Sermo survey, 47% of COVID-19 treating physicians agreed, “we are currently using ventilators too rapidly on patients and we should delay their use as much as possible trying all forms of oxygen therapy initially.” (N=1100 Covid treaters). In this study, physicians also disagreed about whether they were seeing typical ARDS or a new phenomenon. In week 9 of the Barometer, the number of physicians believing ventilation was occurring too rapidly dropped to 34%, indicating intubations were being slowed down, but were still significantly “too rapid.” Recently, several leading medical organizations have recommended delaying intubation and using non-invasive ventilation first. The NIH issued new guidelines advocating a phased approach to breathing support that defers the use of ventilators. The Shanghai guidelines and The Lancet also recommend a similar approach, however, hospitals around the world are not adopting these strategies universally or quickly enough, and each hospital can decide themselves how to treat COVID-19 respiratory failure. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience of treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, more than 49,000 doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia have participated in the Barometer. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Angela Crawford 201-417-9157 Azito35@gmail.com 1.https://jamanetwork.com/journals/jama/fullarticle/2765184?guestAccessKey=906e474e-0b94-4e0e-8eaa-606ddf0224f5 Share: Facebook LinkedIn Twitter NEW YORK, NY 67% of doctors say Remdesivir should be administered earlier May 21, 2020 75% of global physicians treating COVID-19 rate Remdesivir with low to moderate efficacy and find current Remdesivir indication confusing Plasma perceived as most effective treatment for the last five weeks New York – May 21, 2020 – Week 8 (May 11 to 13) results from Sermo’s COVID-19 Real Time Barometer with 4,756 physicians reveal COVID-19 treatment patterns among frontline physicians. In total, Sermo’s Barometer study includes over 42,900 survey interviews in 31 countries including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Complete data published to date and study methodology can be found here. *Results provide physician observations, but are not a substitute for official medical guidelines or clinical trials. Remdesivir Usage is Growing, Particularly in the ICU Overall, 25% of global physicians report using Remdesivir, up from 15% in mid-April. Usage in the United States is higher vs ‘rest of world; 29% vs 21%. In the US, the share of physicians using Remdesivir (29%) has increased by two-thirds since mid-April (at 17%) and currently nearly half (44%) of US physicians treating critical patients in ICU have used Remdesivir, an increase from 25% in mid-April. The Earlier the Better with Remdesivir, but this Contradicts Official Indication The current official indication for Remdesivir is for severe COVID-19. However, two-thirds (67%) of physicians believe Remdesivir is best administered earlier, for all moderate patients in the hospital before their symptoms become severe. Over three-quarters (77%) of physicians express confusion with the official indication. Surveyed physicians shared: “The official indication appears to exclude the period in which it would theoretically be most effective, during virus replication, i.e., the early stages of infection prior to clinical decompensation.” “All viral infections need to be treated earlier, at the onset, not later, when complicated.” “I’m not sure if we have to wait for respiratory failure in order to begin treatment, or can we start it sooner to prevent progression?” “If we wait too long to use it, the patient becomes too critical, and we can’t overcome the illness.” Remdesivir Seen as Only Moderately Effective As they develop a better understanding of the virus and the drug, physicians rating Remdesivir reveal an evolving perception of the treatment and are reaching a common agreement on the moderate effectiveness of Remdesivir. Global Physicians’ Overall Perceived Effectiveness of Remdesivir Nearly half of global physicians (48%) rate Remdesivir as moderately effective. As we examine the trend since mid-April, we note the perception of Remdesivir being moderately effective has increased from 37% to 48%, while the perceptions of it being highly effective and ineffective have decreased. US Doctors aren’t Fully Bought In to Remdesivir A similar trend is seen in the US, where more where more physicians are using Remdesivir and more are seeing the treatment as moderately effective; however, they have a less positive view of Remdesivir than physicians around the world. The impression of Remdesivir having lower efficacy is higher in the US vs internationally. Only 18% of US physicians rate it as highly effective vs 25% of physicians in other countries. Perceived Efficacy and Safety of Various Treatments For the past five consecutive weeks, roughly half of global physicians surveyed have stated they perceive Plasma to be the most highly effective and safe treatment for COVID-19. This week perceptions of Remdesivir’s safety and efficacy remain the same, with only 25% of global physicians finding it highly effective. Efficacy and safety perceptions of Hydroxychloroquine and Remdesivir are quite similar. Our data shows that physicians perceive both Hydroxychloroquine and Remdesivir to be more effective earlier in the disease progression. About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience of treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, more than 43,000 doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia, have participated in the Barometer. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Angela Crawford 201-417-9157 Azito35@gmail.com Share: Facebook LinkedIn Twitter NEW YORK, NY Physicians see false negative tests and Covid re-infections May 14, 2020 As States Ease Up on Restrictions, Accurate Testing and Tracing are Critical to Stopping Disease Spread and Virus Reinfection NEW YORK— May 14, 2020 —The United States has performed over 9.9 million molecular tests for COVID-19 to date. The ability to accurately test and trace new infections is critical for reopening the country. Experts believe easing restrictions before testing becomes more accurate and accessible could lead to a new surge of infections. Sermo’s COVID-19 Real Time Barometer, an international weekly poll including more than 40,000 interviews with physicians in 31 countries, explores a variety of COVID-19 themes. In week 7, perspectives around false negatives and re-infection rates were explored. The survey included 4,476 physicians and was conducted May 3 – 5, 2020. Complete study data and methodology can be found here. False Negatives 85% of physicians surveyed state they have seen some degree of false negative test results. 96% of “Supertreaters” in an ICU setting – highly experienced physicians who have treated over 20 COVID-19 patients – believe they have seen COVID-19 tests produce a false negative. 37% of physicians in the hospital consider more than 20% of the tests have produced false negatives. False Positives Conversely, 41% of physicians reported seeing at least one false positive where someone who does not have the virus tests positive. These inaccuracies present challenges to understanding the pandemic, controlling the spread of the disease, preventing re-infections and ultimately reopening economies. It has been hypothesized the reasons COVID-19 tests may be unreliable and often present false negatives are inadequate or faulty sample collection (swabbing technique), timing of sample collection, test sensitivity, test design and shortages of reagents needed to start up and run the tests. Any one of these can create a false negative test. Test manufacturers as well as leading health organizations, including the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention, have not confirmed how common false negatives are. While the FDA requires manufacturers to report any known instances of false negatives as a condition of granting provisional approval, no such reports are available from the agency. Re-Infection Phenomenon According to the World Health Organization, “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection;” however, some experts feel immunity to the virus is not yet fully understood. As immune response is investigated, physicians on the frontlines are seeing patients being re-infected shortly after they recover from COVID-19. In fact, 9% of worldwide physicians polled by Sermo believe they have seen a patient with a re-infection. Perceived re-infection rates vary widely among countries; only 5% of U.S. doctors report seeing re-infection versus 15% internationally. For example, in Italy and Spain, 15% of physicians have encountered re-infected patients, and in China, 14% of those surveyed saw re-infections. The cause(s) of reinfection are unclear, but may be due to: Inaccurate tests: initially, a patient might have received a false negative or when re-infected, might have experienced a false positive; Reactivation of the virus or a patient had not fully recovered from the disease; Patient engaged in new or repeated contact with an infected person. Respondents in Sermo’s Barometer shared: “We saw a patient who was treated with remdesevir and tocilizumab. He was resolved and then somehow re-infected. We did not find the cause of the re-infection.” “Either the patients are re-infected or the follow-up tests were false negative followed by true positive.” “I treated a young patient with mild COVID-19 and PCR (polymerase chain reaction) symptoms who was admitted to the hospital and then released. This individual returned five weeks later with severe unilateral PCR and pneumonia.” These cases demonstrate an uncertainty of disease persistence or actual re-infection. As tests are improved and more accessible, physicians will begin to feel confident screening patients prior to medical procedures and surgeries that have been postponed during the height of the coronavirus pandemic. Physicians feel the following patients should require COVID-19 pre-screening before an office visit or procedure: 78% said transplant patients 72% said chemotherapy patients 67% said dialysis patients 59% said outpatient surgery centers 53% said dental 47% said vision 41% said regular outpatients (ENT, family practice, GI, internal medicine, nephrology, OBGYN) About the Real Time Barometer The Real Time Barometer is an observational study of the impact of the COVID-19 outbreak as reported by physicians with firsthand experience of treating COVID-19 patients. Each week, thousands of physicians provide insights on topics regarding the global health crisis. To date, more than 40,000 doctors in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia, have participated in the Barometer. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM healthcare professionals across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Angela Crawford 201-417-9157 Azito35@gmail.com Share: Facebook LinkedIn Twitter NEW YORK, NY COVID-19 treatment trends over 6 weeks and 33,700 interviews May 7, 2020 High demand for Plasma and Remdesivir Currently, 55% of global physicians use Hydroxychloroquine, 24% use Tocilizumab, 21% use Remdesivir, 17% use Plasma New York – May 7, 2020 – Week 6 results from Sermo’s COVID-19 Real Time Barometer with 6,150 physicians reveals COVID-19 treatment patterns among frontline physicians. In total, Sermo’s Barometer study includes over 33,700 survey interviews in 31 countries including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. Complete data published to date and study methodology can be found here. Evaluations of COVID-19 treatments demonstrate that physicians have yet to find a universally effective solution; no treatment achieves a majority of physicians rating it as highly effective, with most garnering between 16% to 37% highly effective scores. The one exception is Plasma, which finds 45% of physicians rating it as highly effective. Remdesivir and Hydroxychloroquine are perceived as almost equally safe and effective. Further evaluations of safety reveal additional challenges, as most physicians view commonly used treatments as not highly safe; though, we suspect safety of approved drugs is lower in the context of COVID-19 complications and comorbidities. Plasma and Gamma Globulin stand out, as over half of physicians rate them as highly safe. Remdesivir and other antivirals Overall usage: Globally, 21% of physicians report having used Remdesivir, with a larger share of physicians (27%) using it within the ICU as opposed to just 9% of physicians using Remdesivir among mild patients. Geographic usage: 23% of physicians report using Remdesivir in the U.S., which is less than in Italy (31%), China (30%) and Germany (29%). Usage over time: The share of physicians using Remdesivir has nearly doubled from Week 1 to Week 6, rising from 12% the week of March 25 to 21% the week of April 28. Efficacy: Overall, 29% of physicians feel that Remdesivir is highly effective.This level remains consistent across settings (mild outside hospital/moderate-severe inside hospital/critical in the ICU). COVID-19 Supertreaters (highly experienced physicians who have treated 20+ COVID patients) feel it’s even less effective – only 18% of doctors feel it’s highly effective. One interesting point is that a significantly lower share of physicians perceive Remdesivir as less “highly effective” in the US (18%) vs the rest of the world (30%). Safety: Only 31% of physicians feel Remdesivir is highly safe. Notes on other antivirals: Favipiravir is generally felt to be as effective and as safe as Remdesivir, however, only 7% of physicians report having used it. Acyclovir: Overall, only 7% of physicians have reported using it, with 13% rating it as highly effective (though 30% of physicians in the ICU consider it highly effective); Acyclovir has a higher perceived safety profile (35% feel it to be highly safe). Anti-HIV drugs (e.g. Lopinavir plus Ritonavir – Kaletra): 22% of physicians report using them globally, 16% rate them as highly effective, and 25% rate them as highly safe. Usage has declined from 30% (Week 4) to 23% (Week 5) to 22% (Week 6). Efficacy has also trended downward (23% to 17% to 16% in the last 3 weeks). Oseltamivir (Tamiflu) is used by 14% of physicians globally. Only 18% of physicians feel it to be highly effective, and they also rated Tamilfu as the one of safest drugs (58% rate it as highly effective). Plasma and Gamma Globulin Overall usage: 16% of physicians report having used Plasma. Usage over time: Plasma usage has almost tripled with a 10 point increase since Week 1 and a 4 point since last week. Plasma usage in the ICU has grown the most, showing a close to 60% increase (16% in week 4 to 25% in week 6). Geographic usage: Usage is higher in the U.S. (22%) vs the rest of the world (14%) (~50% more physicians using in the U.S. vs globally). Efficacy: Overall, 45% of physicians feel that it is highly effective, and the results are consistent across settings (mild outside hospital/moderate-severe inside hospital/critical in the ICU). Safety: Plasma is still rated as one of the safest treatment alternatives with 52% of physicians rating it as highly safe. “Convalescent plasma would be useful in certain stages of the disease, less so in others. It certainly has more scientific basis and potential than most of the options that have been loosely tested under anything but controlled conditions.” Sermo member, Emergency Medicine Physician, United States Gamma Globulin is a protein fraction of blood plasma that responds to stimulation of antigens, as bacteria or viruses, by forming antibodies. It’s administered therapeutically in the treatment of some viral diseases. Gamma Globulin is starting to see the same usage trajectory as well as safety and efficacy perceptions as have been seen with plasma over the past three weeks. (7% in week 4, 6% in week 5 and 16% in week 6) 34% of physicians feel Gamma Globulin is highly effective (compared with 44% for plasma) and 50% felt Gamma Globulin to be highly safe as compared to 52% for plasma. Tocilizumab Overall usage: 25% of physicians report using Tocilizumab, with higher usage seen in the ICU (34%). Usage over time: We see a 6-point increase in usage over the last two weeks. Usage has been increasing gradually with 19% of physicians having used Tocilizumab in Week 4, vs 25% in Week 6. Efficacy: Overall 37% of physicians feel that Tocilizumab is highly effective. Geographic usage: Usage in the U.S. is lower than around the globe, with 17% of physicians reporting they use it in the U.S. vs. 28% internationally. Physicians in Italy and Spain had the highest reported usage. Safety: 31% of Physicians rate Tocilizumab to be highly safe. Hydroxychloroquine Overall usage: In Week 6, Hydroxychloroquine is still the most widely used drug following Azithromycin. Globally 55% of physicians report using Hydroxychloroquine. Its use in various settings breaks down as follows: 37% of physicians prescribe it outside the hospital for mild cases, 59% for moderate cases when patients get into the hospital, and 50% in the ICU. Usage over time: We see a 22-point increase in use from Week 1. Usage from Week 1 to Week 6 has increased significantly with 33% of physicians having used Hydroxychloroquine in Week 1 vs. 55% in Week 6. Geographic usage: Usage around the world varies widely; in the U.S., 46% of physicians report using it; that is significantly lower than other countries such as Italy (83%), Spain (78%), Mexico (76%), Brazil (85%), and China (62%). Usage in Great Britain is much lower at 19% and Germany at 13%. Efficacy: Globally 27% of physicians feel that it is highly effective. However, it is felt to be more effective outside of the hospital in mild-symptom patients (32%). This trend follows what we see in usage (higher usage in mild patients).Efficacy perceptions for Hydroxychloroquine were higher in Week 1,where physicians perceived it as the most highly effective drug. Safety: Despite being ranked as one of the least safe drugs (29% of physicians rated it as highly safe), it is still widely used. Ideal vs. actual usage A significant finding was that not all hospitals have access to all treatments they would like to use. We asked physicians which treatments they would use if they had access to any treatment – and the two treatments we saw clear demand for were Remdesivir and Plasma. Overall, 41% of physicians would use plasma if it was an option – a significant 25% gap from the 16% who currently use it. The gap is exceptionally large among physicians treating patients in the ICU – 52% would use plasma if available, while just 25% are actually using it. Remdesivir has a similar “demand gap,” with 39% of physicians saying they would prescribe Remdesivir (compared to 21% currently doing so). The gap is widest among physicians treating moderate/severe patients in the hospital, with 34% saying they would like to use it, compared to 16% that actually use it. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Brooke Matthews sermo@clarity.pr 805-252-5483 Share: Facebook LinkedIn Twitter NEW YORK, NY Experienced COVID treaters say COVID is an “oxygen failure” May 4, 2020 New York – May 4, 2020 – This week, results from Sermo’s COVID-19 Real Time Barometer with over 5,900 physicians explored whether COVID 19 was a new type of disease, the controversial use of ventilators, as well as the new protocols that could change the way physicians treat COVID-19. In total, Sermo’s Barometer study includes over 27,000 survey interviews in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date and study methodology can be found here. Knowledge of COVID-19 and the optimal treatment approach is evolving, and some voices on the front lines have relayed they are charting unfamiliar territory and broadcasting concerns over treatment approaches, particularly the use of ventilators. The statistics around the much sought after breathing device are sobering. In NY, up to 88% of those placed on ventilators died (1). “Panic buying of ventilators” and competition among states to procure ventilators was intense at the onset of the COVID-19 outbreak. Dr. Cameron Kyle-Sidell, a New York-based ER and critical care physician widely broadcast a compelling message on YouTube, “we are treating the wrong disease.” (2) We wanted to further probe his theory and formulated structured questions which were later taken to thousands of international physicians on the front lines. “Nine days ago I opened an intensive care unit to care for the sickest COVID patients. In these 9 days I’ve seen things I’ve never seen before. I presumed I was opening an ICU to treat patients with a virus causing pneumonia that started out mild –– and progressed in severity ultimately ending in acute respiratory distress syndrome or ARDS. ARDS is the disease that every hospital is preparing to treat. And for which many patients might be put on a ventilator. And yet, everything I’ve seen in the last 9 days just doesn’t make sense…I believe we are treating the wrong disease. COVID-19 lung disease…is not a pneumonia and should not be treated as one. Rather, it appears as if it’s some kind of viral-induced disease most resembling high altitude sickness…as if (patients) are on a plane at 30,000 feet and the cabin pressure is slowly being let out. These patients are being starved of oxygen…they eventually get blue in the face, and while they look like patients on the brink of death, they do not look like patients dying of pneumonia…they look more like (they were) dropped off at the top of Mount Everest without time to acclimate.” “I don’t know the final answer to this disease but I’m quite sure that a ventilator is not it. That is not to say that we don’t need ventilators, they are the only way at this time that we are able to give a little more oxygen to patients who need it. But when we treat ARDS, we typically use ventilators to treat respiratory failure, the ventilator does the work that the patients’ muscles can no longer do because they are too tired. These patients’ muscles work fine. I fear that if we are using a false paradigm to treat a new disease that the method that we program the ventilator, one based on a notion of respiratory failure as opposed to oxygen failure, (and there are a great many number of methods we can use with the ventilator), a method being widely adopted in every hospital in the country which aims to increase pressure on the lungs in order to open them up, is actually doing more harm than good…the pressure we are providing to lungs, may not be able to take it, and that the ARDS that we are seeing, may be nothing more than lung injury caused by the ventilator. Now, I don’t know the final answer to this disease. I do sense that we will have to use ventilators, but in a safer way. That safer method challenges long-held dogmatic beliefs within the medical community and among lung specialists which will not be easy to overcome.” In our analysis of results from this past week, we focused on the responses from all physicians treating COVID as well as “COVID Supertreaters in the ICU” (physicians who have treated over 20 COVID-19 patients) and presumably would have the most educated opinions on the matter. Using ventilation too rapidly? Do you believe we are currently using ventilators too rapidly on patients and that we should delay their use as much as possible trying all forms of oxygen therapy initially? From the perspective of COVID-19 Supertreaters in the ICU (physicians who treat over 20 COVID-19 patients) and presumably would have the most experience with ventilators, 48% agreed and 52% disagreed. (n=108 COVID Supertreaters) Among all COVID-19 treating physicians in the study who expressed an opinion (n=1,100), 47% agreed and 53% disagreed “My theory on the split in opinions is that in the beginning of this outbreak, patients were coming in and deteriorating so rapidly that healthcare providers were rushing to help patients breathe in whatever way we could,” said Dr. Mark Rumbak, Sermo physician and pulmonologist. “We are starting to rethink this.” Does COVID-19 result in typical acute respiratory distress syndrome (ARDS)? Do you believe severe COVID-19 is more of a “respiratory failure disease” resulting in ARDS and necessitating ventilation support or a more of an “oxygen failure” disease necessitating oxygen therapy (with ventilation as a last resort)? Among Supertreaters in the ICU, we had an equal split of opinions: 50% believed in the oxygen failure approach vs. 50% respiratory failure (n=118 COVID-19 Supertreaters). Again, among all COVID treating physicians in the study who expressed an opinion (n=1,261), 47% believed in the oxygen failure approach vs. 53% respiratory failure. The two are results related; 63% of physicians who believed COVID-19 to be more of an oxygen failure disease also believed we are using ventilators too rapidly. “What’s highly significant here is that there should be almost unanimous opinion on these topics as we have accepted guidelines for what works and doesn’t with respect to Acute Respiratory distress Syndrome (ARDS). If this is not ARDS the treatment may be completely different. In the case of ARDS we need high Peep and low Fio2, if it’s not ARDS, we need the opposite approach,” said Dr. Rumbak. “Additionally, ARDS has specific histological results. There have been no biopsy results (acutely or post mortem) published as yet. This may be because hospital departments have been closed down for most except COVID-19. If they do publish, we will know what type of respiratory failure this is.” Anonymous pulmonologist Sermo member “It could be a mix of both, perhaps we need to treat that oxygen failure much earlier, more rapidly and with diverse oxygen therapies.” How many succeed on ARDS treatments? In what percent of patient cases with COVID-19 and severe hypoxia does COVID-19 respond to regular ARDS treatments like intubation, high positive end-expiratory pressure (PEEP), lower fraction of inspired oxygen (FiO2)? Only 17% of physicians felt that the majority of patients (60% – 100%) respond to ARDS strategies. So what’s the alternative? We explored other treatments and drugs that could be used to improve oxygenation/ delay intubation. Again, we report on COVID Supertreaters in the ICU. If you believe oxygen is necessary for COVID-19 induced hypoxia, which treatments or drugs do you believe may be helpful in improving oxygenation and delaying intubation? High flow oxygen Cpap or Bipap High-dose steroids Mucomyst (Acetylcysteine) Vitamin C Inhaled nitric oxide Flolan (Epoprostenol Sodium) Other 81% 64% 29% 8% 19% 19% 10% 2% There are alternative oxygen therapies that aren’t standard protocol for COVID-19 patients but are starting to see some use. The ECMO machine (extracorporeal membrane oxygenation), also known as extracorporeal life support, is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube and is a well-established treatment for decompression sickness from scuba diving, serious infections, bubbles of air in the blood vessels and non-healing wounds resulting from diabetes or radiation. “ECMO is an alternative and is used when P/F ratio drops below 80. Although there are less ECMO machines than ventilators they will decrease the amount of ventilators used. Some patients can be extubated while on ECMO and the ventilators used on other patients. ECMO may save lives. ECMO machines are the same machines used in cardiac surgery. As most routine cardiac surgical cases are not being performed due to COVID, they can be used in the ICU. Perhaps we could also use hyperbaric chambers although there are not too many of these. We could try to increase their supply. Some have suggested using the many idle airplanes we have and pressurizing the cabins produce “hyperbaric” oxygen. Many patients can be treated in one plane safely,” said Dr. Rumbak. How helpful would each of these be as alternative oxygen therapies? Highly Helpful” (Very/Extremely Helpful) Among COVID Treaters: Hyperbaric oxygen ECMO 28% (n = 396 COVID treaters with opinion on Hyperbaric oxygen) 44% (n = 467 COVID treaters with opinion on ECMO) “Highly Helpful” (Very/Extremely Helpful) Among COVID Supertreaters in the ICU: Hyperbaric oxygen ECMO 31% (n = 45 COVID Supertreaters in the ICU with opinion on Hyperbaric oxygen) 39% (n = 54 COVID supertreaters in the ICU with opinion on ECMO) A new protocol to delay ventilation? We asked the physicians who felt COVID-19 is more of an oxygen failure issue to build a protocol where they ordered eight different oxygen strategies presented in order of priority to delay intubation. We asked physicians to place these strategies in order of what would be the best protocol to use after ruling out all other causes of hypoxia (heart failure, blood clot, cirrhosis, collapsed lung, shunts heart damage). Overall this was the order of top priority for the following strategies, however, this doesn’t necessarily reflect the order of administration as some treatments would be administered in combination. Use nasal oxygen 1-6L per minute Pronate for better oxygenation Heated high flow nasal cannula 60-80 l/m Use Cpap with oxygen/use Bipap machine Add any of the following treatments to Cpap/Bipap/heated high flow, or non invasive ventilation to improve lung function: inhaled nitric oxide, Flolan (epoprostenol), steroids, plus Vitamin C Non-invasive ventilation (ventilator with Bipap mask) https://jamanetwork.com/journals/jama/fullarticle/2765184?guestAccessKey=906e474e-0b94-4e0e-8eaa-606ddf0224f5 2. https://www.youtube.com/watch?v=Eq6YEYfn2zw&feature=youtu.be About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Share: Facebook LinkedIn Twitter NEW YORK, NY Korea, China, Japan report lowest COVID cases in doctors May 1, 2020 New York – May 1, 2020 – While countries around the globe work to increase availability of COVID-19 testing and flatten the curve, health care personnel on the front lines continue to be at risk of contracting COVID-19 from patients under their care. The latest results from the Sermo COVID-19 Real Time Barometer of 20,000 global physicians found that as of April 21, 58% of U.S. physicians report health care personnel (HCPs) in their hospital/clinic have tested positive for COVID-19. The states that have seen the sharpest increase in physicians reporting infections among HCP colleagues from Week 3 (April 9) to Week 5 (April 21) include Florida (46% to 57%), Texas (35% to 50%), Virginia (41% to 55%) and Ohio (47% to 60%). While there is still significant focus and attention on global COVID-19 “hotspots” including Italy, China and Germany, the countries that are seeing the steadiest increases in physicians reporting infections among HCP colleagues from Week 3 (April 9) to Week 5 (April 21) are Russia (8% to 37%), Mexico (23% to 45%), Brazil (56% to 73%) and Great Britain (65% to 75%). Countries where physicians reported the most COVID-19 infection among colleagues Spain 83% Belgium 82% Great Britain 75% Countries where physicians reported the least COVID-19 infection among colleagues Korea 5% China 11% Japan 16% U.S. States where physicians reported the most COVID-19 infection among colleagues Massachusetts 79% New Jersey 78% New York 76% U.S. States where physicians reported the least COVID-19 infection among colleagues Oregon 30% Kentucky 43% Arizona 44% Anonymous Sermo physicians have shared their experiences: “In Italy we have had more than 100 deaths among medical staff. We did not receive adequate individual protection gear, and we were forced to organize COVID-wards without any indication. By the way, we have 20 regional Health Care Systems, so that political decision has been made by 20 different organizations.” -Cardiologist in Italy “In Greece we have 70 physicians who have fallen ill, none dead. Of course the tests are short and not everyone has taken one.” -Neurologist in Greece “I have been off sick for 13 days now having developed symptoms of fever, chills, aches and a slight cough. I will be writing an article about my experience shortly. Symptoms resolved after 9 days and I am ready to return to work tomorrow.” -Pediatrician in United Kingdom “One of our residents passed away (but is not yet being counted as a covid death). An MA was infected and then infected her husband who is currently intubated. My supervisor, a hands-on administrator, is also intubated.” -Pediatrician in United States “In my hospital there are 6 dead, 4 family doctors, an internist and an emergency doctor, a nurse and several members of the police. There is worry and fear.” -Family Medicine Physician in Spain COVID-19 Testing Availability Sermo continues to study testing availability and found that as of April 21, only 35% of U.S. physicians reported high availability of COVID-19 tests. Globally, Sermo found only 13% of physicians in Spain, 13% of physicians in Brazil, 19% of physicians in Great Britain, and 26% of physicians in Mexico believe COVID-19 test availability is high, with limited week over week changes. Countries where physicians report the highest availability of COVID-19 testing availability Korea 88% Australia 86% China 81% Turkey 72% “Sermo’s latest findings point to the realities we’re seeing around the globe–as the number of COVID-19 cases outpaces the availability of testing, health care personnel on the front lines are faced with an influx of patients putting themselves at significant risk for contracting COVID-19,” said Peter Kirk, CEO, Sermo. “It’s critical to embrace the voice of physicians and recognize the ongoing risk HCPs face and the dire need to scale up testing protocols and follow through on safer at home orders.” In total, Sermo’s COVID-19 Real Time Barometer observational study has polled over 20,000 physicians in 31 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date and study methodology can be found here. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. ### PR Contact: Brooke Matthews 805-252-5483 sermo@clarity.pr Share: Facebook LinkedIn Twitter NEW YORK, NY 52% of US physicians say country has reached outbreak peak April 27, 2020 Majority of Physicians in Many COVID-19 Hotspots Including Korea, Spain, China and Italy Believe Their Countries Have Passed or Reached Outbreak Peak Kentucky is the Only US State Where More Than 50% of Physicians Recommend Lifting Restrictions Within 2 Weeks New York – April 27, 2020 – Around the globe, countries are looking to identify when they have passed or reached peak COVID-19 outbreak to help determine when to lift social distancing restrictions and reopen their economies. The latest results from the Sermo COVID-19 Real Time Barometer of over 5,900 global physicians found that as of April 23rd, physicians in Korea (95%), Spain (92%), China (91%), Italy (89%), Belgium (88%), France (86%) and Greece (84%) believe their countries have passed or reached outbreak peak. This is a stark comparison to the United States, where only 52% (April 23) of physicians believe the country has passed or reached its outbreak peak. Interestingly, when asked the same question on April 2, 66% of U.S. physicians believed that the country was only three to four weeks from reaching or passing outbreak peak. Peak Timing by Region While an increasing percentage of physicians in previously-reported “hot zones” including New York (85%), New Jersey (72%) and Michigan (70%) believe their states have reached or passed outbreak peak, physicians in many states across the U.S. are still predicting more time is needed. Only 53% of physicians in California, 45% in Pennsylvania, 42% in Texas, 40% in Georgia and 37% in Arizona believe their states have passed or reached peak as of April 23rd. Recommend Restriction Lifting Globally, physicians remain conservative in terms of when they recommend restrictions should be lifted. Sermo found that as of April 23, only 19% of physicians in Korea, 34% in Spain, 41% in China, 37% in Italy, 52% in Belgium, 18% in France and 52% in Greece recommend restrictions be lifted within the next two weeks. This tracks with sentiment among physicians in the US where only 27% recommend lifting restrictions in the next two weeks, 66% in three to eight plus weeks and 7% are unsure of when restrictions should be lifted. “Sermo’s latest findings represent the voice of physicians around the COVID-19 outbreak peak. Physicians have frontline views on timing to lift restrictions; the ability to amplify the voices of physicians globally provides a unique opportunity for healthcare providers and policymakers in the U.S. to learn from other countries,” said Peter Kirk, CEO, Sermo. “Our hope is that the insights and recommendations of physicians globally at the local level, can play an important role in helping the U.S. make informed decisions as we look to reopen the economy and determine best practices for easing safer at home orders.” In total, Sermo’s COVID-19 Real Time Barometer observational study has polled over 20,000 physicians in 30 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date and study methodology can be found here. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. ### PR Contact: Brooke Matthews 805-252-5483 sermo@clarity.pr Share: Facebook LinkedIn Twitter NEW YORK, NY Sermo reports jury is still out on Remdesivir effectivenes April 23, 2020 Plasma rated as most safe and effective treatment; 57% of physicians who have used Plasma rate it as highly effective; 60% rate it as safe Efficacy of treatments as seen by 430 COVID Supertreaters (physicians who’ve treated 20+ COVID patients) New York, New York – April 23, 2020 – Sermo, the largest global healthcare polling company and social platform for physicians, has released Week 4 data from its Real Time Barometer study of 5,500 physicians in 30 countries revealing the emergence of treatment patterns and efficacy perceptions. To date, Sermo has conducted studies with over 20,000 physicians over 4 weeks and has published unrestricted access to the results of its studies on sermo.com. *Results represent subjective opinions of COVID-19 treating physicians using various treatments and not the results of clinical trials. Key Findings: In Week 4, Sermo explores perceptions of physicians who were high vs. moderate vs. low treaters of COVID-19 patients, as well as physicians practicing in different settings (hospital (excluding ICU), non-hospital, and ICU). The total number of physician respondents for Wave 4 was 5,500. COVID-19 “Supertreaters” In this Wave, we explore the perceptions of highly experienced COVID-19 treaters, which we call “Supertreaters,” and define as physicians who treat 20+ COVID-19 patients in a particular setting: hospital, non-hospital, or ICU. Of the total number of respondents (5,500), 26% were COVID-19 treaters (n=1,444) and of those, 30% of treaters (n=430) were “COVID Supertreaters.” Remdesivir Users In total, 15% of all COVID-19 treaters (218 physicians) have used Remdesivir in this study. Of those Remdesivir users, 40% (88 physicians) were “COVID Supertreaters.” Usage of Treatments (base=1,444; all COVID-19 treaters who’ve used drug in settings>) The top three drugs that are used are still Azithromycin, Hydroxychloroquine, and Bronchodilators. The percent of physicians having used Hydroxychloroquine, Remdesivir, High-Dose Steroids, Anti-HIV drugs, Plasma and Tocilizumab were higher in hospital vs. non-hospital settings, while Vitamin C was more used in a non-hospital setting. Share of COVID Treating Physicians Who’ve Used Medication Within Setting Non-Hospital (n=636) Hospital (n=1,045) ICU (n=532) Overall (n=1,444) Azithromycin 60% 70% 61% 68% Hydroxychloroquine 40% 66% 67% 61% Bronchodilators 41% 42% 42% 48% High-dose Steroids 13% 29% 35% 30% Anti-HIV drugs 12% 32% 32% 30% Vitamin C 28% 21% 23% 26% Drugs to treat flu 22% 25% 20% 25% Tocilizumab 6% 19% 27% 19% Vitamin D 17% 12% 11% 16% Zinc 17% 11% 14% 15% Remdesivir 6% 16% 21% 15% Plasma 6% 10% 16% 12% Perceived Efficacy Plasma is perceived to be most effective vs. any other treatment. Of physicians who have prescribed Remdesivir, the percent who perceive it as effective is similar across settings ~30%. Perceived efficacy of Hydroxychloroquine for all treaters is 30% and varies widely by setting (from 38% outside of hospital down to 24% in the ICU). Supertreaters rate Hydroxychloroquine slightly lower (28%), and among Supertreaters in the ICU, perceived efficacy is 19%. Though Hydroxychloroquine usage appears to be lower in non-hospital vs. hospital settings, perceived efficacy is higher in non-hospital settings. This may suggest Hydroxychloroquine is more efficacious in milder cases. Tocilizumab bears attention, as it appears to be emerging as a relatively effective treatment option among physicians in hospital settings (52% rate it as very/extremely effective, though it lags with a 27% rating within ICU.) Overall Perceived Efficacy of All Treatments by Setting (Efficacy: % of physicians who rate the drug very or extremely effective; chart reflects all treaters who have used drug in respective setting) Share of Physicians Rating Drug Very/Extremely Effective Within setting (Base Size) Non-Hospital Hospital ICU Overall Plasma 68% (34) 61% (103) 53% (73) 57% Tocilizumab 41% (34) 52% (189) 27% (128) 44% High-dose Steroids 46% (83) 44% (289) 36% (162) 42% Remdesivir 27% (37) 34% (146) 30% (98) 31% Hydroxychloroquine 38% (231) 31% (632) 24% (300) 30% Vitamin D 27% (90) 21% (121) 27% (49) 24% Bronchodilators 26% (247) 25% (418) 26% (200) 24% Anti-HIV drugs 27% (70) 22% (323) 26% (156) 23% Vitamin C 26% (150) 19% (192) 18% (98) 22% Zinc 25% (80) 20% (93) 14% (57) 22% Drugs to treat flu 24% (128) 26% (253) 28% (102) 22% Azithromycin 23% (342) 19% (662) 21% (271) 20% Perceived Efficacy by “COVID-19 Supertreaters” (Efficacy: % of physicians who rate the drug very or extremely effective among Supertreaters, physicians who’ve treated more than 20+ COVID-19 patients in respective setting) Share of Supertreater Physicians Rating Drug Very/Extremely Effective Within Setting (Base Size) Non-Hospital Hospital ICU Overall Plasma 62% (13) 50% (28) 50% (16) 51% High-dose Steroids 38% (26) 49% (119) 35% (46) 44% Tocilizumab 39% (18) 52% (97) 20% (40) 44% Drugs to treat flu 28% (36) 28% (50) 34% (29) 30% Remdesivir 25% (16) 28% (53) 21% (38) 27% Hydroxychloroquine 27% (66) 29% (199) 19% (79) 26% Vitamin C 20% (30) 16% (55) 28% (29) 23% Vitamin D 13% (16) 21% (29) 29% (17) 22% Zinc 20% (15) 17% (24) 24% (17) 21% Bronchodilators 19% (67) 17% (127) 27% (60) 20% Anti-HIV drugs 19% (26) 15% (119) 27% (37) 20% Azithromycin 17% (93) 18% (201) 27% (81) 19% Safety As expected, safety for vitamins, minerals, Azithromycin and Bronchodilators is perceived to be high. Plasma had the highest safety profile among the more novel or advanced treatments for COVID-19 (Remdesivir, drugs to treat flu, Anti-HIV drugs, Hydroxychloroquine, Tocilizumab). Overall Perceived Safety of All Treatments by Setting (Efficacy: % of physicians who rated the drug very or extremely safe; chart reflects all treaters who have used drug in respective setting) Share of Physicians Rating Drug Very/Extremely Safe Within Setting (Base Size) Non-Hospital Hospital ICU Overall Zinc 92% (101) 79% (111) 77% (66) 87% Vitamin D 85% (102) 81% (126) 79% (52) 84% Vitamin C 82% (172) 79% (212) 75% (113) 79% Bronchodilators 70% (257) 71% (434) 67% (215) 69% Plasma 73% (33) 58% (104) 53% (73) 60% Azithromycin 60% (369) 51% (707) 46% (306) 53% Drugs to treat flu 55% (136) 49% (262) 43% (105) 49% High-dose steroids 36% (84) 43% (301) 37% (182) 40% Remdesivir 28% (36) 36% (152) 30% (103) 36% Hydroxychloroquine 37% (248) 36% (666) 29% (330) 35% Tocilizumab 37% (35) 35% (188) 28% (130) 32% Anti-HIV drugs 33% (73) 22% (329) 28% (162) 24% “Plasma (human antibodies from recovered COVID-19 patients) is compelling because plasma antibodies were the treatment of choice for bacterial pneumonia before the introduction of Penicillin. The question is availability and scalability. In the past, we have scaled up antibodies by producing them in sheep and horses, so it would be interesting to look into monoclonal antibodies. Personally, I use antimalarials with azithromycin, high-dose steroids and vitamin C, sometimes an IL-6, and I also use melatonin and zinc. Lastly, we are using treatments that work on multiple fronts, and we may want to look into the efficacy of these combinations vs. just single drugs. We also suspect different efficacy of different drugs for different patient types,” said Mark Rumbak, M.D., Professor of Medicine, Pulmonary and Critical Care at the University of South Florida and Sermo member. “Until we have access to randomized clinical trials with a placebo arm, observational studies of physicians are an effective way to gather and share critical insights,” said Peter Kirk, CEO of Sermo. “Sermo represents the voices of physicians, which is why we are highly focused on sharing our real-time learnings as effectively as possible to better support those on the front lines.” Methodology A sample size of 250 point estimates have a precision of a +/- 6% at a 94% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Israel. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Share: Facebook LinkedIn Twitter NEW YORK, NY 2/3 of U.S. physicians say COVID-19 testing is subpar April 22, 2020 As of April 15, 30% of U.S. physicians vs. 60% in Europe reported getting test results back within a day New York – April 21, 2020 – As policymakers and health professionals look to forecast when the U.S. can begin easing safer at home restrictions, the availability and timing of reliable COVID-19 testing has been heralded as one of the key determinants. The latest results from the Sermo COVID-19 Real Time Barometer of 5,500 physicians found that as of April 15, only one-third (34%) of U.S.-based physicians believe the status of COVID-19 testing meets the levels needed. Regional Testing Availability Globally, 87% of physicians in Korea, 71% in Australia, 73% in China and 65% in Germany have reported high availability of tests. In the US, only 21% of physicians in North Carolina, 24% in Ohio, 25% in Virginia, 26% in New Jersey, 27% in Missouri and 29% in Arizona believe there is a high availability of tests in their respective states. An anonymous Sermo General Practice physician commented, “I worked in a Primary Care Center and we have not had tests to be able to attend to our suspected patients. Medications are limited for our patients and there is a lack of masks as well as protective suits to avoid taking risks when caring for our patients.” Timing for Test Results Turnaround time for test results in the U.S. continues to be a barrier in the fight against COVID-19. As of March 25th, only 15% U.S. physicians reported that they’re able to get COVID-19 test results back within a day compared to 51% in Europe. Some progress has been made to date, but is still not at the level needed to allow physicians and patients to take swift action; as of April 15, 30% of U.S. physicians reported they were able to get test results back within a day compared to 60% in Europe. “The availability of COVID-19 testing is one of the critical factors that will help determine what the future looks like when it comes to opening the country, and these insights from our physicians are important data points to helping make this determination,” said Peter Kirk, CEO, Sermo. “We think it’s important to amplify the voices of physicians on the frontlines who have unparalleled firsthand insights into this global crisis, and it’s clear from their feedback that we still have much to consider as the U.S. looks to reopen its economy.” In total, Sermo’s COVID-19 Real Time Barometer observational study has polled over 20,000 physicians in 30 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date and study methodology can be found here. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Share: Facebook LinkedIn Twitter NEW YORK, NY 1/4 of doctors say HCPs should take hydroxychloroquine April 17, 2020 Sermo’s Barometer studies have polled over 20,000 physicians globally regarding COVID-19 New York – April 17, 2020 – Hydroxychloroquine, a widely available and inexpensive drug initially used for malaria as well as lupus and rheumatoid arthritis, has been the subject of intense medical and political debate as researchers work quickly to determine its ability to fight coronavirus. According to this week’s Sermo COVID-19 Real Time Barometer of 5,158 physicians, one-quarter of global physicians agree that healthcare workers should take hydroxychloroquine to prevent COVID-19 infections with 50% having used or seen hydroxychloroquine used in their professional settings since March 25, 2020. There is little data about the efficacy of hydroxychloroquine, and the Centers for Disease Control and Prevention (CDC) has cited cardiotoxicity as a leading concern with the treatment, particularly in patients with underlying health issues and immunosuppression. Hydroxychloroquine use among patients: In the US alone, there are more than 24 hydroxychloroquine trials underway to test the drug’s capabilities for preventing and treating coronavirus. While universities like NYU Langone Medical School are evaluating whether hydroxychloroquine can prevent people exposed to the novel coronavirus from getting sick and states like South Dakota are conducting their own clinical trials, physicians are increasingly tasked with making real-time decisions based on the limited information available. Prophylactic use of Hydroxychloroquine for patients: By the first week of April 2020, of the physicians who had prescribed hydroxychloroquine to their patients, 22% of them had already prescribed or had seen hydroxychloroquine prescribed prophylactically in their setting (n=1443). While most patient types receiving hydroxychloroquine were high risk (including first responders), a significant share of physicians had even used hydroxychloroquine for low risk patients: 87% of physicians indicated use in high risk patients, including first responders (n= 277) 31% of physicians indicated use for low risk patients (n=100) Hydroxychloroquine usage for suspected undiagnosed cases: Findings from the Sermo study also reveal that physicians have prescribed hydroxychloroquine for both symptomatic patients and undiagnosed patients, and the use of hydroxychloroquine in clinical settings has been on the rise since March 25, 2020. As of April 8, 50% of global physicians have used or seen hydroxychloroquine used in their professional settings (Week 1, March 25: 33%; Week 2, April 1: 44%; Week 3, April 8th: 50%). Additionally, physicians reported the patient types they are treating with hydroxychloroquine include: Week 1 through Week 2 – 57% vs. 65% (respectively) of physicians used hydroxychloroquine for diagnosed patients with severe symptoms Week 1 through Week 2 – 45% vs. 49% (respectively) of physicians used hydroxychloroquine for diagnosed patients with mild symptoms Week 1 through Week 2 – 17% vs. 22% (respectively) of physicians used hydroxychloroquine for undiagnosed patients with severe symptoms Week 1 through Week 2 – 16% of physicians used hydroxychloroquine for undiagnosed patients with mild symptoms N= physicians who have prescribed hydroxychloroquine (W1: 2573, W2: 1443) An anonymous emergency medicine physician on Sermo commented: “Despite the superstorm of controversy surrounding hydroxychloroquine, it still remains the leading treatment option for severe patients and is even being used in milder cases and patients who are simply suspected of COVID. At this stage with so little evidence, doctors have very limited options.” Sermo’s COVID-19 Real Time Barometer observational study polled over 20,000 expert physicians in 30 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date can be found here. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Share: Facebook LinkedIn Twitter NEW YORK, NY Doctors report on using Hydroxychloroquine and Azithromycin April 15, 2020 Percentage of New York Physicians Who Have Used Hydroxychloroquine Nearly Doubled, Italian and French Physicians Jumped 30% Points + Over 2 Weeks Plasma Still Perceived as Most Effective but Not Widely Used Perception of Hydroxychloroquine’s Efficacy is Significantly Higher Among Physicians in Europe and China vs US Physicians (50% vs 29%) New York, New York – April 15, 2020 – Week three data of the Barometer study from 4016 physicians in 30 countries conducted by Sermo reveals the emergence of treatment patterns and efficacy perceptions. Sermo, the largest global healthcare polling company and social platform for physicians, has published unrestricted access to the results of its Real Time Barometer study on sermo.com. Key findings: In Wave 3 we explored perceptions of physicians who were high vs moderate vs low treaters of COVID patients. The total number of physician respondents for Wave 3 was 4016. Of those, 33% treated COVID patients (n=1337). The COVID treaters (1337) breakdown was: 42% of COVID treaters have treated between 1-5 patients 20% of COVID treaters have treated between 6 -10 patients 38% of COVID treaters have treated between 11 and more patients We did not find significant differences between highly active and low active COVID treaters in the below findings. Usage patterns among COVID treaters (N= 1337) The top three treatments that doctors reported having prescribed were Azithromycin (58%), Hydroxychloroquine (50%), and Bronchodilators (48%); traditional Chinese medicine has been used by 67% of physicians in China. Week over week increases in usage Percentage of physicians in New York who have used Hydroxychloroquine nearly doubled since Wave 1 week of March 25 (23% to 40% to 43% wave over wave). Italy and France had the highest increase in COVID treaters having prescribed Hydroxychloroquine wave over wave; an increase from 50% to 83% for Italy and an increase from 20% to 50% for France. The number of COVID treaters that report having used Hydroxychloroquine and Azithromycin both increased 17% points since Wave 1 the week of March 25. Hydroxychloroquine Wave 1: 33%, Wave 2: 44%, Wave 3: 50% Azithromycin Wave 1: 41%, Wave 2: 50%, Wave 3: 58% The number of COVID treaters that report having used Bronchodilators increased 12% points (from 36% to 48%) week over week. Usage of anti-HIV drugs (e.g. Lopinavir plus Ritonavir), drugs to treat the flu (e.g. Oseltamivir), and plasma from recovered patients remains steady week over week, while use of non-approved drugs (e.g. Remdesivir) decreased slightly. Perceived treatment efficacy Physicians who treat COVID patients in Italy, Spain, France, and China have higher perceptions of Hydroxychloroquine’s efficacy vs the US (~50% vs 29%). The top treatments that have been used/seen used and reported as very or extremely effective among COVID treaters (N= 1337) include: 46% plasma from recovered patients (n=363); 40% Hydroxychloroquine (n=875); 38% high dose steroids during a cytokine storm (n=556) No significant differences of perceived efficacy were observed between highly active COVID treaters and users of these drugs (physicians treating 11+ patients) and lower active COVID treaters (1-10 patients) 55% of physicians in China who have used traditional Chinese medicine rated traditional Chinese medicine as effective or extremely effective Most popular Hydroxychloroquine dosage regimen 75% report using 400mg BID on day one (800mg total), then 400 mg daily for 4-5 days 10% report using 600mg BID on day one (1,200mg total), then 400 mg daily for 4 days Methodology Most results are reported for individual countries with a minimum sample size of 250. A sample size of 250 point estimates have a precision of a +/- 6% precision at a 94% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Niki Franklin Racepoint Global on behalf of Sermo +1 617 624 3264 Sermo@racepointglobal.com Share: Facebook LinkedIn Twitter NEW YORK, NY Insight into do-not-resuscitate protocol for COVID patients April 13, 2020 69% of hospital physicians globally say their hospitals have already adjusted ventilator prioritization policy in case of shortages; US behind other countries New York, New York – April 13, 2020 – The COVID-19 pandemic has put unprecedented pressure on global healthcare systems and created wartime triaging challenges that most healthcare providers have never faced. To put these situations into context, Sermo, the largest global healthcare polling company and social platform for physicians, is leveraging its capabilities to publish ongoing COVID-19 studies* with thousands of global physicians. What to do if a patient codes In typical medical emergencies when a patient codes, physicians use all measures to save a patient’s life. That effort requires that many HCPs work on the patient at once using techniques like de-intubation where bodily fluids from the patient can potentially spread and infect the healthcare team. Today, with the risk of infection to first responders, the “all measures“ approach seems to have changed. Sermo’s study reveals that over half of global physicians felt the HCP team should limit their exposure when trying to save patients’ lives. When asked, “what do you personally believe should be the protocol for COVID-19 patients that code,” the 4,982 global physician respondents said: 53% – use all measures to save the patient’s life, but limit the number of healthcare professionals working on the patient 26% – use all measures to save the patient’s life, with as many healthcare professionals as needed 10% – do not resuscitate 11% – do not know Resuscitate or Do NOT Resuscitate? Regional differences in DNR approach Physicians in the US are almost 3 times as likely to say ‘do not resuscitate (US 14% vs ROW 5%; n= 4982) Ventilator prioritization policies in hospitals have changed Overall, 69% of hospital physicians globally reported their hospital has already adjusted the protocol for who receives a ventilator if they are in short supply (n=892 COVID treaters in hospitals). This appears to have happened earlier in Europe and ROW at ~75%, versus US at 53% and NY at 55%. How hospital administrators and ethicists prioritize the use of ventilators; how doctors personally believe ventilators should be prioritized We surveyed both physicians and hospitals on both their personal ethical beliefs regarding who should be prioritized for ventilator use and also asked them how their hospitals are making the same decisions. The criteria for deciding ventilator assignment included patients with the highest chance of recovery, patient most ill and at highest risk of death, first responders, age of the patient, and first come first serve. Physicians’ personal ethical criteria versus hospitals’ ethical criteria for treating patients in a ventilator shortage In choosing a hierarchy for the use of a ventilator for COVID-19 patients, physicians and hospitals agree on the first and second priority – 1, patients with the highest chance of recovery and 2, those most ill and highest risk of death. However, they differ slightly on the third criteria: physicians personally believe first responders should have more priority over the age of the patient, whereas hospitals believe age of the patient should be prioritized over first responders. First come first serve and age of patient were reported to be the least important criteria overall. Physician ethical beliefs differ by country The first wave of Sermo’s study data showed that among physicians in all countries except China, the top criteria for deciding who should receive a ventilator first was patients with the highest chance of recovery (47%) followed by those most ill and at highest risk of death (21%), and then first responders (15%). With the pandemic changing so rapidly, Sermo re-polled the physicians on this question and the Wave II data showed an increase in prioritizing those with the highest chance of recovery across the globe: 52% prioritized those with the highest chance of recovery 21% those most ill and at highest risk of death 14% first responders 8% age of the patient 5% first come first serve “The insights gleaned from our platform provide a direct country-specific view into how physicians are responding to this pandemic. While similar challenges are global in nature, responses vary and tension points around the ethical decisions these physicians are facing come to light,” said Peter Kirk, CEO, Sermo. The second study wave represents more than 4,982 physicians in 30 countries. The data focuses on questions around ethical dilemmas, such as ventilator shortages, physician decisions on patient prioritization, what to do if a patient codes, and more. The data also analyzes differences in response to these dilemmas by country. To view full results and country breakdowns, visit sermo.com. *Results provide physician observations but are not a substitute for official medical guidelines. Methodology Results are reported for individual countries with a minimum sample size of 250. Such a sample size provides for point estimates with a +/- 6% precision at a 94% confidence level. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Niki Franklin Racepoint Global on behalf of Sermo +1 617 624 3264 Sermo@racepointglobal.com Share: Facebook LinkedIn Twitter NEW YORK, NY Zinc and vitamins c, d recommended to treat/prevent COVID April 9, 2020 28% advise daily Vitamin C for protection; traditional Chinese medicine used and found effective among nearly half of Chinese physicians NEW YORK, NEW YORK – April 9, 2020 – Week two data of the Barometer study from 5,000 physicians in 30 countries conducted by Sermo reveals trends around over the counter products used and recommended for COVID-19. Sermo, the largest global healthcare polling company and social platform for physicians, has published unrestricted access to the results of its Real Time Barometer study on sermo.com. While both the CDC and the WHO state that the only way to minimize the chances of contracting COVID-19 is to take preventative steps such as handwashing, social distancing, and cleaning surfaces, there seems to be emerging trends around physician recommendation and usage of vitamins, supplements, homeopathy as well as traditional Chinese medicine. Key Findings: Other than typical cold/flu medications (acetaminophen, anti-histamines, etc.) to treat COVID-19, physicians report having recommended or seen recommended to their patients Vitamin C (32%), Zinc (21%), and Vitamin D (19%) By region (n=2506): Vitamin C: US at 32% (NYC at 40%; California at 35%); Europe at 24%; and ROW at 34% Zinc: US at 26% (NYC at 35%; California at 27%); Europe at 11%; and ROW at 16% Vitamin D: US at 26% (NYC at 35%; California at 27%); Europe at 11%; and ROW at 19% In terms of overall efficacy, 16% of physicians have seen Vitamin C as effective in treating COVID 19; 10% for Zinc and 8% for Vitamin D 28% of physicians have recommend taking daily Vitamin C (supplements/fruits/vegetables) to protect themselves from COVID-19 45% of Chinese COVID treaters have used or seen used traditional Chinese medicine to treat COVID; 52% found it effective (n=79) Research on vitamin and supplement effects on Coronavirus has already begun, and past research exists on Zinc and cold viruses. A research team at Zhongnan Hospital in Wuhan, China, began a study on vitamin C treatments for COVID-19 on Feb. 14. The program is expected to be completed at the end of September. The team claims, “Vitamin C plays a role in reducing inflammatory response and preventing the common cold. A few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections.” Anonymous physicians on Sermo commented: “While there are no supplements or vitamins that can prevent you from getting COVID, I believe that Zinc can help diminish its symptoms and severity and ultimately help a patient recover. Zinc has been shown to inhibit viral replication of SARS, which is a cousin of COVID-19. As long as there are no contraindications, I would recommend taking zinc if someone is experiencing COVID symptoms. See the UC Health’s take on Zinc.” “We know that stress, anxiety, poor nutrition and sleep can depress the immune system, which makes it easier to catch infections. Vitamins and supplements may strengthen our immune system and as such help protect us from infection.” Methodology Most results are reported for individual countries with a minimum sample size of 250. A sample size of 250 point estimates have a precision of a +/- 6% precision at a 94% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Niki Franklin Racepoint Global on behalf of Sermo +1 617 624 3264 Sermo@racepointglobal.com Share: Facebook LinkedIn Twitter NEW YORK, NY Sermo reports on Hydroxychloroquine, plasma and Remdesivir April 8, 2020 Data from week two of largest ongoing international market research study on COVID-19 New York, New York – April 8, 2020 – Week two data of the Barometer study from 5,000 physicians in 30 countries conducted by Sermo reveals the emergence of treatment patterns. Sermo, the largest global healthcare polling company and social platform for physicians, has published unrestricted access to the results of its Real Time Barometer study on sermo.com.  Key findings:   Usage patterns and efficacy perceptions among COVID treaters: The top three treatments that doctors most reported prescribing were Azithromycin (50%), Hydroxychloroquine (44%), and bronchodilators (36%) The treating physician percentage for Hydroxychloroquine went up across the board globally COVID treaters reported having prescribed or seen Hydroxychloroquine prescribed increase by 11% (from 33% to 44%) week over week and Azithromycin increase by 9% (from 41% to 50%) Italy had the highest increase in having prescribed or seen Hydroxychloroquine prescribed (from 50% to 71%). Reported usage in New York nearly doubled (23% to 40%), week over week. Perceived treatment efficacy:  The top three treatments that have been used/seen used and reported as very or extremely effective among COVID treaters include: 52% plasma from recovered patients (n=261) 38% Hydroxychloroquine (n=1160) 37% non-approved drugs (e.g. Remdesivir) (n=389) Italy, Spain, France, and China have higher perceptions of Hydroxychloroquine’s efficacy vs. the rest of the world Plasma from recovered patients is perceived as more effective than Hydroxychloroquine (52% of COVID treaters felt it was very to extremely effective vs Hydroxychloroquine at 38%) Plasma, however, is reported as one the least utilized treatments, suggesting either a lack of availability, scalability, or awareness Usage of anti-HIV drugs (e.g. Lopinavir plus Ritonavir), drugs to treat the flu (e.g. Oseltamivir), and plasma from recovered patients, remains steady week over week at 19%, 17%, and ~5%, respectively; use of non-approved drugs (e.g. Remdesivir) decreased slightly from 12% to 10% Starting to surface in the data as a treatment option is Tocilizumab, an IL-6 inhibitor Most popular Hydroxychloroquine dosage regimen: 42% report using 400mg BID on day one (800mg total), then 400 mg daily for 5 days 31% report using 400mg BID on day one (800mg total), then 200mg BID for 4 days An anonymous Pediatrician on Sermo commented, “I took Chloroquine for a year in southeast Asia to prevent malaria. So did another 3,000,000+ soldiers. I suffered no ill effects and this letter is proof of no death. The dead do not have time for the FDA’s randomized clinical trials. Just ask them.” “The data is fantastic, representing a large international data set and our first glimmer of treatment. While reason for optimism, as a clinical researcher, I strongly recommend to pause at further interpretation until we can measure the clinical effectiveness,” said Dr. Brian Ferris, Vascular Surgeon and President of the Pacific NW Vascular Society in Washington state. “We are humbled by the tireless work of doctors on the front lines and their contribution, enabling us to collect this data and make it universally available,” said Peter Kirk, CEO of Sermo. “To all the doctors who are participating, in aggregate you form the powerful voice of doctors globally.”   Methodology Most results are reported for individual countries with a minimum sample size of 250. A sample size of 250 point estimates have a precision of a +/- 6% precision at a 95% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contact: Niki Franklin Racepoint Global on behalf of Sermo                                                                          +1 617 624 3264                                                                                        Sermo@racepointglobal.com Share: Facebook LinkedIn Twitter NEW YORK, NY Sermo doctors reveal global COVID treatment patterns April 2, 2020 Sermo Reports on Hydroxychloroquine Efficacy, Rise in Prophylaxis Use; Over 80% Expect 2nd Outbreak New York, New York – April 2, 2020 – Widespread confusion, conflicting reports, inconsistent testing, and off-indication use of existing and experimental drugs has resulted in no single source of information from the frontlines. To create a centralized and dynamic knowledge base, Sermo, the largest healthcare data collection company and global social platform for physicians, leveraged its capabilities to publish results of a COVID-19 study with more than 6,200 physicians in 30 countries. The study was completed in three days. Data covers current treatment and prophylaxis options, timing to the outbreak peak, effectiveness of government responses, and much more. Results of the first wave can be found at sermo.com. Multiple study waves including a deeper dive into treatments will be conducted over the next several weeks, and Sermo is calling all physicians globally to participate. Key findings; Sermo Real Time Barometer*: Treatments & Efficacy The three most commonly prescribed treatments amongst COVID-19 treaters are 56% analgesics, 41% Azithromycin, and 33% Hydroxychloroquine Hydroxychloroquine usage amongst COVID-19 treaters is 72% in Spain, 49% in Italy, 41% in Brazil, 39% in Mexico, 28% in France, 23% in the U.S., 17% in Germany, 16% in Canada, 13% in the UK and 7% in Japan Hydroxychloroquine was overall chosen as the most effective therapy amongst COVID-19 treaters from a list of 15 options (37% of COVID-19 treaters) 75% in Spain, 53% Italy, 44% in China, 43% in Brazil, 29% in France, 23% in the U.S. and 13% in the U.K. The two most common treatment regimens for Hydroxychloroquine were: (38%) 400mg twice daily on day one; 400 mg daily for five days (26%) 400mg twice daily on day one; 200mg twice daily for four days Outside the U.S., Hydroxychloroquine was equally used for diagnosed patients with mild to severe symptoms whereas in the U.S. it was most commonly used for high risk diagnosed patients Globally, 19% of physicians prescribed or have seen Hydroxychloroquine prophylactically used for high risk patients, and 8% for low risk patients Second Wave of Outbreak The second global outbreak is anticipated by 83% of global physicians, 90% of U.S. physicians but only 50% of Chinese physicians Average Testing Time On average tests in the U.S. take 4-5 days, and in 10% of cases the wait is more than 7 days 14% of U.S. physicians and over 50% in all of Europe and Japan report getting test results in 24 hours; in China 73% of doctors get tests back in 24 hours, while 8% get tests back within the hour Prioritizing Treatment if Ventilator Shortage In all countries except China, the top criteria for deciding who should receive a ventilator first was patients with the highest chance of recovery (47%) followed by those most ill and at highest risk of death (21%), then first responders (15%) In China the priorities were reversed as the most ill and highest risk of death received ventilators First responders were more important in the U.S. France, Japan, and Italy prioritized age Brazil and Russia prioritized higher risk patients Peak Timing & Restrictions In the U.S., 63% of physicians recommend restrictions be lifted six or more weeks from now and 66% believe the peak is at least 3-4 weeks away Government Effectiveness The large majority of physicians globally believe government actions are very to somewhat effective A majority of physicians believe state and government are weighing public and economic concerns appropriately Top Three Equipment Needs Top three needs globally are Personal Protective Equipment (PPE), followed by rapid COVID-19 testing kits, then ventilators Top Three Information Needs Physicians are most in need of knowing when rapid tests will become available, when new treatments will become available, and the efficacy of existing medications to treat coronavirus COVID-19 Concerns A majority of physicians are very concerned about spreading it to family members and ~50% are concerned about catching COVID-19 in the next two months 81% of physicians have taken special precautions at home, including changing their clothes and showering before joining family; some even stay in isolation Close to a quarter of physicians and over a third of patients report extreme stress For the full methodology click here. “This is a treasure trove of global insights for policy makers. Physicians should have more of a voice in how we deal with this pandemic and be able to quickly share information with one another and the world,” said Peter Kirk, CEO, Sermo. “With censorship of the media and the medical community in some countries, along with biased and poorly designed studies, solutions to the pandemic are being delayed. We invite global physicians to contribute to help inform policy makers, their colleagues, and the public.” “This survey of front line doctors shows the value of critical information sharing between countries. That is the only way that a new insight from one country can rapidly save lives around the world,” said Dr. Murali Doraiswamy, professor of psychiatry and medicine at Duke University School of Medicine and a scientific advisor to Sermo. *Results provide physician observations but are not a substitute for official medical guidelines. Methodology Results are reported for individual countries with a minimum sample size of 250. Such a sample size provides for point estimates with a +/- 6% precision at a 94% confidence level. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com. Media Contacts: Niki Franklin Racepoint Global on behalf of Sermo +1 617 624 3264 Sermo@racepointglobal.com Share: Facebook LinkedIn Twitter NEW YORK, NY Data from physicians in 30 countries provide COVID insight March 27, 2020 5,400+ doctors who have already participated will help create a trusted single source of data that will shape policy, treatment guidelines, and provide real-world insights New York, New York – March 27, 2020 – Sermo, the leading global social platform for physicians and largest healthcare data collection company, today announced the launch of its COVID-19 Real Time Barometer. With a network of 1,3MM HCPs in 150 countries, Sermo is uniquely positioned to provide this single source feed of real time data of physicians’ insights and perspectives on how the world is faring against COVID-19. The study will address a broad range of topics including treatments being used and their efficacy and safety, ethical questions related to wartime triaging and medical shortages, patient types experiencing the most complications, hospital preparedness, peak timing, social distancing impact and much more. “Policy is being decided on the fly by politicians and governments, and oftentimes without accurate data because of the rapidly changing pandemic. There is no clear view of what is happening, there is no macro lens – things are changing hour to hour, patient to patient,” said Peter Kirk, CEO, Sermo. “Physicians and scientists on the frontlines need a voice during this time, and Sermo is providing that avenue in a systematic and trusted way through our physician-only platform and this study.” Media is invited to partner with Sermo to share and amplify this important data with all stakeholders alike. There will be approximately 5 consecutive weekly waves with each wave featuring repeated questions to enable us to track trends over time. If you’re a physician looking to participate in the study or a healthcare constituent interested in receiving updates on the COVID-19 study, please visit https://www.sermo.com/covid-barometer. About Sermo Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, please visit www.sermo.com and follow us on Twitter, Facebook and LinkedIn. 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