Light-based Immunomodulation for Guarding Against Human Respiratory Tract Infections

Methods: Subjects 18 years and older working at a DoD medical facility and VA medical facility will be randomized into Active Treatment (Emit Bio ) and sham (inactive device). Basic demographic information will be obtained. Subjects will use the device at home every other day for 5 minutes. Baseline viral upper respiratory PCR panel will be obtained to ensure pre-existing infections are not counted. At first sign of upper respiratory infection symptoms, subjects will contact research personnel and have viral respiratory PCR panel obtained. Research coordinators will also contact subjects every two weeks to ask if they are experiencing or have experienced any upper respiratory symptoms or if they have experienced any side effects of treatment. Subjects reporting any current symptoms or symptoms in the prior 2 weeks will have upper respiratory PCR panel obtained. Any subjects with confirmed or unconfirmed PCR URI will be contacted daily until symptoms subside to assess secondary outcomes including duration of symptoms, missed days of work, outpatient medical visits, ED visits, hospitalizations, medication prescriptions for respiratory illness and over the counter treatments.

Screening visit (Approx 30 min):

* Obtain and document signed Informed Consent document and HIPAA Authorization * Verify subject eligibility based on inclusion/exclusion criteria (research coordinators may use the electronic medical record to verify inclusion/exclusion) * Record all medications the subject is taking * Collect demographic information to include phone number, email address, DoD ID, age, race, ethnicity, sex, whether they directly care for patients, what department they work in, any therapies regularly used to prevent URI (ie zinc, mouth washes, supplements), and immunocompromised state or medications that may suppress the immune system, weight (pounds), height (inches), and BMI

Randomization:

Subjects will be randomized using block randomization (blocks of 6) into one of two research treatment groups, with approximately 50 subjects in each arm for a total of 100 subjects. The study staff assigning subjects to their group will be unblinded to the groups, but patients, investigators, and study staff conducting screening and gathering data will be blinded. The unique study code will be assigned in sequential order beginning with 001.

Group 1: Active RD-X19 every other day for 3 months Group 2: Sham RD-X19 every other day for 3 months

Visit 1 (week 0) (may be same day as screening visit) (approx. 30 minutes):

* Subject will be given the RD-X19 device and shown how to use the device * Subjects will be instructed to use the device for 5 minutes every other day * Subject will be given "Instructions for Treatment" handout

Visits 2-7 (weeks 2-12) (approx. 30 min) can be performed virtually or in person

* Subjects will be asked if they have experienced any upper respiratory symptoms in the last 2 weeks, this may include cough, congestion, sore throat, fatigue, runny nose, sinus pain or pressure, fever (subjective or Temp \>100 F), sneezing. * Subjects experiencing any of the above symptoms will be tested for URI causing viruses using PCR based testing. * Any subjects with confirmed or unconfirmed PCR URI will be contacted daily until symptoms subside to assess secondary outcomes including duration of symptoms, missed days of work, outpatient medical visits, ED visits, hospitalizations, medication prescriptions for respiratory illness and over the counter treatments. They will also be assessed daily using the WURSS 24 (Wisconsin Upper Respiratory Symptom Survey) daily symptom report until they report a score of 0 for question 1 (How sick do you feel today?) * Subjects who have not experienced any URI symptoms will be assessed for adherence to RDX19 over the previous 2 weeks and encouraged to continue using the device. They will also be asked if they are experiencing any side effects of the treatment such as throat or mouth irritation, sores in the mouth or on the lips or any other perceived side effects.

Device will only be used for a single patient and should be returned to research staff at the end of the study for disposal.

• duration of symptoms [Time frame: upper respiratory infection duration, an average of 2 weeks]
• missed days of work [Time frame: upper respiratory infection duration, an average of 2 weeks]
• outpatient visits [Time frame: upper respiratory infection duration, an average of 2 weeks]
• emergency department visits [Time frame: upper respiratory infection duration, an average of 2 weeks]
• hospitalizations [Time frame: upper respiratory infection duration, an average of 2 weeks]
• Wisconsin Upper Respiratory Symptom Survey (WURSS 24) [Time frame: upper respiratory infection duration, an average of 2 weeks]
• number and type of medication prescriptions for respiratory illness [Time frame: upper respiratory infection duration, an average of 2 weeks]
• number and type of over the counter treatments used [Time frame: upper respiratory infection duration, an average of 2 weeks]
• differences in incidence of URI amongst different viruses from PCR panels [Time frame: through study duration, an average of 12 weeks]
• treatment side effects [Time frame: through study duration, an average of 12 weeks]
• adherence to daily use of RD-X19 device throughout study [Time frame: through study duration, an average of 12 weeks]