COVID-19: Another Variant in U.S. / Antibody Cocktail for Prevention? / WHO Recommendations / In-School Transmission

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Catch up on the latest COVID-19 news:

B.1.1.28.1 variant in U.S. The Minnesota Department of Health on Monday confirmed the first known U.S. case of the SARS CoV-2 variant known as B.1.1.28.1 (or Brazil P.1). The variant was first detected in Brazil and is believed to be more transmissible than older strains of SARS-CoV-2. The Minnesota case was identified in a resident who'd recently traveled to Brazil.

Antibody cocktail for prevention? Regeneron's monoclonal antibody cocktail may help prevent COVID-19 in people with high-risk exposures, according to interim results from the company's phase 3 trial. In an exploratory analysis among the first 400 patients randomized, no symptomatic COVID-19 cases occurred among those who received casirivimab-imdevimab injections — but there were eight cases among placebo recipients. For overall SARS-CoV-2 infection (with or without symptoms), the incidence was halved with the antibodies (5% of recipients vs. 10% with placebo). Viral load was roughly 100-fold higher among infected placebo recipients compared with antibody recipients. In November, the FDA granted an emergency use authorization for the antibody cocktail to treat mild-to-moderate COVID-19.

WHO recommendations: The World Health Organization has updated its clinical guidelines on managing COVID-19. The group now suggests that COVID-19 patients who are at home use pulse oximetry to monitor their oxygen saturation levels. For hospitalized patients, the WHO suggests use of low-dose anticoagulants to help prevent thrombosis. And for hospitalized patients receiving supplemental oxygen, including noninvasive ventilation, prone positioning is suggested. The complete guidelines are available at the link below.

In-school transmission: When appropriate COVID-19 mitigation strategies are in place, K–12 schools may be able to offer in-person learning with limited risk for in-school transmission, according to findings in MMWR. Researchers examined COVID-19 transmission in 17 rural Wisconsin schools between the end of August and end of November. Students received cloth masks through a grant, students and staff were instructed to wear masks, and staff were advised to maintain 6 feet of distance from others. Among some 5530 students and staff included, 191 developed COVID-19; 4% of these cases (all students) were linked to in-school transmission. COVID-19 case rates were lower among students and staff than in the county as a whole (3450 vs. 5470 per 100,000). Of note, student mask adherence was high — above 92%.