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Latest COVID-19 Updates

 

 

San Bernardino County COVID-19 Testing

 

California Department of Public Health (CDPH) has increased the number of sites where community members can pick up at-home testing kits. Free at-home antigen and PCR test kits are now available at every county testing site without an appointment. For more information regarding antigen tests, please visit: https://sbcovid19.com/rapidtests/.

 

Avoid Hospital ER's
Avoid Hospital ER's

 

Hospitals are urging patients with asymptomatic or relatively mild COVID-19 infections as well as cases of the flu or seasonal illness, to seek care in more appropriate settings such as urgent care clinics or primary care offices. If you are seeking COVID-19 testing, you should visit a local community testing site. Please visit covid19.ca.gov/get-tested/ for testing options.

 

Monoclonal Antibody Treatment


The U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorizations (EUA) for monoclonal antibodies to treat COVID-19 for certain patients. 

What are monoclonal antibodies?  Our bodies naturally make antibodies or proteins to fight viruses we may be exposed to, like the virus that causes COVID-19.  Monoclonal antibodies are produced in a laboratory and are designed to mimic and act like our own natural antibodies to limit the amount of virus in our bodies.

Physicians are now using monoclonal antibodies as early treatment for certain patients who have contracted COVID-19.  Monoclonal antibodies are also being used as a preventive treatment for patients who are immunocompromised. This treatment may also be considered when someone has been exposed, or is at high risk of being exposed, to an individual who is infected with COVID-19. 

Early treatment with monoclonal antibodies is important. For those with COVID-19 symptoms, treatment needs to be administered within 10 days of the first symptom. If you believe you may be a candidate for monoclonal antibodies, please contact your medical provider since physician authorization is required to receive this treatment.   

COVID-19 Variants​​

Information about the characteristics of these variants is rapidly emerging. Scientists are working to learn more about how easily they spread, whether they could cause more severe illness, and whether currently authorized vaccines will protect people against them.

Find data and technical information about variants circulating in the United States.

What We know

Viruses constantly change through mutation, and new variants of a virus are expected to occur. Sometimes new variants emerge and disappear. Other times, new variants persist. Multiple variants of the virus that causes COVID-19 have been documented in the United States and globally during this pandemic.

Viruses constantly change and become more diverse. Scientists monitor these changes, including changes to the spikes on the surface of the virus. By carefully studying viruses, scientists can learn how changes to the virus might affect how it spreads and how sick people will get from it.

If you think about a virus like a tree growing and branching out; each branch on the tree is slightly different than the others. By comparing the branches, scientists can label them according to the differences. These small differences, or variants, have been studied and identified since the beginning of the pandemic.

Some variations allow the virus to spread more easily or make it resistant to treatments or vaccines. Those variants must be monitored more carefully.

Learn more about how scientists monitor viruses.

Variants in the United States

We are monitoring multiple variants; currently there are four notable variants in the United States:

B.1.1.7 (Alpha): This variant was first detected in the United States in December 2020. It was initially detected in the United Kingdom.

B.1.351 (Beta): This variant was first detected in the United States at the end of January 2021. It was initially detected in South Africa in December 2020.

P.1 (Gamma): This variant was first detected in the United States in January 2021. P.1 was initially identified in travelers from Brazil, who were tested during routine screening at an airport in Japan, in early January.

B.1.617.2 (Delta): This variant was first detected in the United States in March 2021.  It was initially identified in India in December 2020.

These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases will put more strain on healthcare resources, lead to more hospitalizations, and potentially more deaths.

So far, studies suggest that the current authorized vaccines work on the circulating variants. Scientists will continue to study these and other variants.

Learn more about SARS-CoV-2 Variant Classifications and Definitions.

How common are these variants

CDC tracks multiple variants circulating in the United States and provides an estimate of how common they are in the nation and at the regional level. This data can change over time as more information is available.

Based on current data, variant B.1.1.7 is the most common variant across the country.

What we are doing to learn more

Scientists are studying these variants to learn more about them and to quickly detect new variants. They want to understand whether the current and new variants

  • Spread more easily from person-to-person
  • Cause milder or more severe disease in people
  • Are detected by currently available viral tests
  • Respond to medicines currently being used to treat COVID-19
  • Change the effectiveness of COVID-19 vaccines

Learn more about what CDC is doing to track variants.

COVID Data Tracker - US COVID-19 Cases Caused by Variants:  Read More on the CEC Website

 

SARH-Bug100x100

New Variant of Virus that Causes COVID-19 Detected

Since November 2020, the United Kingdom (UK) has reported a rapid increase in COVID-19 cases in London and southeast England. This rapid increase in cases has been linked to a different version—or variant—of the virus that causes COVID-19 (SARS-CoV-2). Public health professionals in the UK are evaluating the characteristics of this new variant.

What we know
Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. Sometimes new variants emerge and disappear. Other times, new variants emerge and start infecting people. Multiple variants of the virus that causes COVID-19 have been documented in the United States and globally during this pandemic.

The virus that causes COVID-19 is a type of coronavirus, a large family of viruses. Coronaviruses are named for the crown-like spikes on their surfaces. Scientists monitor changes in the virus, including changes to the spikes on the surface of the virus. These studies, including genetic analyses of the virus, are helping us understand how changes to the virus might affect how it spreads and what happens to people who are infected with it.

Recent reports indicate that about 6 in 10 cases reported in London are caused by the new variant. Genetic analysis of the new variant shows changes to the spikes on the virus and to other parts of the virus. Initial studies suggest that the new variant may spread more easily from person to person. So far, scientists in the UK see no evidence that infections by this variant cause more severe disease.

What we do not know
It is still very early in the identification of this variant, so we have a great deal to learn. More studies on the new variant are needed to understand

  • How widely the new variant has spread in the UK and potentially around the world
  • How the new variant differs from earlier variants
  • How the disease caused by this variant differs from the disease caused by other variants that are currently circulating

What it means
Public health officials are quickly studying the new variant to learn more so that they can control its spread. They want to understand whether the new variant

  • Spreads more easily from person to person
  • Causes milder or more severe disease in people
  • Is detected by currently available viral tests
  • Responds to medicines currently being used to treat people for COVID-19
  • Affects the effectiveness of COVID-19 vaccines. There is no evidence that this is occurring, and most experts believe this is unlikely to occur because of the nature of the virus.

Some countries have announced travel bans to and from the UK while scientists work to better understand the new variant.

 

Implications of the Emerging SARS-CoV-2 Variant VOC 202012/01

Executive summary
A new variant strain of SARS-CoV-2 that contains a series of mutations has been described in the United Kingdom (UK) and become highly prevalent in London and southeast England. Based on these mutations, this variant strain has been predicted to potentially be more rapidly transmissible than other circulating strains of SARS-CoV-2. Although a variant may predominate in a geographic area, that fact alone does not mean that the variant is more infectious. Scientists are working to learn more about this variant to better understand how easily it might be transmitted and whether currently authorized vaccines will protect people against it. At this time, there is no evidence that this variant causes more severe illness or increased risk of death. Information regarding the virologic, epidemiologic, and clinical characteristics of the variant are rapidly emerging. CDC, in collaboration with other public health agencies, is monitoring the situation closely. CDC will communicate new information as it becomes available.

Does this variant have a name?
At present, the variant is referred to as “SARS-CoV-2 VOC 202012/01” (i.e., the first variant of concern from 2020, December), or “B.1.1.7.” The press often uses the terms “variant,” “strain,” “lineage,” and “mutant” interchangeably. For the time being in the context of this variant, the first three of these terms are generally being used interchangeably by the scientific community as well.

Why has this variant been in the news recently?
Since November 2020, a variant strain of SARS-CoV-2 has become prevalent in the southeast of England, reportedly accounting for 60% of recent infections in London. This variant has a mutation in the receptor binding domain (RBD) of the spike protein at position 501, where amino acid asparagine (N) has been replaced with tyrosine (Y). The shorthand for this mutation is N501Y, sometimes noted as S:N501Y to specify that it is in the spike protein. This variant carries many other mutations, including a double deletion (positions 69 and 70).

Why has this variant emerged in the UK?
We do not know. By chance alone, viral variants often emerge or disappear, and that may be the case here. Alternatively, it may be emerging because it is better fit to spread in humans. This rapid change from being a rare strain to becoming a common strain has concerned scientists in the UK, who are urgently evaluating the characteristics of the variant strain and of the illness that it causes.

Have we seen this variant in the United States?
The VOC 202012/01 variant has not been identified through sequencing efforts in the United States, although viruses have only been sequenced from about 51,000 of the 17 million US cases. Ongoing travel between the United Kingdom and the United States, as well as the high prevalence of this variant among current UK infections, increase the likelihood of importation. Given the small fraction of US infections that have been sequenced, the variant could already be in the United States without having been detected.

What do we know already about variants containing N501Y?
Prior work on variants with N501Y suggests they may bind more tightly to the human angiotensin-converting enzyme 2 (ACE2) receptor. It is unknown whether that tighter binding, if true, translates into any significant epidemiological or clinical differences. In one laboratory study of transmission of the virus between ferrets, this mutation (and one other) spontaneously arose in the ferrets during the experiment. The significance of this observation remains to be elucidated. VOC 202012/01 so far has no known association with animals or animal contact.

What about the other mutations in this variant of SARS-CoV-2?
SARS-CoV-2 mutates regularly, acquiring about one new mutation in its genome every two weeks. Many mutations are silent (i.e., cause no change in the structure of the proteins they encode) because they produce a three-letter codon that translates to the same amino acid (i.e., they are “synonymous”). Other mutations may change the codon in a way that leads to an amino acid change (i.e., they are “non-synonymous”), but this amino acid substitution does not impact the protein’s function.

VOC 202012/01 has 14 non-synonymous (amino acid [AA] altering) mutations, 6 synonymous (non-AA altering), and 3 deletions, notably including

69/70 deletion: this double deletion has occurred spontaneously many times, and likely leads to a change in the shape of (i.e., a conformational change in) the spike protein.
P681H: near the S1/S2 furin cleavage site, a site with high variability in coronaviruses. This mutation has also emerged spontaneously multiple times.

ORF8 stop codon (Q27stop): This mutation is not in the spike protein but in a different gene (in open reading frame 8), the function of which is unknown. Similar mutations have occurred in the past. In Singapore, one strain with this type of mutation emerged and disappeared.

What implications could the emergence of new variants have?

Among the potential consequences of these mutations are the following:

  • Ability to spread more quickly in humans. There is already evidence that one mutation, D614G, has this property to spread more quickly. In the lab, G614 variants propagate more quickly in human respiratory epithelial cells, out-competing D614 viruses. There also is evidence that the G614 variant spreads more quickly than viruses without the mutation.
  • Ability to cause either milder or more severe disease in humans. There is no evidence that VOC 202012/01 produces more severe illness than other SARS-CoV-2 variants.
  • Ability to evade detection by specific diagnostic tests. Most commercial polymerase chain reaction (PCR) tests have multiple targets to detect the virus, such that even if a mutation impacts one of the targets, the other PCR targets will still work.
  • Decreased susceptibility to therapeutic agents such as monoclonal antibodies.

  • Ability to evade vaccine-induced immunity. FDA-authorized vaccines are “polyclonal,” producing antibodies that target several parts of the spike protein. The virus would likely need to accumulate multiple mutations in the spike protein to evade immunity induced by vaccines or by natural infection.

Among these possibilities, the last—the ability to evade vaccine-induced immunity—would likely be the most concerning because once a large proportion of the population is vaccinated, there will be immune pressure that could favor and accelerate emergence of such variants by selecting for “escape mutants.” There is no evidence that this is occurring, and most experts believe escape mutants are unlikely to emerge because of the nature of the virus.

Is this new variant related to the newly emergent variant in South Africa?
On December 18, 2020, the South African government announced that it had also seen the emergence of a new strain in a scenario similar to that in the UK. The South African variant also has the N501Y mutation and several other mutations but emerged completely independently of the UK strain and is not related to it.

What is CDC doing to track emerging variants of SARS-CoV-2?
In November 2020, CDC officially launched the National SARS-CoV-2 Strain Surveillance (NS3) program to increase the number and representativeness of viruses undergoing characterization. When fully implemented in January 2021, each state will send CDC at least 10 samples biweekly for sequencing and further characterization. In addition, CDC’s COVID-19 response is actively seeking samples of interest, such as samples associated with animal infection and, in the future, samples from vaccine-breakthrough infections. Data from these efforts are continuously analyzed at CDC, and genomic data are rapidly uploaded to public databases for use by researchers, public health agencies, and industry. To coordinate US sequencing efforts outside of CDC, since early in the pandemic, CDC has led a national coalition of laboratories sequencing SARS-CoV-2 (SPHERES). The SPHERES coalition consists of more than 160 institutions, including academic centers, industry, non-governmental organizations, and public health agencies. Of the approximately 275,000 full-genome sequences currently in public databases, 51,000 are from the United States. (The UK currently has the most sequences, with 125,000).

Information gathered from CDC website