States Start to Loosen Restrictions as U.S. COVID Cases Level Off

THURSDAY, Jan. 28, 2021 (HealthDay News) -- Some states have started to ease tight social distancing restrictions as COVID-19 infections and hospitalizations begin to plateau across the United States.

Still, the emergence of more infectious coronavirus variants in this country has prompted many officials to proceed cautiously on reopening their economies, the Associated Press reported.

The recipe for the balancing act seems simple, but experts say it isn't.

"If the frequency [of hospitalizations] goes up, you tighten it up. If the frequency goes down, you loosen up. Getting it just right is almost impossible," Dr. Arnold Monto, a public health professor at the University of Michigan, told the AP. "There's no perfect way to do this."

As Michigan's coronavirus infection rate dropped to the nation's fifth-lowest over the last two weeks, Gov. Gretchen Whitmer announced bars and restaurants can serve customers inside next week for the first time in more than two months, but it will be at 25% of capacity and with a 10 p.m. curfew on service. The state has already resumed in-person classes at high schools and partially reopened movie theaters.

"We're in a stronger position because we've taken this pause," Whitmer said. "But we are also very mindful of the fact that this variant is now here in Michigan. It poses a real threat."

Meanwhile, Chicago and its surrounding suburbs allowed indoor dining over the weekend for the first time since October, the AP reported. Major cultural attractions including the Field Museum and Shedd Aquarium reopened with crowd limits.

Washington, D.C., also recently ended its month-long ban on indoor dining, and California Gov. Gavin Newsom this week lifted stay-at-home orders he imposed last month when hospitals were so overwhelmed with virus patients that they were on the verge of rationing lifesaving care, the AP reported. Restaurants and places of worship will be able to operate outdoors, and many stores will be able to have more shoppers inside.

In Oregon, Gov. Kate Brown announced that some indoor operations, such as gyms and movie theaters, can reopen Friday with limited capacity. Indoor dining is still banned in the hardest-hit counties.

After North Dakota dropped to the nation's second-lowest case rate, Gov. Doug Burgum has not only relaxed limits on the number of people who can gather at restaurants and bars but also allowed a statewide mask mandate to expire last week, the AP reported.

The reason for the relaxation of social distancing in some places? Newly confirmed U.S. cases have dropped over the past two weeks, from an average of about 248,000 per day to around 166,000, the AP reported. And the number of people in the hospital with COVID-19 has fallen by tens of thousands, to 109,000.

Still, U.S. health officials have predicted that the more contagious, and possibly more lethal, variant sweeping Britain will probably become the dominant source of infection in America by March. So far, 315 cases of the British variant have been reported in at least 27 states, according to the U.S. Centers for Disease Control and Prevention. And other variants are circulating in South Africa and Brazil. The Brazil variant was detected for the first time in the United States this week, in Minnesota.

Antibody cocktails show more mettle against COVID than thought

Promising new data on two coronavirus antibody cocktails suggests these therapies can keep patients out of the hospital and even prevent illness altogether in some people.

Eli Lilly said Tuesday that its two-antibody combo reduced the risk of hospitalizations or death by 70% in newly diagnosed COVID-19 patients at high risk of serious illness and hospitalization because of their age or other health conditions, the AP reported. All 10 deaths seen in the study were among those receiving placebo, not the antibody cocktail.

At the same time, Regeneron Pharmaceuticals Inc. reported preliminary results from an ongoing study that indicated its antibody cocktail prevented symptomatic infections in housemates of someone with COVID-19. Instead of an IV drip, the drug was given as multiple shots, which will make the treatment easier to deliver, the AP said.

Neither report has been published or subjected to peer review, and the Regeneron data is based on only one quarter of the patients in its study, the AP reported.

U.S. regulators have allowed emergency use of some Lilly and Regeneron antibodies for mild or moderate COVID-19 cases that do not require hospitalization as research on the treatments continued. Now, both companies are asking regulators to expand authorization of their drugs based on the new findings, the AP said.

Regeneron's results were on the first 409 people in a study that has enrolled more than 2,000 so far. All tested negative for the virus but live with someone who has COVID-19.

There were roughly half as many infections among those given the antibody treatment versus a placebo, and none on the drug developed any symptoms, the AP reported. Infections also were shorter and the amount of virus lower among those given the antibodies.

Lilly's new results were from a study of 1,035 non-hospitalized patients recently diagnosed with COVID-19. About 2% on the drug were later hospitalized or died versus 7% of the placebo group, the AP reported.

Travel bans to stop new variants

As more infectious coronavirus variants first detected in Britain, Brazil and South Africa circulate globally, Biden announced plans to bar travel by non-citizens into the United States from South Africa.

The South Africa travel ban will go into effect on Jan. 30 and an existing ban will be extended on non-citizen travelers from Europe and Brazil, The New York Times reported.

In small studies published last week, scientists found that the South African variant is less susceptible to antibodies created by natural infection or by vaccines made by Pfizer and Moderna, which have both been authorized for emergency use in the United States, the European Union and elsewhere. Those vaccines can be altered in a matter of weeks, but experts warn that it would be difficult to update them constantly, the Times reported.

There was better news on Monday, however: In a small study involving 8 patients, Moderna said that although its vaccine did show a sixfold reduction in levels of antibodies when pitted against the South Africa variant, those antibodies "remain above levels that are expected to be protective," the Times reported.

Dr. Tal Zaks, Moderna's chief medical officer, told the newspaper it is already developing a booster vaccine that could perform better against the South Africa variant "to be ahead of the curve should we need to."

Meanwhile, coronavirus vaccines held up against the British variant in one study. But Prime Minister Boris Johnson said recently that the variant was not only more contagious but may also be more deadly. While scientists agree that the evidence of the British variant's greater lethality is preliminary and based on limited data, U.S. health officials took note of the news.

"We need to assume now what has been circulating dominantly in the U.K. does have an increase in what we call virulence to cause more damage, including death," Dr. Anthony Fauci told CBS News this week.

The emergence of coronavirus variants has made the campaign to vaccinate all Americans even more urgent. As of Thursday, more than 24.6 million Americans have been vaccinated, while over 47.2 million doses have been distributed, according to the CDC. More than 3.8 million people have received their second shot.

A global scourge

By Thursday, the U.S. coronavirus case count passed 25.6 million while the death toll passed 429,000, according to a Times tally. On Thursday, the top five states for coronavirus infections were: California with over 3.2 million cases; Texas with more than 2.3 million cases; Florida with nearly 1.7 million cases; New York with more than 1.3 million cases; and Illinois with over 1.1 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was over 10.7 million by Thursday, a Johns Hopkins University tally showed. Brazil had nearly 9 million cases and more than 220,000 deaths as of Thursday, the Hopkins tally showed.

Worldwide, the number of reported infections neared 101 million on Thursday, with nearly 2.2 million deaths recorded, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: The New York Times; CBS News; Associated Press