Monoclonal antibodies to prevent household transmission of SARS-CoV-2

A remarkable new NEJM study has shown that the prophylactic administration of monoclonal antibodies reduces the risk of household contacts developing symptomatic or asymptomatic infection with SARS-CoV-2. For those who did develop symptomatic infection, monoclonal antibodies reduced to duration of disease and the duration of high viral load. This study opens up the possibility of a new tool to prevent the spread of SARS-CoV-2 to vulnerable patients in our hospitals. Is the future of managing hospital contacts of SARS-CoV-2 the prophylactic administration of monoclonal antibodies?

Visual abstract from the study
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To FFP or not to FFP: variation in national guidelines on respiratory protection during the COVID-19 pandemic

Probably the most contentious aspect of the COVID-19 pandemic has been PPE for staff. And within that, the most contentious aspect of PPE has been respiratory protection when caring for patients with confirmed or suspected COVID-19: to FFP or not to FFP? I have been involved in a review of international guidelines to identify variation and track the changes in the guidelines over time. Things have changed as evidence has emerged, but international guidelines still disagree on where and when FFP respirators should be worn when caring for patients with suspected or confirmed COVID-19. The review also tracked variation and changes in recommendations about what should be considered an AGP.

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Hospital-onset COVID-19 (HOCI): a systematic review

As we get into gear to prepare for the next epidemic wave of COVID-19 affecting healthcare providers (hoping that it will not come), it’s a good time to review where we have got to with the surveillance of healthcare-associated COVID-19. Colleagues at Imperial have just published a systematic review of the latest literature on this important issue. Whilst uncertainties remain about surveillance definitions and exactly what “healthcare-associated COVID-19 infection” is, the message is clear that healthcare-providers must have in place clear and rapid systems for identifying healthcare-associated COVID-19 to prevent the spread of the SARS-CoV-2 virus in healthcare facilities.

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B.1.617.2: an update

PHE released the latest epidemiological summary of the B.1.617.2 VOC (aka “the variant that was first identified in India”) a few days ago. Evidence is emerging rapidly, and the datasets are far from conclusive. But it now seems clear that B.1.617.2 is more transmissible, causes no more hospitalisation or mortality, and vaccine effectiveness is slightly reduced when compared with other variants.

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The role of ventilation in preventing the transmission of SARS-CoV-2

I gave a talk at the Sussex Infection Prevention Development Week yesterday on ventilation and preventing the spread of SARS-CoV-2. I learnt a lot in putting together the talk, so thought I’d share my slides (here) and some of the key points. Ventilation is a crucial way to prevent the spread of SARS-CoV-2 (and other respiratory viruses), and I hope that improved ventilation in health and social care settings will be one of the good things to come out of this pandemic.

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SARS-CoV-2 variant: an update

PHE have published a rapid epidemiological comparison of the SARS-CoV-2 variant (VOC 202012/01 aka B1.1.7) with ‘wild-type’ SARS-Cov-2 in this country. Most of the characteristics don’t look to be different – the variant is not associated with more hospitalizations or an increase in 28-day mortality. However, there does seem to be an increase in secondary attack rates of the variant compared with wild-type SARS-CoV-2.

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The new COVID-19 variant: a primer

Unless you have been living under a rock, you’ll have seen that there’s a new COVID-19 variant on the scene. This block summarises the key information that has emerged so far about this new variant. It seems to be more transmissible, no more virulent, and there’s no evidence that the vaccines that are approved or nearly approved will be less effective against the variant.

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