Both telephone-based and f-to-f CBT showed improvements in depression, subjective burden, and assistance support in dementia AA CGs. Replication with a larger sample size (N = 106) is currently in progress. Study limitations and future directions for research are also addressed.

On March 3, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). In December 2020, the B.1.1.7 genetic variant of SARS-CoV-2, the virus that causes COVID-19, was first reported after emergence and rapid circulation in the United Kingdom (1). Evidence suggests that the B.1.1.7 variant is more efficiently transmitted than are other SARS-CoV-2 variants, and widespread circulation could thereby increase SARS-CoV-2 infection and hospitalization rates (1,2). The first reported SARS-CoV-2 B.1.1.7 variant case in the United States was confirmed by sequencing in Colorado on December 29, 2020.* This report describes a person who traveled from the United Kingdom to the United States after experiencing COVID-19-compatible symptoms † and was eventually confirmed to be infected with the B.1.1.7 variant. On January 10, 2021, CDC notified the Texas Department of State Health Services (DSHS) of a SARS-CoV-2 B.1.1.7 variant case; Corpus Christi-Nueces County Public Health District staff members conducted a case investigation on January 10-11. The patient, aged 61 years, had visited family in the United Kingdom during November 13-December 30, 2020, and reported having been exposed to a relative experiencing COVID-19-compatible symptoms (cough, runny nose, and headache) on December 24. Another relative at the same gathering received a positive COVID-19 test result in the United Kingdom on January 10. The patient received a negative SARS-CoV-2 antigen test result on December 28 in preparation for travel back to the United States but experienced symptoms on December 29 and reported taking acetaminophen on December 30. On December 30, the patient disclosed a runny nose during the pretravel interview but was cleared to fly from London to Dallas, Texas the same day. Upon arrival in the United States on December 31, the patient stayed overnight in a hotel and then drove home (approximately 8 hours). On the way home, the patient stopped five times, including twice * https://covid19.colorado.gov/press-release/cdphe-confirms-two-additionalcases-and-one-possible-case-of-the-b117-variant † Patient initially experienced runny nose and headache before departure and later experienced loss of taste and smell, severe headache, chills, and a dry cough after return to the United States, which are symptoms compatible with COVID-19.

The first three SARS-CoV-2 phylogenetic lineages classified as variants of concern (VOCs) in the United States (U.S.) from December 15, 2020 to February 28, 2021, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1) lineages, were initially detected internationally. This investigation examined available travel history of coronavirus disease 2019 (COVID-19) cases reported in the U.S. in whom laboratory testing showed one of these initial VOCs. Travel history, demographics, and health outcomes for a convenience sample of persons infected with a SARS-CoV-2 VOC from December 15, 2020 through February 28, 2021 were provided by 35 state and city health departments, and proportion reporting travel was calculated. Of 1,761 confirmed VOC cases analyzed, 1,368 had available data on travel history. Of those with data on travel history, 1,168 (85%) reported no travel preceding laboratory confirmation of SARS-CoV-2 and only 105 (8%) reported international travel during the 30 days preceding a positive SARS-CoV-2 test or symptom onset. International travel was reported by 92/1,304 (7%) of persons infected with the Alpha variant, 7/55 (22%) with Beta, and 5/9 (56%) with Gamma. Of the first three SARS-CoV-2 lineages designated as VOCs in the U.S., international travel was common only among the few Gamma cases. Most persons infected with Alpha and Beta variant reported no travel history, therefore, community transmission of these VOCs was likely common in the U.S. by March 2021. These findings underscore the importance of global surveillance using whole genome sequencing to detect and inform mitigation strategies for emerging SARS-CoV-2 VOCs.