National Covid-19 trends, November 14

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November 14, 2023

This is a chart from the CDC's influenza-like illness (ILI) surveillance. It displays colored lines representing ILI trends from 2018-2019 through 2023-2024, the present year. The 2023-2024 line shows higher ILI spread this year so far than in all other prior years except for 2022-2023. — The CDC’s monitoring of influenza-like illness suggests that several viruses, including Covid-19, are starting to spread more as the 2023-2024 virus season (shown as the red line on this chart) goes on.

Here are the latest national Covid-19 trends, according to the CDC and major wastewater surveillance providers:

New hospital admissions with Covid-19 have fallen by 8%, from 2,300 admissions per day during the week ending October 28 to 2,100 admissions per day during the week ending November 4.
Test positivity has fallen by 6%, from 9% of Covid-19 tests returning positive results during the week ending October 28 to 8.5% positive tests during the week ending November 4.
Healthcare visits for influenza-like illness have increased by 10% between the week ending October 28 and the week ending November 4.
SARS-CoV-2 concentration in wastewater has increased by 4% between November 1 and November 8, per Biobot Analytics.
SARS-CoV-2 concentration in wastewater has increased by 11% between November 1 and November 8, per WastewaterSCAN.

Over the last three years, Covid-19 has followed a similar pattern during the fall and winter months in the U.S.: after an increase in cases over the summer, disease spread has waned in the early fall — then returned with a new surge around Thanksgiving. While the holiday surge was supercharged in 2021 thanks to the appearance of Omicron, this general pattern has been fairly consistent.

Right now, we’re at the tail end of the “early fall lull” and seeing early signs of a holiday season increase. Those signs are mainly visible through wastewater surveillance, as data from both Biobot Analytics and WastewaterSCAN show higher coronavirus concentrations in sewage over the last two weeks, based on their respective testing networks.

Covid-19 data from our healthcare system have not started to show this increase yet, according to the CDC — which is unsurprising, as healthcare system data typically lag a couple of weeks behind wastewater data. The CDC’s latest numbers show that both hospitalizations for Covid-19 and the rate of tests returning positive results have been relatively steady over the last month, declining by just a few percentage points.

However, rates of influenza-like illness are on the rise, according to the CDC. This metric includes people who go to the doctor reporting common respiratory symptoms like fever, congestion, and coughing; the CDC uses it as a proxy for several common diseases, including Covid-19, the flu, and RSV. In the week ending November 4, about 2.9% of all healthcare visits were for respiratory diseases, representing a 10% increase from the prior week.

Both the CDC and the wastewater surveillance providers note that the Southeast, Central, and West Coast regions are reporting greater increases in Covid-19 and other respiratory diseases right now. According to the CDC’s map of influenza-like activity, Alaska, New Mexico, and Puerto Rico are currently reporting high rates of these diseases, while several Southeast states are reporting moderate-to-high rates.

Variants from the Omicron XBB family are still the culprit for most Covid-19 cases in the U.S., according to the CDC’s latest variant estimates. If you’re among the 86% of American adults who haven’t received an updated Covid-19 vaccine for this fall yet, this is a great time to do it, before the likely winter surge.