National Covid-19 trends, November 21

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November 21, 2023

A chart displays the concentration of SARS-CoV-2 virus in wastewater, averaged for the U.S. from Biobot Analytics' network of testing sites. In the last six months: coronavirus levels rose sharply in the early fall, fell in September and October, then have risen again through mid-November. — Wastewater surveillance data from the company Biobot Analytics (last updated November 20) show a steady increase in coronavirus spread over the last month.

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

New hospital admissions with Covid-19 have increased 9%, from 2,100 admissions per day during the week ending November 4 to 2,300 admissions per day during the week ending November 11.
Test positivity has increased 1%, from 8.3% of Covid-19 tests returning positive results during the week ending November 4 to 8.4% positive tests during the week ending November 11.
Healthcare visits for influenza-like illness have increased 17% between the week ending November 4 and the week ending November 11.
SARS-CoV-2 concentration in wastewater has increased 7% between November 8 and November 15, per Biobot Analytics.
SARS-CoV-2 concentration in wastewater has increased 6% between November 8 and November 15, per WastewaterSCAN.

All major Covid-19 metrics currently point to slow-but-steady increases in coronavirus transmission at the national level. Travel and gatherings for Thanksgiving are likely to accelerate the virus’ spread, contributing to a potential winter surge.

Wastewater surveillance data from Biobot Analytics and WastewaterSCAN have both shown increased national coronavirus levels for the last month. Biobot’s data show a 28% increase in SARS-CoV-2 levels in wastewater between October 18 and November 15; WastewaterSCAN’s data show a 36% increase in the same timeframe.

Healthcare system data from the CDC are starting to show this trend as well. New Covid-19 patients admitted to hospitals, emergency department visits for Covid-19, and the share of PCR tests in the CDC’s surveillance network returning positive results all increased slightly between November 4 and November 11. As the CDC’s data are reported with delays, we can assume this trend has likely continued this past week.

Other respiratory viruses are spreading, too. Doctor’s visits for influenza-like illness — a metric that includes flu, RSV, and other diseases along with Covid-19 — shot up by 17% from November 4 to November 11. About 3.5% of doctors’ visits reported through the CDC’s surveillance network that week were for respiratory illnesses, bypassing the official threshold for respiratory virus season (2.9%) and putting the U.S. at higher disease levels than we historically see at this time of year.

Southeast states are reporting the highest levels of respiratory illness, according to the CDC, while wastewater surveillance data show higher coronavirus levels in the Northeast and Midwest compared to the other two regions. But the national trends, combined with the upcoming holiday, suggest that Americans across the country should be on guard for new infections of Covid-19 and other diseases.

Meanwhile, public health agencies continue to dismantle important sources of Covid-19 data. The CDC is no longer publicly reporting excess deaths associated with Covid-19: the page that typically supplies this information was archived on September 27 and states that “datasets will no longer be updated.” While the raw data underlying this dashboard are still available through the CDC’s mortality data portal, the prior dashboard provided a far more accessible way to look at trends. Its end further buries the realities of the continuing pandemic, as “official” death counts may be extreme undercounts. In lieu of the CDC publicizing this important data, Gregory Travis (@greg_travis) has put together an excess deaths dashboard.