National Covid-19 trends, December 5

Written by

–

December 5, 2023

This chart from the CDC's wastewater surveillance dashboard shows SARS-CoV-2 viral activity levels in wastewater, on a line chart. The national levels are shown in black, and regional levels are shown in yellow (Midwest), purple (South), light blue (Northeast), and teal (West). The national line and all regional lines except the West show increases in the last month, ending November 25. — This chart, from the CDC’s new wastewater surveillance dashboard, shows SARS-CoV-2 viral activity levels in wastewater for the U.S. nationally (black line) and by region (colored lines). Activity is increasing across the country as of November 25.

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 10%, from 2,500 admissions per day during the week ending November 18 to 2,800 admissions per day during the week ending November 25.
Test positivity has increased 14%, from 8.8% of Covid-19 tests returning positive results during the week ending November 18 to 10% of positive tests during the week ending November 25.
Healthcare visits for influenza-like illness have increased 6% between the week ending November 18 and the week ending November 25.
SARS-CoV-2 concentration in wastewater has increased 9% between the week ending November 18 and the week ending November 25, and the national wastewater viral activity level is high, per the CDC.
SARS-CoV-2 concentration in wastewater has increased 28% between November 22 and November 29, per Biobot Analytics.
SARS-CoV-2 concentration in wastewater has increased 9% between November 22 and November 29, per WastewaterSCAN.

As I anticipated last week, major metrics for Covid-19 and other respiratory viruses show increased disease spread during the week of Thanksgiving. This trend will likely continue through December (if not longer) as Americans continue to travel and gather for the holidays with relatively few precautions.

The CDC’s National Wastewater Surveillance System (NWSS) has launched a new dashboard to share its Covid-19 data. This dashboard is a win for anyone following wastewater surveillance data, as it provides national, regional, and state-level trends from the more than 1,000 sites reporting to the CDC. (NWSS’s previous dashboard only published site-level data.) The CDC also announced last week that data collection has resumed at about 350 sites involved in a wastewater testing contract dispute.

To calculate the new national, regional, and state-level trends, the CDC is standardizing data from health agencies and testing companies with different methods for sampling sewage and processing their test results. This leads to data that are more representative of the U.S., but the standardization process may need to be adjusted over time. Some advocates have also criticized the CDC for using blue and gray colors for its new dashboard, in contrast to the brighter reds and oranges that used to characterize its Covid-19 maps.

Along with the CDC, I’m still looking at two other wastewater data providers — Biobot Analytics and WastewaterSCAN — that have consistent methods across their testing networks. This week, all three dashboards show steady increases in national Covid-19 spread, continuing a trend that started in mid-October. Biobot’s national data show the sharpest increase, with coronavirus levels increasing by nearly 30% from November 22 to November 29. All three providers also show the highest coronavirus levels in the Midwest, followed by the Northeast and South.

Healthcare system data from the CDC (including hospital admissions, emergency department visits, and the rate of Covid-19 tests with positive results) similarly show increases during the week of Thanksgiving. As I predicted in last week’s update, the downturn in test positivity was temporary: this metric is now back up to 10% of tests in the CDC’s lab testing network returning positive results.

Other respiratory viruses are also trending up following the holiday. According to the CDC, respiratory illness levels have been increasing since mid-October, as have hospital admissions for flu and positive test rates for flu and RSV. Several states in the Southeast, along with Texas, New Mexico, Colorado, and California, now report high or very high levels of influenza-like illness.

Vaccines are one of very few Covid-19 precautions still encouraged by the federal government. But recent data suggest there are significant gaps in access to this fall’s vaccines: white and Asian Americans have been more likely to receive the 2023 vaccines than Black and Latino Americans. When public officials insist that “we have the tools” to combat Covid-19, it’s important to ask: who can access those tools?