National COVID-19 trends, December 3

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December 3, 2024

Two state-by-state maps are presented side by side. In both, states are colored according to epidemic trends: growing and likely growing in dark and light purple, declining and likely declining in dark and light green, not changing in gray, not estimated in white. The map on the left, representing COVID-19, has a mix of green and purple. Text above it reads: "As of November 26, 2024, we estimate that COVID-19 infections are growing or likely growing in 10 states, declining or likely declining in 15 states, and not changing in 22 states." The map on the right, representing influenza, has more purple and only one state in green. Text above it reads: "As of November 26, 2024, we estimate that influenza infections are growing or likely growing in 33 states, declining or likely declining in 1 state, and not changing in 8 states." — Data from the CDC’s Center for Forecasting and Outbreak Analytics, as of November 26.

Here are the latest national COVID-19 trends, according to the U.S. Centers for Disease Control and Prevention (CDC) and major wastewater surveillance providers:

About 1.4 in every 100,000 people were hospitalized for COVID-19 during the week ending November 16. (Note that these are provisional data.)
COVID-19 test positivity has increased 7%, from 4.2% of COVID-19 tests returning positive results during the week ending November 16 to 4.5% of tests during the week ending November 23.
SARS-CoV-2 concentration in wastewater has increased 2% between the week ending November 16 and the week ending November 23, and the national wastewater viral activity level is “low,” per the CDC.
SARS-CoV-2 concentration in wastewater has increased 7% between November 13 and November 20, and the national wastewater trend is “medium,” per WastewaterSCAN.
Healthcare visits for influenza-like illness have increased 8% between the week ending November 16 and the week ending November 23, and this metric has just met the threshold for flu season.

As expected, the U.S.’s winter surge is getting started, though disease levels are still lower than usual for this time of year. Our latest data are from the week leading up to Thanksgiving, so these numbers don’t yet reflect travel and gatherings for the holiday — we’ll see that in future updates. Meanwhile, other viruses, including the bird flu H5N1, continue to spread.

Wastewater data from the CDC and WastewaterSCAN indicate that SARS-CoV-2 spread was just starting to increase in the U.S. in the week before Thanksgiving; the two data providers report increases of 2% and 7% from the prior week, respectively. (Biobot Analytics hasn’t posted an update for this period yet.) It’s important to note that the CDC compiles data from a number of different wastewater surveillance programs, some of which have had holiday reporting delays, so the agency’s numbers will be updated later in the week.

COVID-19 test positivity was also starting to increase during the week before the holiday, according to the network of testing labs still reporting to the CDC. Hospitalizations remain rather low: the CDC’s hospital surveillance network estimates around 1.4 COVID-19 hospitalizations per 100,000 people as of November 16, compared to 4.9 per 100,000 at this time in 2023 and 7.1 per 100,000 in 2022. Remember that this is a delayed indicator compared to other metrics, and that we have no real-time tracking of Long COVID — now the most common adverse outcome of a COVID-19 case.

The Midwest continues to report higher disease levels than other regions. This trend is clear from wastewater data as well as emergency department (ED) visits. The CDC’s modeling center, which estimates infection trends by state based on ED visits, reports that cases were “growing or likely growing” in 10 states as of November 26 (two days before Thanksgiving), including several in the Midwest: Indiana, Illinois, Iowa, Kansas, Michigan. Other states with the same estimated status are Massachusetts, Maryland, Idaho, Utah, and Arizona.

Other, more traditionally seasonal diseases are also spreading right now. As of November 23, healthcare visits for influenza-like illness (meaning fever, cough, sore throat, etc.) have reached the threshold for flu season, at about 3% of visits reported in the CDC’s flu surveillance network. The agency’s modeling center estimates flu cases are “growing or likely growing” in 33 states. As Dr. Jennifer Beam Dowd wrote recently at Those Nerdy Girls, while COVID-19 is still more dangerous than the flu, seasonal flu causes thousands of hospitalizations and deaths each year.

Meanwhile, the bird flu H5N1 continues to spread. Los Angeles Times reporter Susanne Rust recently shared on Bluesky that every California sewershed monitored by WastewaterSCAN (about 30 sites across the state) has tested positive for this virus in recent weeks. This testing captures farms and wildlife as well as humans, so these results don’t necessarily mean H5N1 is secretly spreading among Californians. But they do indicate how widespread the lineage has become; it remains another reason to keep wearing a high-quality mask and taking other precautions.