National COVID-19 trends, April 29

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Map of the U.S., color-coded by state. The chart is titled, "COVID-19," and text at the top reads: "As of April 22, 2025, we estimate that COVID-19 infections are growing or likely growing in 4 states, declining or likely declining in 20 states, and not changing in 21 states." Four states are shaded in purple for "growing or likely growing": West Virginia, Alabama, Florida, Hawaii. Other states are in green for "declining or likely declining," gray for "not changing," or white for "not estimated."
Chart from CDC Center for Forecasting and Outbreak Analytics, estimates as of April 22

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 1.3 in every 100,000 people were hospitalized for COVID-19 during the week ending April 12.
  • COVID-19 test positivity stayed the same, with 3.4% of COVID-19 tests returning positive results during the weeks ending April 12 and April 19.
  • SARS-CoV-2 concentration in wastewater has decreased 1% between the week ending April 12 and the week ending April 19, and the national wastewater viral activity level is “low,” per the CDC.
  • SARS-CoV-2 concentration in wastewater has decreased 14% between April 9 and April 16, and the national wastewater trend is “medium,” per WastewaterSCAN.

We remain in a moderate period between COVID-19 surges in the U.S., with all national metrics reporting plateaus or slight declines. Some data sources suggest that infections may be starting to go up in parts of the South, but these data are tentative so far. Meanwhile, Trump-appointed health officials are threatening the approval process for COVID-19 vaccines.

Wastewater data from the CDC, WastewaterSCAN, and Biobot Analytics all report declines in national SARS-CoV-2 levels for mid-April, though the CDC reports a very slight decline (1%) compared to a heftier 14% from WWSCAN. All three sources have reported relatively minor changes in viral levels over the last month: levels have declined, but stayed in moderate territory.

National healthcare system metrics paint a similar picture. Test positivity (from the network of labs reporting to the CDC) has declined slowly since early March, and in the most recent week of data, stayed consistent from the prior week with 3.4% of tests reporting positive results. Emergency department visits and hospitalizations (from CDC networks) have also slowly declined through the spring so far.

Some regional data sources suggest that COVID-19 cases may be starting to increase in the South. The CDC reported an uptick (about 11%) for the region’s average wastewater viral activity level last week. And the agency’s forecasting center estimated that cases are “growing” in Florida and Alabama, and “likely growing” in West Virginia and Hawaii, as of April 22.

However, it is worth noting that all recent COVID-19 data are tentative and subject to change. When I looked into the CDC’s wastewater reports more, I found that the increases in the South may be largely driven by states with limited data available: the agency reports significant state-level SARS-CoV-2 increases in Louisiana, Mississippi, and West Virginia, but there are only five testing sites with recent data across the three states. The trend may change when data from more sites become available.

While COVID-19 is at more moderate levels now, experts anticipate a surge this summer, followed by likely many more surges as people continue to abandon collective health measures. And U.S. government agencies may make it even harder to access one of the few measures that remains widespread, as the Food & Drug Administration (FDA) introduces new challenges for vaccine developers like Novavax and potentially Pfizer and Moderna, too. We will continue reporting on these concerning developments and sharing how you can push back.

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