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 19.
- COVID-19 test positivity declined slightly, from 3.4% of COVID-19 tests returning positive results during the week ending April 19 to 3.2% during the week ending April 26.
- SARS-CoV-2 concentration in wastewater has increased 2% between the week ending April 19 and the week ending April 26, and the national wastewater viral activity level is “low,” per the CDC.
- SARS-CoV-2 concentration in wastewater has decreased 3% between April 16 and April 23, and the national wastewater trend is “medium,” per WastewaterSCAN.
COVID-19 trends in the U.S. remain similar to their status over the last few weeks: at a moderate plateau nationally, with all metrics reporting very little change. There are a few states that have reported increases in recent weeks, but it’s difficult to tell if these are more isolated hotspots or early signs of a summer surge.
Wastewater data from the CDC and WastewaterSCAN indicate that SARS-CoV-2 levels in U.S. wastewater, on average, have declined slowly but consistently since late February. Viral levels remain in what I’d call a moderate range, about one-third of the peaks of our most recent winter surge but still several times higher than what we’ve seen during true low points earlier in the pandemic.
Healthcare system data similarly show that COVID-19 levels have slowly declined over the last few months, but not dropped too far. Test positivity, as reported by a network of labs still sharing data with the CDC, has dropped from 3.9% during the week ending February 22 to 3.2% during the week ending April 26. Trends from emergency departments and hospital admissions are similar.
At the regional level: the CDC’s wastewater data for the South reported a decrease in the most recent week of data, after an increase in the prior week. This week, the agency reports increases in the Midwest (up 9% from the prior week) and West (up 16%). As I noted last week, these trends are sometimes aggregated from just a few testing sites with recent data, so I will wait for further reporting before I call this the sign of a new surge.
Outbreaks in Hawaii may be one reason for the CDC’s reported increase in the West, as the islands are included in this region. Hawaii’s state-level COVID-19 dashboard reports clear increases in cases over the last month, and this state is also the only one estimated to have “growing” infections by the CDC’s disease forecasting center, as of April 29. The center estimates that infections are “likely growing” in Utah, and declining or not changing in all other states.
Public health experts and modelers I follow remain certain that we’re likely to see a summer COVID-19 wave this year, given patterns for travel and indoor gatherings without widespread health precautions, combined with waning immunity. But it’s unclear when that will start or how big it will get, given that the COVID-19 trend this past winter was different from prior years. And in our fragmented data landscape, seeing the early signs of a surge is harder than ever.
Meanwhile: the CDC reported last week that 216 children died of the seasonal flu in the 2024-25 season. That’s the highest number reported since the 2009-10 H1N1 flu pandemic — and it’s likely an undercount, as it takes months for health agencies to review death certificates and update these tallies. The agency has also reported over 2,000 pediatric COVID-19 deaths since the start of the pandemic, also likely a significant undercount.
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