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 0.6 in every 100,000 people were hospitalized for COVID-19 during the week ending November 8.
- COVID-19 test positivity stayed about the same, with 2.77% of COVID-19 tests returning positive results during the week ending November 8 and 2.84% positive during the week ending November 15.
- SARS-CoV-2 concentration in wastewater decreased 4% between November 8 and November 15, and the national wastewater viral activity level is “very low,” per the CDC.
- SARS-CoV-2 concentration in wastewater decreased 1% between November 5 and November 12, and the national wastewater trend is “medium,” per WastewaterSCAN.
- Healthcare visits for influenza-like illness increased 6% between the week ending November 8 and the week ending November 15, and this metric is below the level indicating the official start of flu season.
CDC data continue to come back online following the end of the government shutdown. Those data indicate that COVID-19 levels through mid-November remain much lower than what we see during surges, but are starting to increase in parts of the U.S.; different metrics disagree on which parts. More outbreaks are likely to follow the holiday this week, but it will be weeks before they show up in future data updates due to reporting lags.
Wastewater data from the CDC — finally back this week! — as well as WastewaterSCAN and Biobot Analytics all agree that the national average of SARS-CoV-2 levels in wastewater has not changed much between mid-October and mid-November. The CDC and WWSCAN both report increases in their averages for the first week of November, followed by slight decreases the next week. Biobot reports slight increases in both weeks.
As the CDC resumes wastewater data updates, it’s important to remember that the agency’s wastewater viral activity levels are calculated based on only recent measurements (originally the last year, now the last two years). They do not account for periods of truly low COVID-19 spread earlier in the pandemic, when public health measures were more widespread. So, when the CDC says activity is “very low,” I interpret that as, “at a moderate baseline, and could be much lower if we were still collectively masking.”
Wastewater and healthcare system data generally agree that the Midwest is seeing the most obvious COVID-19 increases as of mid-November. The CDC’s wastewater and healthcare system data (test positivity and emergency department data) show this trend, as do wastewater data from WWSCAN and Biobot. This increase also shows up in state-reported wastewater data from Indiana and Minnesota.
All three national wastewater data sources report recent increases in the Northeast, and Biobot also reports an increase in the West. But the CDC’s test positivity and ED data show some increases in the South, too. The agency’s infectious disease forecasting center, which uses ED data, estimates that cases are “growing or likely growing” in 19 states as of November 18, including Southwest states Colorado and New Mexico, as well as South states Oklahoma and Mississippi.
While COVID-19 is rising somewhat unevenly, flu is increasing more consistently across the U.S., as is RSV. We have not crossed the CDC’s threshold for flu season yet (which happens when 3% of healthcare visits are for respiratory symptoms, as tracked by a CDC system), but that will likely change in the coming weeks.
Bird flu also continues to spread in animals, continuing scientists’ worries about an H5 virus mutating and jumping more easily to humans. On Friday, Washington state’s health department announced that the person infected with the bird flu H5N5 had died. The agency’s press release was quick to note that “this person was an older adult with underlying health conditions,” but flu can be dangerous for anyone, as The Sick Times has previously reported.
