Several national COVID-19 metrics have now reported two weeks of declines, suggesting we have passed the peak of this winter’s wave — but higher disease levels may continue for many more weeks. This wave has hit the Midwest and Northeast much harder than the West and South; watch for potential increases in the latter two regions later in the winter. Flu also remains a concern.
The three major wastewater surveillance sources (the CDC, WastewaterSCAN, and Biobot Analytics) all agree that SARS-CoV-2 levels are declining nationally as of mid-January. The CDC reports a more pronounced decline than the other two sources, which could be a result of states with the most testing sites — several of which are in the Midwest and Northeast — skewing the national average.
As I noted last week, this winter’s peak has been notably lower than the peaks of prior winter surges, according to national averages. This isn’t true for all regions, though: the Midwest in particular has reported very high SARS-CoV-2 levels in wastewater, comparable to or perhaps higher than last winter (depending on which dataset you look at). Viral levels have been high in the Northeast, too.
Healthcare system metrics similarly show declines or plateaus in national averages, with the highest levels in the Midwest, followed by the Northeast. Test positivity is starting to decline in Midwest health regions that reported the highest positivity rates this winter (Great Lakes, Central Plains). And the CDC’s disease forecasting center estimates that COVID-19 cases are “declining or likely declining” in 26 states as of January 20, including states across these regions.
In the coming weeks, I will be watching to see if the South and West report further increases in COVID-19 levels, as they have had a relatively milder winter of this disease so far. Notably, the CDC forecasting center estimates that cases are “growing or likely growing” in five states: Texas, Missouri, West Virginia, Virginia, and North Carolina. Test positivity is also increasing in the Mid-Atlantic states.
Meanwhile, while national flu metrics have continued to decline, there are potential signs that this winter’s flu wave could rebound. Epidemiologist Caitlin Rivers noted in her newsletter this week that flu activity went up in school-aged children: “Although the increase is small, kids are often the first to register new flu trends,” she wrote. The CDC forecasting center also estimates that flu cases are “growing or likely growing” in 27 states.
In other public health news: the U.S. is on the verge of losing its measles elimination status, as that disease has now spread in low-vaccination areas for a year. But one top CDC official “said he was unbothered by the prospect” at a media briefing last week, Amy Maxmen reported for KFF Health News. With measles, like with COVID-19, the Trump administration is downplaying ongoing spread and failing to promote prevention measures.
