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:
- SARS-CoV-2 concentration in wastewater decreased 15% between October 7 and October 14, and the national wastewater trend is “high” (high concentration and downward trend), per WastewaterSCAN.
- SARS-CoV-2 concentration in wastewater decreased 7% between October 10 and October 17, and the national wastewater viral activity level is “low,” per the CDC.
- COVID-19 test positivity decreased 6%, from 3.8% of COVID-19 tests returning positive results during the week ending October 10 to 3.6% positive during the week ending October 17.
This summer’s COVID-19 wave is still lingering into the fall, as much of the country reports ongoing moderate to high disease levels in mid-October. While there’s some conflicting data about where cases are increasing and decreasing, it’s clear that parts of the Northeast and Midwest are starting to see outbreaks, as is expected when the weather starts getting colder.
COVID-19 levels are mostly declining in the South, but remain higher in many areas as they are still coming down from late-summer peaks. In Florida, for example, the CDC reports wastewater viral activity levels are “very high,” which I interpret as actually incredibly high given the minimizing baselines that the agency uses for its calculations. The CDC and WastewaterSCAN also both report SARS-CoV-2 levels may be increasing again at some testing sites in Florida, though these are preliminary data that could be adjusted in future weeks.
The West also continues to be a COVID-19 hotspot. The CDC reports “very high” wastewater viral activity levels in Washington state and Montana (though Montana has limited data, with only two testing sites across the state), and “high” levels in California, Nevada, and Hawaii. COVID-19 activity is clearly declining in California, which has one of the most robust wastewater testing networks of any state, but may not have reached its peak yet in other states further north and further inland.
The CDC’s infectious disease forecasting center, which uses emergency department data for its modeling, estimates that COVID-19 cases are “growing” in four states — including Utah and Colorado — as of October 21 and “likely growing” in six states, with five out of those six in the Mountain West and upper Midwest. Colorado’s public health agency reports growing SARS-CoV-2 concentrations in wastewater at several testing sites in the state, and WWSCAN reports sky-high concentrations at one testing site in Boise, Idaho. Future data will tell if this is a true high level or related to testing or environmental issues.
In the Northeast, a couple of states report higher SARS-CoV-2 levels in wastewater: Connecticut, Massachusetts, Rhode Island. Connecticut is also reporting a higher COVID-19 hospitalization rate, via the CDC’s hospitalization surveillance network: 2.8 COVID-19 hospitalizations per every 100,000 people, compared to 1.2 for every 100,000 nationally. Other parts of the Northeast are reporting declines from the late-summer surge, at least through mid-October.
The Midwest remains the region with the lowest COVID-19 levels, but that’s likely to change as the weather continues to get colder. Wastewater and ED data show a couple of potential early hotspots: Ohio and West Virginia both have “growing” cases according to the CDC’s forecasting center, and there are WWSCAN testing sites with high coronavirus levels in Kansas, Indiana, Iowa, and Michigan.
Flu cases also continue to increase across the U.S. as we get into an earlier-than-usual flu season. The West and South are reporting higher flu levels than other regions so far, but indicators like test positivity, emergency department visits, flu levels in wastewater, and doctor’s visits for flu-like illness are increasing across all regions. Nationally, test positivity for flu is now higher than test positivity for COVID-19 (5.7% versus 3.6%, from the week ending October 17).
In other flu news: last week, the Washington State Department of Health reported a recent human case of the bird flu strain H5N1 — the first human case in the U.S. this year, and the first one linked to dairy cows in the state. ProPublica also recently investigated unchecked bird flu spread at a mink farm in Utah. Bird flu hasn’t been in the headlines much lately, but it remains a threat to farmworkers and a potential precursor for the next pandemic.
