Everyone seems to be getting COVID

With COVID-19 cases on the rise once again, everyone seems to either be getting infected or know someone who is. Without the robust data tracking that was available during the public health emergency, a clear picture is harder to discern, but some trends can still be observed. 

Hospital admissions jumped by 20 percent in the most recent week, having been on the rise since the start of November. That trend is reflected across the country, apart from the Western U.S., with roughly 10 percent of U.S. counties now considered to have high hospital admission rates. 

Available wastewater surveillance data also indicates that most sites — 74 percent — are reporting higher levels of virus levels, with 44 percent reporting the highest levels they’ve ever recorded. The Centers for Disease Control and Prevention (CDC) notes, however, that different wastewater sampling sites began collecting at different times, meaning these indicators are relative and should be coupled with other data. 

“We have wastewater data and we have hospitalization data, and then we have just lots of anecdotes,” said William Schaffner, professor in the division of infectious diseases at the Vanderbilt University School of Medicine. “And my colleagues across the country, as I speak with them on conference calls, are all experiencing pretty much the same thing.” 

According to Schaffner, the cause of the increasing cases can be attributed to the winter weather and associated travel and gatherings. The current respiratory viral season “certainly wasn't helped” by lax viral mitigation practices either. 

“There is less social distancing; people are out and about. They want to return to normal, and vaccine fatigue and COVID fatigue are almost palpable out there,” Schaffner said. 

He also notes that the current dominant strain in the U.S. is likely pushing cases even higher. 

“We have a dominant Omicron variant out there now — the JN.1 variant — which is extraordinarily contagious. All these Omicron variants are contagious, but this one is outrunning the rest,” Schaffner said. “It's spreading very widely and causing a great deal of so-called mild infection that is not serious enough to get you hospitalized, but nonetheless you can be miserable for three or four days.”

The most recent estimates from the CDC indicate that the omicron JN.1 subvariant is causing 61.6 percent of COVID-19 cases in the U.S. The updated COVID-19 vaccines are believed to still be effective against this strain, despite the mutations it carries — but vaccines don’t have any effect if they stay on shelves instead of being administered to people. 

A recent report from the CDC estimates that only 21.4 percent of adults have received the updated COVID-19 shot. 

As Schaffner notes, a widely circulating virus largely impacts vulnerable and older people, which are the types of patients he and his colleagues are mostly seeing admitted to the hospital. 

Based on the degree of COVID-19 hospital admissions, the CDC categorizes individual counties into low, medium and high rates. Roughly 10 percent of U.S. counties are considered to have high hospital admission rates, according to the latest federal data, and 37.2 percent are considered to have medium admission levels. 

The CDC stopped publishing national case data after the end of the public health emergency last year, but hospital admission data for coronavirus is still regularly updated. This trending data now serves as the community indicator for what recommended steps people should take to protect their health.

When counties are experiencing medium or high levels of hospital admissions, the CDC advises that people at a high risk of experiencing severe illness should mask when in indoor public spaces. People who socialize with immunocompromised people should consider masking or testing themselves before meeting up with them.

Unlike previous years, however, health care stakeholders say health systems haven’t been overwhelmed by the current rate of hospitalizations. And despite the rise in cases, Schaffner said he wouldn’t say the U.S. is currently experiencing a surge.

“I’m reluctant to call it a surge, because we have used that term last season and the season before when we really had very large increases that stressed hospital systems severely,” he said. “We're having a substantial seasonal increase. I don't think we've reached the levels that we had last year.” 

Most health experts say they expect the current state of elevated viral activity will continue through January, including World Health Organization technical lead for COVID Maria Van Kerkhove, who said this week that she expects “trends to continue into January through the winter months in the Northern Hemisphere.”