COVID Rates Surge Amidst the Holiday Season

Earlier this month, the Centers for Disease Control and Prevention (CDC) released data from the National Wastewater Surveillance System (NWSS) identifying high SARS-CoV-2 viral activity levels in wastewater across the United States.

According to the data collected, viral activity rates are the highest in the Midwest, which includes Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin, as of December 9, 2023.

The lowest rates nationally were identified in the western region, an aggregate of levels in Alaska, Arizona, California, Colorado, Guam, Hawaii, Idaho, Montano, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.

Beyond regional data, the CDC also provides individual state data, noting that Arkansas, Delaware, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, South Carolina, South Dakota, Vermont, West Virginia, and Wisconsin have very high SARS-CoV-2 activity in their wastewater.

Comparatively, only Alaska, Hawaii, and Washington have low activity levels. Despite insufficient data from some states and territories, the available information indicates alarming levels of viral activity, implying high infection and disease spread levels.

With the holiday season in full gear, COVID-19 rates may increase even more as more people gather and travel.

Shortly after this discovery, the CDC issued a health advisory warning healthcare providers and the public about low vaccination rates for respiratory viruses, including COVID-19, influenza, and respiratory syncytial virus (RSV). Last year, around the same season, rising rates of these three respiratory viral infections were called the tripledemic.

“Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes COVID-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks,” noted the CDC in the advisory.

According to the notice, influenza hospitalizations across all age groups increased by 200% between November and December. On top of general increases in hospitalizations, the CDC identified 12 pediatric influenza deaths in the 2023–2024 season.

Data on vaccination coverage identified low influenza vaccination rates compared to last year. For example, as of November 11, 2023, the pediatric influenza vaccination rate in the 2023–2024 season was 35.9%, lower than the 39.1% rate in the 2022–2023 season. Similarly, the rates among adults were lower at 36.1% compared to 38.4%.

Additionally, COVID-19 hospitalization rates increased by 51% across all age groups. The CDC notes that pediatric COVID-19 vaccination rates are only 7.7%. Adult vaccination rates are higher but insufficient at 17.2%.

Although vaccinations have effectively prevented infection, serious illness, and hospitalizations, national vaccination rates have not reflected the evidence-based recommendations of public health organizations. According to the CDC, a lack of provider recommendations, concerns about side effects, experiencing side effects, and forgetting to or not having time to get vaccinated are the most common reasons for low immunization rates.

To combat this, the CDC is asking providers to recommend immunizations for eligible patient populations using all the available tools, including the CDC Healthcare Provider Toolkit: Preparing Your Patients for the Fall and Winter Virus Season. They also offer a guide for vaccine conversations to have with patients.

Moving forward, the best way to address the rising rates of respiratory illness is to begin with prevention. Vaccination and good public health practices can help keep patients and their families safe this holiday season.