Centers for Disease Control and Prevention
COVID-19 hospital admissions in Arizona by week
COVID-19 hospital admissions increased nearly 17% nationwide during the week of Dec. 23, according to the Centers for Disease Control and Prevention. Hospitalization numbers are up in Arizona, too.
There were 502 people admitted to Arizona hospitals for COVID-19 during the week of Dec. 23.
Thats much higher than weekly admissions the state reported during summer and fall. But its a small fraction of the hospitalizations the state saw during the last three years. Its about a 40% decrease compared to the same point last winter.
Medical experts say getting an updated COVID-19 vaccine is the best way to protect yourself from severe outcomes of the virus. The CDC reports only about 18% of Arizona adults had gotten the updated shot as of mid-December.
At the start of the COVID-19 pandemic, many health experts were concerned about the new disease's impact on older adults and people who are immunocompromised.
Jenna Nobles, sociology professor at the University of Wisconsin-Madison, was interested in another potentially vulnerable group pregnant people.
"We know that emerging infectious diseases can be extremely consequential for pregnancies, both people who are carrying the pregnancies and the infants who are born from them," Nobles said.
Now, more than three years later, Nobles and her research partner Florencia Torche from Stanford University have published a studythat identifies a spike in premature births caused by COVID-19.
They found that from 2020 into 2023, maternal COVID infection increased the risk of preterm births by 1.2 percentage points. The rate was especially high during the second half of 2020, coming in 5.4 percentage points higher than anticipated.
"A one percentage point jump is already very large," Nobles said. "To move the needle that much on population risk is akin to exposing pregnant people to weeks of very high levels of environmental exposure, air pollution from wildfire for example."
The study also found that the premature birth rate returned to normal levels after the roll-out of the COVID-19 vaccine. Nobles said the decline in early births happened earlier in communities that had early adoption of the vaccines by residents.
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"That becomes a really important piece of information to have," she said. "It's not just that vaccines are safe and effective in pregnancy. It's also that avoiding vaccines can be very harmful, particularly in the context of emerging infections like COVID."
She said the research could help people who are pregnant now and considering getting the vaccine for the first time or even the latest booster.
Nobles' research used data from 40 million people provided by the California Department of Public Health, which recorded COVID-19 test results for people in a hospital to give birth during the three-year period. She said the state agency was also able to provide information about those peoples' previous births, allowing the researchers to understand a person's risk for premature birth prior to the pandemic and more definitively link the increase to COVID-19.
"That's a really important part of this study design," Nobles said. "A challenge is that who gets COVID is not random in populations and certainly early in the pandemic, people were differentially exposed who had frontline jobs and who lived in more crowded settings."
While the research offers a look back on how COVID-19 impacted pregnancies during the height of the pandemic, Nobles said she hopes the study will also inform how healthcare providers and officials are thinking about what data should be collected during a future epidemic or pandemic.
"Data like vital statistics records that are partnered with information about infectious disease and vaccine uptake, they can be a very important tool to study how the effects of epidemics are evolving in real time," she said.
She said maternal and infant health outcomes should be among the metrics that leaders consider as they develop a public health response to future infectious disease.
It is four years since the novel coronavirus (2019-nCoV, later renamed as Severe Acute Respiratory Syndrome Coronavirus-2 or SARS-CoV2) was first reported on December 31, 2019 from China. In the months which followed, it caused severe COVID-19 waves in nearly every country, across the world. Alongside, at end December or early new year, there would be news of a new variant or sub-variant, or of a surge in cases in some countries. At the end of 2021, it was an Omicron variant (BA.1.1.529), and by the end 2022, the COVID-19 case surge in China made news. Now, a new subvariant of the Omicron variant of SARS-CoV-2, the JN.1, is making news.
The JN.1 sub-variant of Omicron has been reported from multiple countries and designated as a variant of interest (VoI) by the World Health Organization. This has raised some concerns and caused some worries. But is it really cause for concern? The short answer is a no. The reason is that the reporting of a new variant or sub-variant is on expected lines. In fact, in May 2023, while declaring the end of the COVID-19 pandemic, WHO had highlighted the need for continuous tracking of the virus and its variants. The rationale was simple. The pandemic is over, but SARS-CoV-2 was and is circulating in all countries and all settings and will continue to do so for long, and possibly forever. That is how most viruses behave. Therefore, there is always the possibility of some seasonal changes in the number of cases, at unpredictable intervals. A linked feature is that the genetic material of the circulating viruses especially of the respiratory virus keeps changing over a period. These changes in genetic structure (genome) result in the designation of new variants and sub-variants.
Since the reporting of the novel virus in 2019, more than 1,000 subvariants and recombinant sub-lineages have been reported. Against this backdrop, the emergence of JN.1 is not surprising. However, every change in genome does not matter, and the international agencies and subject experts are on task to assess the risk. However, if mutations or genetic changes result in an alternation in the characteristics of the virus (such as higher transmission, more severe disease or immune escape from vaccine induced or natural immunity), it merits greater attention. The variants are then termed as VoI or variants of concern (VoC). At present, there is no VoC in circulation in any part of the world. On March 16, 2023, WHOs Technical Advisory Group on SARS-CoV-2 Virus Evolution had downgraded the Omicron as the previous variants of concern. However, national and global agencies are tracking the virus and JN.1 has been designated as VoI.
JN.1 has been designated a VoI, which means it has some genetic changes and indicative characteristics in circulating viruses which need to be monitored by the health agencies and government. Such a designation is a call to step up genomic sequencing scientific work and use data to track the virus. JN.1 is not a new virus but a sub-variant of BA.2.86, which itself is a subvariant of the Omicron variant of SARS-CoV-2. Till now, there is no evidence that JN.1 causes more severe disease or causes immune escape and is, thus, not a reason for worry. In short, designating a variant as VoI does not automatically mean there is a reason to worry. Till now, there is no evidence that JN.1 is responsible for severe disease or immune escape. In fact, the waste-water surveillance in some Indian cities had indicated that the new sub-variant has circulated to a majority of the population without major change in reported or clinical cases in the way of a silent wave.
Does it mean we need to get additional shots of COVID-19 vaccines? Current scientific evidence supports that vaccines and natural infection continue to provide protection from any sub-variant, though there is some possibility of a decline in protection, as time has lapsed since the last vaccination. Immunologically, the natural infections which have happened in addition to vaccine shots, have provided hybrid immunity to people in India and many countries. Therefore, there is no immediate reason to worry. There is no scientific evidence to support having a fourth shot of COVID-19 vaccines, for any age group.
We also need to interpret the rise in COVID-19 cases more carefully. The spike in COVID-19 cases in India could be more artificial than real. It is likely that ramped up COVID-19 testing is picking more cases. Then, some deaths are being attributed to COVID-19. However, there is no evidence that those deaths are causally linked to SARS-CoV-2. These appear to be in the individuals who were already sick and had COVID-19, as an incidental finding. The average five or six deaths in a day in India also need to be considered in perspective.
To put this in context, every day in India, an estimated 27,000 people die due to a range of reasons that include old age. In contrast, respiratory diseases and tuberculosis kill 50 to 60 times more people every day than COVID-19 now. We need to shift attention to preventable deaths due to many other reasons.
Yet, four years should help us to learn. The governments COVID-19 response and actions should be more nuanced and informed by all evidence and real time data. Citizens need to act responsibly and not share unverified social media messages or forwards. Science communication from the government needs to be more interactive, and public communication messaging should be more routine and easy to understand. There is a possibility scenario where reported COVID-19 cases may increase slightly in the days ahead, or in the months ahead as it happened in April 2023 when daily cases had spiked. However, for most circulating respiratory viruses including SARS-CoV-2, mere transmission or an increase in cases is not an immediate concern. Right now, SARS-CoV-2 infections do not appear to change clinical outcomes in any age groups.
How should we respond to current or any future uptick due to SARS-CoV-2? The short answer is in the same way that we respond to any seasonal rise in cases of flu, respiratory illnesses or dengue virus. By the government increasing standard public health preventive measures such as Severe Acute Respiratory Infections (SARI) and Influenza-like Illness (ILI) surveillance, waste water surveillance and improving provision of required services at health facilities. The clinical management should focus on a syndromic approach to respiratory illnesses. At the individual and community levels, there is no need to disturb the routine or change your travel or vacation plans. People with cough and cold or flu-like illness must follow good respiratory etiquette such as wearing masks in public places, covering their nose and mouth when coughing or sneezing and frequent handwashing, irrespective of whether it is a type of SARS-CoV-2, seasonal flu or any other respiratory illness. It is proven that the risk to children is the lowest among any age group and thus, school closure should never be considered an option in response to a COVID-19 case surge.
It is time we handle SARS-CoV-2 or COVID-19 just like any other respiratory illness. It is more of an individual health concern than a public health concern. COVID-19 is not a novel virus any more and is here to stay. But it is not a reason to worry.
Dr. Chandrakant Lahariya is a medical doctor with over 15 years of work experience with the World Health Organization (WHO) in the India Country office, the regional office for Africa, Brazzaville; and the WHO headquarters in Geneva. The views expressed are personal
Temperatures are dropping and we are in the middle of the season where everyone begins to get sick. There are *** variety of respiratory illnesses going around like the flu, COVID and RSV. As we spend more time indoors, there has reportedly also been an uptick in *** persistent cough that doctors say does not fall in any of these categories. Baltimore, Doctor Janet o'mahoney told the Huffington Post that these links coughs may be purely viral and caused by the regular viruses that cause colds like Rhinovirus. Another doctor told the site that *** persistent cough is most likely due to prolong inflammation in the airways which can last anywhere from two weeks to two months after initially getting sick. Experts say it could also be sinus congestion, *** sore throat and postnasal drip if your symptoms persist for *** couple of weeks. Doctors say it's important to continue to follow up with your physician.
Respiratory virus activity is high and rising across the United States, CDC data shows
Updated: 4:21 PM EST Jan 1, 2024
As seasonal virus activity surges across the United States, experts stress the importance of preventive measures such as masking and vaccination and the value of treatment for those who do get sick.Tens of thousands of people have been admitted to hospitals for respiratory illness each week this season. During the week ending Dec. 23, there were more than 29,000 patients admitted with Covid-19, about 15,000 admitted with the flu and thousands more with respiratory syncytial virus, or RSV, according to data from the U.S. Centers for Disease Control and Prevention.Nationally, COVID-19 levels in wastewater, a leading measure of viral transmission, are very high higher than they were at this time last year in every region, CDC data shows. Weekly emergency department visits rose 12%, and hospitalizations jumped about 17% in the most recent week.And while Covid-19 remains the leading driver of respiratory virus hospitalizations, flu activity is rising rapidly. The CDC estimates that there have been more than 7 million illnesses, 73,000 hospitalizations and 4,500 deaths related to the flu this season, and multiple indicators are high and rising.RSV activity is showing signs of slowing in some parts of the U.S., but many measures, including hospitalization rates, remain elevated. Overall, young children and older adults are most affected."It's a wave of winter respiratory pathogens, especially respiratory viruses. So it's Covid, it's flu, and we can't diminish the importance of RSV," said Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. "So it's a triple threat, and arguably a fourth threat because we also have pneumococcal pneumonia, which complicates a lot of these virus infections."Respiratory virus activity has been on the rise for weeks. Now, flu-like activity is high or very high in two-thirds of the United States, including California, New York City and Washington, as well as throughout the South and Northeast, according to the CDC."Remember, all of these numbers are before people got together for the holidays," Hotez said. "So don't be disappointed or surprised that we even see a bigger bump as we head into January."Vaccines can help prevent severe illness and death, but uptake remains low this season despite a historic first, with vaccines available to protect against each of the three major viruses. Just 19% of adults and 8% of children have gotten the latest Covid-19 vaccine, and 17% of adults 60 and older have gotten the new RSV vaccine, CDC data shows. Less than half of adults and children have gotten the flu vaccine this season."We have, as a population, underutilized both influenza and the updated Covid vaccines, unfortunately," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. "But it's not too late to get vaccinated, because these viruses are going to be around for a while yet."According to the CDC, hospital bed capacity remains "stable" nationally, including within intensive care units. But with high levels of respiratory viruses, hospitals in at least five states are returning to requiring masks.Mass General Brigham spokesman Timothy Sullivan said it will require masking for health-care staff who interact directly with patients starting Tuesday, and patients and visitors will be "strongly encouraged to wear a facility-issued mask."In Wisconsin, UW Health and UnityPoint Health Meriter have expanded mask policies to cover more people. UW requires all staff, patients and visitors to wear a mask for patient interactions in clinic settings, including waiting areas and exam rooms.UnityPoint Health Meriter says masks continue to be required for team members and visitors in patient rooms.Bellevue, a public hospital in New York City, said on social media last week that it had reinstated its mandatory masking policy due to an uptick in respiratory illnesses.In Pennsylvania, the University of Pittsburgh Medical Center has required everyone to wear a mask when entering or inside since Dec. 20. The systemwide masking policies were adjusted to "address the increase of respiratory virus cases" but may change when there is a "marked decrease in respiratory health cases," according to the health care system.An order posted last week by the Los Angeles County Health Officer requires all health-care personnel and visitors to mask while in contact with patients or in patient-care areas, based on the CDC's categorization of Covid-19 hospital admission levels.During the week ending Dec. 23, more than 230 U.S. counties were considered to have "high" levels of Covid-19 hospital admissions, defined by the CDC by at least 20 new hospital admissions for every 100,000 people. Nearly a thousand other counties, about a third of the country, have "medium" Covid-19 hospital admission levels, with at least 10 admissions for every 100,000 people.Vaccines and masks can help reduce the risk of severe illness before getting sick, but treatments are also available to help prevent people from getting very sick if they do become infected.Antiviral treatments for Covid-19, such as Paxlovid, and flu, such as Tamiflu, can be especially helpful for people who are more likely to get very sick, including people who are 50 or older and those with certain underlying conditions, such as a weakened immune system, heart disease, obesity, diabetes or chronic lung disease."If more people at higher risk for severe illness get treatment in a timely manner, we will save lives," the CDC said in a recent blog post. But "not enough people are taking them."Seasonal respiratory virus activity can be hard to predict, but CDC forecasts suggest that hospitalization rates will continue at elevated levels for weeks and that this season, overall, will probably result in a similar number of hospitalizations as last season."One of the ways to help us all go into a happy new year is for us to be as protected as we can against these viruses," Schaffner said."Of course, I continue to recommend vaccination, prudent use of the mask by high-risk people and, should you become sick, do not go to work and spread the virus further. Call your health care provider, because you may have some treatment available that will get you healthier sooner."
As seasonal virus activity surges across the United States, experts stress the importance of preventive measures such as masking and vaccination and the value of treatment for those who do get sick.
Tens of thousands of people have been admitted to hospitals for respiratory illness each week this season. During the week ending Dec. 23, there were more than 29,000 patients admitted with Covid-19, about 15,000 admitted with the flu and thousands more with respiratory syncytial virus, or RSV, according to data from the U.S. Centers for Disease Control and Prevention.
Nationally, COVID-19 levels in wastewater, a leading measure of viral transmission, are very high higher than they were at this time last year in every region, CDC data shows. Weekly emergency department visits rose 12%, and hospitalizations jumped about 17% in the most recent week.
And while Covid-19 remains the leading driver of respiratory virus hospitalizations, flu activity is rising rapidly. The CDC estimates that there have been more than 7 million illnesses, 73,000 hospitalizations and 4,500 deaths related to the flu this season, and multiple indicators are high and rising.
RSV activity is showing signs of slowing in some parts of the U.S., but many measures, including hospitalization rates, remain elevated. Overall, young children and older adults are most affected.
"It's a wave of winter respiratory pathogens, especially respiratory viruses. So it's Covid, it's flu, and we can't diminish the importance of RSV," said Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. "So it's a triple threat, and arguably a fourth threat because we also have pneumococcal pneumonia, which complicates a lot of these virus infections."
Respiratory virus activity has been on the rise for weeks. Now, flu-like activity is high or very high in two-thirds of the United States, including California, New York City and Washington, as well as throughout the South and Northeast, according to the CDC.
"Remember, all of these numbers are before people got together for the holidays," Hotez said. "So don't be disappointed or surprised that we even see a bigger bump as we head into January."
Vaccines can help prevent severe illness and death, but uptake remains low this season despite a historic first, with vaccines available to protect against each of the three major viruses. Just 19% of adults and 8% of children have gotten the latest Covid-19 vaccine, and 17% of adults 60 and older have gotten the new RSV vaccine, CDC data shows. Less than half of adults and children have gotten the flu vaccine this season.
"We have, as a population, underutilized both influenza and the updated Covid vaccines, unfortunately," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. "But it's not too late to get vaccinated, because these viruses are going to be around for a while yet."
According to the CDC, hospital bed capacity remains "stable" nationally, including within intensive care units. But with high levels of respiratory viruses, hospitals in at least five states are returning to requiring masks.
Mass General Brigham spokesman Timothy Sullivan said it will require masking for health-care staff who interact directly with patients starting Tuesday, and patients and visitors will be "strongly encouraged to wear a facility-issued mask."
In Wisconsin, UW Health and UnityPoint Health Meriter have expanded mask policies to cover more people. UW requires all staff, patients and visitors to wear a mask for patient interactions in clinic settings, including waiting areas and exam rooms.
UnityPoint Health Meriter says masks continue to be required for team members and visitors in patient rooms.
Bellevue, a public hospital in New York City, said on social media last week that it had reinstated its mandatory masking policy due to an uptick in respiratory illnesses.
In Pennsylvania, the University of Pittsburgh Medical Center has required everyone to wear a mask when entering or inside since Dec. 20. The systemwide masking policies were adjusted to "address the increase of respiratory virus cases" but may change when there is a "marked decrease in respiratory health cases," according to the health care system.
An order posted last week by the Los Angeles County Health Officer requires all health-care personnel and visitors to mask while in contact with patients or in patient-care areas, based on the CDC's categorization of Covid-19 hospital admission levels.
During the week ending Dec. 23, more than 230 U.S. counties were considered to have "high" levels of Covid-19 hospital admissions, defined by the CDC by at least 20 new hospital admissions for every 100,000 people. Nearly a thousand other counties, about a third of the country, have "medium" Covid-19 hospital admission levels, with at least 10 admissions for every 100,000 people.
Vaccines and masks can help reduce the risk of severe illness before getting sick, but treatments are also available to help prevent people from getting very sick if they do become infected.
Antiviral treatments for Covid-19, such as Paxlovid, and flu, such as Tamiflu, can be especially helpful for people who are more likely to get very sick, including people who are 50 or older and those with certain underlying conditions, such as a weakened immune system, heart disease, obesity, diabetes or chronic lung disease.
"If more people at higher risk for severe illness get treatment in a timely manner, we will save lives," the CDC said in a recent blog post. But "not enough people are taking them."
Seasonal respiratory virus activity can be hard to predict, but CDC forecasts suggest that hospitalization rates will continue at elevated levels for weeks and that this season, overall, will probably result in a similar number of hospitalizations as last season.
"One of the ways to help us all go into a happy new year is for us to be as protected as we can against these viruses," Schaffner said.
"Of course, I continue to recommend vaccination, prudent use of the mask by high-risk people and, should you become sick, do not go to work and spread the virus further. Call your health care provider, because you may have some treatment available that will get you healthier sooner."
With both COVID-19 and other respiratory virus rates up, nearly all the major hospital groups in Massachusetts are bringing back mask requirements for doctors and staff, and in some cases for patients and visitors as well.
Beth Israel Lahey, Boston Medical Center and Dana Farber have already reimposed requirements. Mass General Brigham and UMass Memorial plan to require masking starting Jan. 2, followed by Tufts Medicine on Jan. 3.
Several of the health institutions said theyve been closely tracking data including wastewater measurements, hospitalizations and emergency room visits ready to make the mask changes.
COVID-19 cases are up, and the states data measuring COVID detected in wastewater used to track trends of the number of people with the illness has shown a spike since Thanksgiving. That measurement is considered a good early warning sign of increases since the virus can show up in wastewater as much as a week before positive test results do.
But while most people associate masking with COVID-19, hospitals say the rise in a range of respiratory viruses, like RSV and various strains of influenza, is also behind the call to mask up. And while using masks to prevent infectious disease transmission is not a new concept, experts consider them a public health lesson from the pandemic.
We have a tool that is not just specific to COVID, and these respiratory viruses do on their own have a significant level of morbidity, mortality, missed days from work, said Dr. Cassandra Pierre, infectious disease specialist at Boston Medical Center. We've had this understanding from COVID that we can protect our health care workers, our patients and our staff by using the same mask mandates that were helpful during the pandemic.
At Mass General Brigham facilities, patients and visitors are strongly encouraged to wear masks, but they are still optional for those groups at most locations.
Boston Medical Center, meanwhile, is already requiring patients and visitors in most settings to wear a mask. Pierre said that decision was especially important given the vulnerable and minority population at Boston Medical Center whove typically borne the brunt of COVID-19 and other respiratory complications.
Dana Farber Cancer Institute reimposed mask mandates for patient-facing staff as well as patients and visitors last week.
Weve seen a steady increase in both the incidents of COVID, influenza and of RSV, said Anne Gross, chief nursing officer at Dana Farber Cancer Institute. Those are very serious illnesses for people at risk, in particular the elderly and people like our cancer patients.
But Gross also said anyone heading into crowded places should consider masking again.
These illnesses are transmitted in the air, said Gross. When you are going to places where there are a lot of people, it just makes sense to minimize your risk.
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As the holiday season winds down and Covid-19 cases start to pick up, a variant called JN.1 has now become the most common strain of the virus spreading across the United States.
JN.1, which emerged from the variant BA.2.86 and was first detected in the United States in September, accounted for 44 percent of Covid cases nationwide by mid-December, up from about 7 percent in late November, according to data from the Centers for Disease Control and Prevention.
To some extent, this jump is to be expected. Variants take some time to get going, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. Then they speed up, they spread widely, and just when theyre doing that, after several months, a new variant crops up.
JN.1s momentum this month suggests that it may be more transmissible or better at evading our immune systems than other variants currently circulating, according to a C.D.C. report published Dec. 22. The agency said that Covid remains a serious public health threat, especially for those who have always been at high risk of severe disease, such as older adults, infants, people with compromised immune systems or chronic medical conditions and those who are pregnant.
As far as experts can tell, JN.1 does not seem to be causing severe illness in most other people, though even a mild case can still make you feel quite miserable for three or four days, Dr. Schaffner said. The symptoms of a JN.1 infection are similar to those caused by previous Covid variants, including a cough, fever, body aches and fatigue.
To protect yourself against infection and severe disease, experts continue to recommend wearing masks, improving ventilation indoors when possible, staying home when sick and getting the latest Covid vaccine.
Preliminary research shows that the updated Covid vaccines released in September produce antibodies effective against JN.1, which is distantly related to the XBB.1.5 variant that the vaccines were designed to target. People may not build up as many antibodies to JN.1 as they would to XBB.1.5, but the levels should still decrease the risk.
For those who were recently infected or boosted, the cross-protection against JN.1 should be decent, based on our laboratory studies, said Dr. David Ho, a virologist at Columbia University who led the research on JN.1 and Covid vaccines, which was released as a preprint paper in early December. Rapid tests also continue to be a valuable tool, and the C.D.C. has said tests already on the market work well at detecting JN.1.
There are signs that Covid cases are once again creeping up. There were just under 26,000 hospitalizations due to Covid the week of Dec. 10, a 10 percent increase from about 23,000 hospitalizations the week prior. But Covid hospitalizations are still far lower than they were during the peak of the first Omicron wave in January 2022, and so far only about half as high as they were during the peak of the tripledemic last winter, when Covid-19, flu and R.S.V. cases all surged at the same time.
It is too early to know whether JN.1 is responsible for the rise in hospitalizations or whether cases are picking up partly because of an increase in travel and large get-togethers for Thanksgiving and the winter holidays.
When people are gathered inside close to each other, having parties and traveling and the like, those are the kind of circumstances where all respiratory viruses, including JN.1, have opportunities to spread, Dr. Schaffner said. Covid generally also has some seasonality, he added; countries in the Northern Hemisphere tend to see a lull in cases in the fall before infections and hospitalizations rise again in the winter.
JN.1 will most likely remain the dominant version of the coronavirus through spring, Dr. Schaffner said. He and other experts noted that while vaccines offer protection against it and other variants, uptake remains low, with only 18 percent of adults having received the latest shots. Experts said everyone should consider getting vaccinated, especially those who are over age 65, are immunocompromised, have health conditions that put them at higher risk of severe illness or are traveling to visit loved ones who may be vulnerable.
Give yourself a New Years present by getting this vaccine if you havent done it yet, Dr. Schaffner said.
COVID wastewater levels are trending steeply upward in the U.S. It may leave you wondering if your winter illness is because of humanitys newest scourge or something different entirely.
As always, its impossible to distinguish COVID from the flu, RSV, and other common winter illnesses like rhinoviruses, enteroviruses, and parainfluenza viruses by symptoms alone. Even with the new, highly mutated COVID variant Pirola JN.1, now globally dominant, this remains true. Whats more, its possible to have two or more infections at the same time.
As always, testingat a health care facility or at home, in the case of COVIDis the only true way to determine the source of your illness. And while you should consult your health care provider, if your symptoms are mild and you dont have other health conditions, the cause may not matter.
Still, with a new COVID variant making a splash, its fair to wonder if coronavirus symptoms have changed or if precautions like masking are again warranted. Heres what you need to know to manage the winter illnesses that are likely headed your way.
The jury is still out. Cases of diarrhea, which may or may not be related, are reportedly on the rise. This comes as speculation swirls that the virus might be taking up residence in the gutversus like the upper respiratory tract, where Omicron tends to hang out, or the lower respiratory tract, where initial strains of COVID wreaked havoc.
Keep an eye out for GI symptoms and realize they could be signs of COVID, not just the stomach flu, experts advise. But as Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, points out, COVID has always caused GI symptoms in some, including nausea, vomiting, and diarrhea.
Otherwise, keep an eye out for the usual COVID symptoms, which may include:
Once again, the jury is still out. What we do know, however, is that COVID hospitalizations are trending upward in the U.S. and elsewhere, as are cases of JN.1.
In the U.S., COVID hospital admissions had risen 10% week-over-week as of Dec. 16, according to the latest federal health data. And JN.1 was projected to lead U.S. COVID cases, estimated to be behind 44% of them as of Dec. 22.
Globally, reported sequences of JN.1 increased eightfold in a three-week period during late November into early December, according to the World Health Organizations Dec. 22 COVID update. Reported hospitalizations rose 23% globally during that period.
But correlation does not equal causation. Its important to note that sequencing of COVID samples and reporting of various metrics like hospitalizations and deaths have declined greatly since the height of the pandemic, meaning statistics could appear misleading. For example: Hospitalizations may be rising quicker than we realize. Or perhaps JN.1 is responsible for a smaller share of sequences than we know.
Its also important to note that while COVID hospitalizations are on the rise globally, JN.1 may not be to blamenot entirely, at least. Population immunityor the collective resistance to a virus in a group of people due to vaccination and/or prior infectionwanes after three to six months, on average. With COVID vaccine and booster uptake at low levelsonly 18% of U.S. adults have received the latest booster, released in Septemberthe disease will spread more widely, and severe outcomes like hospitalizations and deaths could become more common, regardless of variant.
At-home COVID tests remain as accurate as theyve ever been, experts say. But they caution that many infected people test too early or too late, when viral loads are low and unlikely to turn a test positive. If you have symptoms but test negative, wait another couple of days and test again, experts recommend.
In short: the usual suspects. Around 12% of all tests for COVID, flu, and RSV performed in the U.S. were returning positive mid-December, according to the latest available data from the U.S. Centers for Disease Control and Prevention. For some perspective, a long-ago abandoned goal from the World Health Organization and other public health agencies was a test-positivity rate of below 5%, for communities that wanted to cast aside pandemic precautions.
Experts are increasingly recommending it, and not just because of COVID. Some hospitals, like those in New York and Illinois, are again requiring masks because of high levels of respiratory pathogen circulation in their area. And Yolo County in Northern California is recommending masking in public spaces due to surging levels of COVID and RSV.
Dr. Stuart Ray, vice chair of medicine for data integrity and analytics at Johns Hopkins Department of Medicine, recommends wearing an effective respirator in public spaces, especially indoors, when it doesnt interfere with essential tasks.
Not a bad way to keep your face warm, too, he adds.
Only 4.5% of a cohort of pediatric COVID-19 patients admitted to US hospitals during the period of Omicron predominance had completed their primary COVID-19 vaccine series, and 7.0% had started but didn't finish the series, The Pediatric Infectious Disease Journal reports.
The study team, led by Centers for Disease Control and Prevention (CDC) researchers, enrolled 597 vaccine-eligible COVID-19 inpatients aged 8 months to 4 years at 28 hospitals participating in the Overcoming COVID-19 network from September 2022 to May 2023. A total of 62.1% of patients were aged 8 months to 1 year, and 37.9% were aged 2 to 4 years.
A complete vaccination series was defined as at least two Moderna or three Pfizer/BioNTech mRNA COVID-19 doses received at least 14 days before hospitalization.
The vast majority of patients (88.4%) were unvaccinated. Most children (74.1%) who completed the primary COVID-19 vaccine series were White. Completion of the vaccine series was low in all regions but highest in the Northeast (12.2%) and lowest in the South (1.5%).
In total, 4.5% of the children had completed their primary COVID-19 vaccination series, and 7.0% started but did not complete their primary series. Of the 528 unvaccinated patients, 48.0% were previously healthy, 3 needed extracorporeal membrane oxygenation (ECMO), and 1 died.
Most critically ill children were unvaccinated or hadn't completed their primary series, including 94.3% of children admitted to an intensive care unit (ICU), 88.2% who received invasive mechanical ventilation (IMV), and 92.0% with life-threatening infections. This included all three patients who required ECMO and the 29 who required vasopressors to maintain their blood pressure.
All six critically ill patients who completed their vaccine series and were hospitalized had one or more chronic respiratory or neurologic conditions, including four who had both.
Among children younger than 2 years, 44.7% had at least one underlying illness, compared with 69.9% of those aged 2 to 4. The most common underlying conditions were respiratory or neurologic/neuromuscular. A small proportion (1.2%) of children also had influenza, and 11.4% also had respiratory syncytial virus (RSV).
Of the 597 children, 29.1% were admitted to an ICU, and 12.6% had a life-threatening illness, including 8.5% needing IMV. Children with chronic respiratory and neurologic/neuromuscular illnesses were most likely to need high levels of respiratory support.
Of the 42 patients but didn't complete their primary vaccination series before hospital admission, 33 were overdue for a dose, and 9 were hospitalized between doses but weren't overdue for the next dose. Overdue doses were more common among those who started the Pfizer vaccine series (81.8%) than among Moderna initiators (18.2%).
The longer timeframe required to complete the 3-dose Pfizer-BioNTech primary series may also allow for more opportunities for infection during inter-dose intervals.
The authors said that low vaccine uptake in this age-group may be due to logistical challenges, including problems with vaccine distribution, reliance on pediatricians and hospitals rather than pharmacies to give doses to very young or medically complex patients, and the relative complexity of the Pfizer vaccine series (three doses given at different intervals).
"The longer timeframe required to complete the 3-dose Pfizer-BioNTech primary series may also allow for more opportunities for infection during inter-dose intervals," they wrote.
The findings underscore the importance of improving COVID-19 vaccine uptake and awareness of disease severity in young children, the researchers said. "Despite an observed decrease in the proportion of hospitalized children <5 years of age requiring ICU admission during the period of Omicron predominance, similar proportions are still requiring IMV," they wrote.
