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5 min read National Report

Outbreak Outlook - National - February 19

Some states still struggling against a rebound of influenza and Covid-19

Outbreak Outlook - National - February 19

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Respiratory Diseases

ILI

Influenza-like illness remained about the same this week, with 4.7% of visits to the doctor for fever and cough or sore throat. This is above the baseline of 2.9% that marks flu season. Current activity is a mix of influenza A, which is more common in the winter months, and influenza B, which is more often associated with springtime. 

Outpatient influenza-like illness activity. Source: CDC

By age: Activity continued to increase in the 0-4 and 5-24 age groups to 10.4% and 7.3%, respectively. And as I suspected, what I think of as the parents-with-young-kids age group (25-49) also registered an increase. It’s fairly common to see ILI trends rise first in children and then spread to adults, which is what I am seeing this week.

By region: More than half of the country, 27 states, is seeing high or very high levels of ILI activity. The South is most heavily affected and activity is still rising, but parts of the Midwest are also now seeing increases after a relatively mild start to the season. New York City and Washington D.C. are also in the very high category. It’s a little uncommon for flu to make a second stand like this, so it’s worth keeping an eye on trends in the weeks to come (watch this space!).

By severity: Although outpatient ILI is being stubborn, emergency department visits for influenza are declining, and so is the number of new influenza hospitalizations. Even the beleaguered 5-17 age group saw a tiny dip in ER visits, if you squint a bit (8.5% to 8.1%).


Covid-19

The national picture on Covid-19 hospitalizations is complex, with some regions seeing improvements while others are still elevated. Here’s the scoop:

Positives: Most of the country is seeing declining Covid-19 hospitalizations. This includes most states in the Western region, including California, Washington, and New Mexico. The Northeast is looking better as well. Hospitalizations there are generally improving after winter spikes, with some states like Vermont achieving significant reductions. Moreover, wastewater concentrations remained relatively stable across the country, with the Northeast having the highest levels.

Concerns: The South is seeing a resurge of Covid-19. Hospitalizations jumped in places like Arkansas, Washington D.C., Texas, and Louisiana, erasing previous declines. The South-Central states are most affected by this new increase; other parts of the Southern census region are doing okay, which is why the increase is not evident on the plot below. There has been a noticeable uptick in hospitalizations among people ages 70+ in these areas, so caution is warranted.

Parts of the Midwest, including North Dakota, Kansas, and Nebraska also reported increases in Covid-19 activity, but overall levels are lower there.

Going Forward: I am not sure why the South is seeing a resurgence in both ILI/influenza and Covid-19. We do sometimes see a small spring “wave” of Covid, but that’s usually more of an April event. My guess is that this is just a temporary setback and activity will begin declining again soon, but my confidence in that prediction is low. I’ll keep a close eye out in the weeks to come.


RSV

PCR test positivity for RSV continues to improve. After a peak in late November, positivity at the national level has now decreased to below 5%. However, the West and Midwest still have test positivities between 5-10%, so the season is lingering a bit in those areas.


Other Respiratory


Stomach Bugs

Norovirus activity remains elevated, with test positivity around 12%. The next month or two is typically peak norovirus season. Norovirus spreads very easily from person to person, causing vomiting and diarrhea. Wash your hands frequently with soap and water to prevent transmission.


Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New

Previously reported:


In other news

white flower on snow covered ground during daytime
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