With the holidays approaching and travel peaking, COVID-19 is on the rise again across the country. However, this year's winter COVID surge is starting later than normal, with some experts warning of a possible “quiet” rise in transmission during the holidays.
They're calling it “quiet” because this winter surge follows a long period of unusually low COVID activity this fall. Many people are unaware that COVID levels have risen sharply over the past two weeks, according to the latest wastewater data from the U.S. centers. for disease control and prevention show.
As a result, people may not know that their risk of infection is increasing and may not test if they have only mild symptoms, allowing the virus to spread at holiday gatherings, during travel and more.
According to CDC data, virus activity of SARS-CoV-2 – the virus that causes COVID-19 – is “high” or “very high” in wastewater in 21 states as of December 14.
“There is a good chance that many people will become ill in the coming weeks without realizing it. Most people don't keep CDC data, and so the only way to know if we're in a wave is if they've gotten sick,” Michael Hoerger, Ph.D., associate professor at Tulane University School of Medicine and public health expert in tracking COVID-19 trends, tells TODAY.com.
While the data doesn't yet show the U.S. is in a major COVID wave, the country is entering its 10th COVID wave since the pandemic began, Hoerger added.
But there is a lot of uncertainty about how bad this year's winter surge will be and how long it will last. “This is a very risky time because there are a lot of people interacting indoors, so we don't really know how quickly transmission could increase,” Hoerger said.
A risk of “silent” transmission during the holidays
COVID-19 wastewater levels are lower than they were at this point last winter, but there has been a sharp increase over the past two weeks, according to CDC data. And the number of cases will likely continue to rise, experts say.
“As of Friday, December 20, COVID-19 levels in wastewater have moderated nationally,” says Dr. Jonathan Yoder, deputy director of the CDC Division of Infectious Disease Readiness and Innovation, told TODAY.com. Wastewater data from the previous week was 'low' nationally. Levels are highest in the Midwest.
“Nationwide, COVID-19 levels in wastewater increased during the month of December, following a period of low levels in October and November,” Yoder added.
National and regional trends in SARS-COV-2 viral activity levels in wastewater
The CDC no longer tracks the total number of new COVID cases in the US, but instead estimates transmission levels using wastewater surveillance, test positivity and emergency department visits.
The COVID test positivity rate is 5.6%, up 0.5% from the previous week, according to CDC data. COVID-related emergency room visits and deaths are also increasing very slightly.
“The problem with this winter's wave is that it is very different from the previous ones,” Hoerger explains. In recent years, COVID has followed a similar pattern: cases increase in November, increase steadily, and peak around late December or early January.
“Normally people would have been warning for a month or so by now because they would see friends and family getting infected,” Hoerger says.
“Transmission was crazy low in November, and so people are being lulled into a false sense of security,” he adds.
COVID-19 levels are rising about a month later than normal, leaving the country in “uncharted territory,” Hoerger said.
“You can think of the start of the wave as a sort of silent transmission period where people aren't really aware of it, and that coincides with the start of leisure travel,” he explains.
Hoerger, director of the Pandemic Mitigation Collective, which uses the COVID-19 prediction model, predicts that as of December 16, one in 64 (1.6%) people will be actively contagious in the U.S., and there will be about 750,000 new people. daily infections, and these are increasing.
This COVID-19 wave comes late and “out of nowhere,” he wrote on X.
Other experts agree that the number of infections is expected to increase in the coming weeks.
“We expect that these holiday gatherings and travel and everything will provide opportunities for an increase in COVID, as well as (influenza) and RSV,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, told TODAY.com.
“It's silent (transmission) because most of these infections are quite mild, so people don't test, or they brush them off as a cold,” Schaffner added.
Although the COVID surge in late summer this year provided some immunity to the U.S. population, it is likely starting to wane, experts say. And the current variants in circulation, including XEC and the descendants of the FLiRT family, are highly transmissible.
“These current variants cause much milder infections, which go largely unnoticed,” Schaffner said, adding that people with mild or no symptoms can still spread the virus to others.
“The transmissibility of these viruses, if you will, contributes to a silent epidemic,” Schaffner says.
Where COVID is spreading in the US
Current virus activity level of SARS-CoV-2 in wastewater by US state
According to the latest CDC data, COVID viral activity in wastewater is currently “very high” in five states and “high” in 16 states. The states with the highest COVID wastewater levels as of December 14 include:
“If you see increased viral activity in COVID-19 wastewater in your area, it may indicate there is a higher risk of infection,” Yoder says.
However, regional variation in wastewater data also depends on the number and specific location of wastewater monitoring sites being monitored, Hoerger says. Some states have no data and others have limited coverage. “Take regional variation with a grain of salt,” says Hoerger.
Overall, declines in testing and delays in reporting could make it challenging to accurately track COVID-19 levels, the experts note.
COVID-19 symptoms in 2024
The symptoms caused by the dominant variants in circulation, XEC and KP.3.1.1, are very similar to those caused by previous omicron subvariants, according to experts.
Common COVID-19 symptoms include:
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Nausea or loss of appetite
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Loss of sense of taste or smell
The symptoms will vary from person to person. Even milder infections can be “debilitating” for days, Schaffner says.
Although the latest variants of COVID-19 appear to cause milder illness, they can still cause severe illness that requires hospitalization. Certain people are at greater risk of developing serious illness. This includes people over the age of 65, people with underlying medical conditions, and people with weakened immune systems.
Every time a person becomes infected with COVID, he or she is at risk of developing a long bout of COVID, which can cause symptoms that persist and reemerge weeks or months after infection, according to the CDC.
Are new COVID boosters effective?
The updated 2024-2025 COVID-19 vaccine is recommended by the CDC for everyone 6 months and older.
The new mRNA COVID vaccine is monovalent, meaning it targets one variant – in this case the KP.2 'FLiRT' variant. The strains currently in circulation are closely related to KP.2, and the new booster should provide good protection, TODAY.com previously reported.
However, uptake of the new vaccine has been low so far, with only 21% of adults in the US having received the shot, according to the latest CDC data.
“The best protection is to get vaccinated. Although vaccinated people sometimes become infected with the virus that causes COVID-19, staying up to date on COVID-19 vaccines lowers their risk of getting very sick, being hospitalized, or dying from COVID-19.” , says Yoder.
How to protect yourself from COVID-19
When COVID-19 levels rise, it is important that people take steps to protect themselves and their families, according to the CDC.
You can take the following steps to prevent infection and prevent the spread of COVID-19 to others:
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Stay up to date on COVID-19 vaccinations.
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Test if you have symptoms or exposure.
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Seek treatment for COVID-19 if you are at high risk.
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Practice social distancing.
This article was originally published on TODAY.com
