People's CDC COVID-19 Weather Report

Week of May 30, 2022

The Current Situation – “The Weather”:

The U.S. is clearly in a surge; while cases are underreported, the CDC’s delayed “community level” maps are starting to turn red across the nation.

CDC’s COVID-19 community levels in US by county with map and table of data. Most of the U.S. map is green, indicating low levels (2305 counties, 71.52percent of the US, change of -4.29percent from last week). Medium levels appear in the West and scattered throughout the Midwest and northeast (668 counties, 20.73percent of the US, change of 5.74percent). High levels appear in the northeast (250 counties, 7.76percent of the US, change of -1.46percent). Text at bottom reads: “Time period: Community levels were calculated on Thursday, May 26, 2022. New COVID-19 cases.”

The CDC transmission map shows most of the country – 87% of counties & 96% of people – at high/substantial transmission. While earlier mask mandates could have reduced cases, the CDC has yet to call for masking or any other layers (besides vaccines) to protect the public.

People's CDC’s COVID-19 community transmission in US by county with map and table of data. Most of the U.S. map is red, indicating high levels (2004 counties, 62.2 percent of the US, change of 5.59 percent from last week). Substantial levels appear in the Midwest and Northwest (489 counties, 15.18 percent of the US, change of -1.46 percent). Moderate levels appear in the South, Midwest, and Northwest (519 counties, 16.11 percent of the US, change of -3.04 percent).Low levels appear only in the middle of the US and Nevada (208 counties, 6.46 percent of the US, change of -1.09 percent).

On Variants: In 2022, we’ve had 3 successive subvariants of Omicron wash over the country. BA2.12 is now the dominant variant in the US making up about 58% of all new cases for the week ending May 21.

A chart showing weeks 2/19/2022 through 5/21/2022 with levels for each viral lineage shown vertically. In February, BA.1.1 was the dominant lineage, with small levels of B.1.1.529. As time goes on, BA.2 starts to grow and BA.1.1 and B.1.1.529 shrink. Around the end of March, BA.2.121 appears and also grows. In mid-May, BA.2.121 and BA.2 are equally found. By 5/21/2022, BA.2.121 overtakes BA.2 as the dominant variant.

Geographically, we see that while BA2.12 (red) makes up the majority of cases in the Northeast and Great Lakes regions, it is still growing in the West and South; we are sadly not done with this surge yet.

A grayscale map of the United States describing proportions of COVID variants in 10 regions with pink and red pie charts. Each regional pie chart indicates a large number of cases comprised of the BA.2 variant, shown in pink, but there is an increasing proportion of cases comprised of the BA.2.12 variant, shown in red. The majority of the pie chart is red in regions like the Northeast and some of the Midwest, 40-50 percent is red in the East Coast, Southwest, and Great Lakes area, and 30-40 percent is red in the the Pacific Northwest. On the bottom right, text says "Regional proportions from specimens collected the week ending 5/21/2022. US territories not shown are included in HHS regions Puerto Rico, Virgin Islands - Region 2; American Samoa, Federated States of Micronesia, Guam; Marshall Islands, Northern Mariana Islands, Palau - Region 9. Updated May 24, 2022."

Two variants (BA.4 & BA.5) have been found in South Africa (due to their excellent surveillance work). They have similar changes as BA.2.12. Early lab studies suggest BA.4 & BA.5 can escape immunity from earlier strains, like BA.2. This means folks who recently had COVID may be vulnerable again.

Neutralization experiments revealed that the immunity induced by BA.1 and BA.2 infections is less effective against BA.4/5. Cell culture experiments showed that BA.2.12.1 and BA.4/5 replicate more efficiently in human alveolar epithelial cells than BA.2, and particularly, BA.4/5 is more fusogenic than BA.2. Furthermore, infection experiments using hamsters indicated that BA.4/5 is more pathogenic than BA.2. Altogether, our multiscale investigations suggest that the risk of L452R/M/Q-bearing BA.2-related Omicron variants, particularly BA.4 and BA.5 to global health is potentially greater than that of original BA.2. — Source: 3710612 (biorxiv.org)

Wastewater Monitoring: Cases are highly undercounted in this surge. Wastewater data does not rely on testing or reporting. Nationally, rates are still about as high as the fall Delta surge, but may be leveling off.

A graph demonstrating differences in wastewater viral concentration and daily clinical cases. At the top left is a legend. The top line, in solid blue, represents viral concentration as determined by wastewater. The bottom line, in light blue, represents a daily average of clinical cases and follows the same pattern but is slightly lower throughout and much lower during large COVID-19 waves. Bars in the same light blue color represent the total amount of clinical daily cases. There are small spikes in the graph in April 2020, January 2021, and September 2021, and a large spike in January 2022. The end of the graph shows low levels in April 2022 but a rapid increase to the current date. At the bottom, text reads "Source: Wastewater data from Biobot Analytics, Inc; Clinical data from USA Facts."

Regionally we see important differences. While the Northeast (orange) may have peaked, the rest of the country (South, Midwest, West top to bottom) are still increasing. In every region but the South, these levels are higher than the Delta peak.

“Covid-19 Wastewater Monitoring by Region.”“Wastewater: Effective SARS-CoV-2 virus concentration (copies per milliliter of sewage.)” The chart displays trends in wastewater in the last 6 weeks, from April 2022 to May 2022. There are four lines that all start below a concentration of 250 at the beginning of April. The yellow line representing the Northeast shows the greatest rise in concentration over 6 weeks and is nearly double the lowest level, exceeding 1,000 in concentration at the second week of May, and starting to lower by the current week. The purple line representing the Midwest and pink line representing the South are rising steadily but slower and end around level 750. The aqua line representing the West shows a small bump between the end of April and early May which dipped down slightly and has resumed slightly increasing, to a concentration of approximately 400. At bottom, source: Wastewater data from Biobot Analytics Inc. Clinical data from USA Facts.

This data is a strong reminder we need better surveillance–and to use that surveillance to take action.

Conclusions and Relevant: The true magnitude of NYC’s BA.2/BA.2.12.1 surge was vastly underestimated by routine SARS-CoV-2 surveillance. Until there is more certainty that the impact of future pandemic surges on severe population health outcomes will be diminished, representative surveys are needed for timely surge detection, and to estimate the true burden of infection, hybrid protection, and uptake of time-sensitive treatments. — Source: The prevalence of SARS-CoV-2 infection and uptake of COVID-19 antiviral treatments during the BA.2/BA.2.12.1 surge, New York City, April-May 2022 (medrxiv.org)

Hospitalizations: For the fifth week in a row, hospitalizations continue to increase nationally. While hospitalizations are still relatively low, this should be expected whenever cases rise for prolonged times. This measure does not capture the risk of long covid & other outcomes.

New admissions of patients with confirmed COVID-19, United States, shown in two charts, both covering August 01, 2020 - May 24, 2022. On the left is all ages combined, and on the right is by age group; both x axises are time, and y axises are new admissions per 100,000 population. Below each chart is a legend on colors corresponding to age groups. The number of hospital admissions per 100,000 people is higher by age group consistently across time, with spikes in January 2021, August 2021, and January 2022. For all ages, there have been 4,719,794 total admissions from Aug 01, 2020 - May 24, 2022, 3,614 current 7-day average from May 18-2022 - May 24, 2022, 3,271 prior 7-day average May 11, 2022 - May 17, 2022,, 21,526 peak 7-day average Jan 09, 2022 - Jan 15, 2022, a +10.5 percent change from prior 7-day average of May 11, 2022 - May 17, 2022, and a -83.2 percent change from peak 7-day average of Jan 9, 2022 - Jan 15, 2022. — *Source: Unified Hospital Dataset, White House COVID-19 Team, Data Strategy and Execution Workgroup.*

In the hardest hit Northeastern regions, hospitalizations among kids reached their second highest levels of the pandemic. Without further action, this may be replayed across the rest of the nation.

New Admissions of Patients with Confirmed COVID-19, United States, HHS Region 2, shown in two charts, both covering Aug 01, 2020 to May 19, 2022. On the left is all ages combined, and on the right is by age group; both x-axises are time and y axises are new admissions p-er 100,000 population. The all ages chart shows a large spike in Jan 2022. The one by ages shows the oldest age group spiking higher than others in Jan 2021 and all ages spiking in Jan 2022. For all ages, there have been 10,346 total admissions from Aug 01, 2020 - May 24, 2022, 37 current 7-day average from May 18-2022 - May 24, 2022, 41 prior 7-day average May 11, 2022 - May 17, 2022, 109 peak 7-day average Dec 29, 2021 - Jan 04, 2022, a -10.7 percent change from prior 7-day average of May 11, 2022 - May 17, 2022, and a -66.0 percent change from peak 7-day average of Dec 29, 2021 - Jan 04, 2022. — *Source: Unified Hospital Dataset, White House COVID-19 Team, Data Strategy and Execution Workgroup.*

Deaths: In the past week, from May 19 to 25, 2,140 people died of COVID nationally.

Be Prepared, Whatever the Weather: Boosters are available for everyone 5 & older, with some eligible for 2nd booster. The FDA will meet June 15 to review vaccine data for children under 5. If they recommend authorization, young children could begin vaccination early this summer.

Vaccines alone will not prevent spread nor Long COVID. Masks & ventilation (also paid sick leave & access to testing) are key. Some health departments are doing amazing work to help communities improve air quality.

Forecast: Some universities, citing high levels of community transmission, have reinstated mask mandates for indoor spaces on campus, including the University of Hawaii University of California, Los Angeles, and University of Delaware.

On Long COVID: According to the CDC, approximately 1 in 5 adults will experience a new condition starting one month or more after surviving COVID. COVID survivors have twice the risk for developing pulmonary embolism or respiratory conditions.

Other conditions after COVID included cardiovascular conditions, blood clots and vascular issues, kidney failure, musculoskeletal conditions, and neurologic and mental health conditions.

Image has text with a graphic of a person and various body parts noted. “Approximately 1 in 5 adults ages 18+ have a health condition that might be related to their previous COVID-19 illness, such as: Neurologic and mental health conditions (arrow pointing to person’s head with asterisk: Adults aged 55 and older at increased risk), kidney failure (arrow pointing to person’s kidney), musculoskeletal conditions (arrow pointing to person’s shin), cardiovascular conditions (arrow pointing to person’s heart), respiratory conditions (arrow pointing to lungs), [and] blood clots and vascular issues (arrow pointing to circulatory system). Talk to your health care provider if you have symptoms after COVID-19. bit.ly/MMWR7121, May 24, 2022”

Vaccination alone may not significantly reduce long-term health consequences of COVID infection. A new study found that vaccination only reduced the risk of Long COVID by about 15% compared to those who were not vaccinated.

Sources (in order):

News Updates for 5/30/22:

https://emergency.cdc.gov/han/2022/han00467.asp
“Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Paxlovid treatment helps prevent hospitalization and death due to COVID-19. COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms or a new positive viral test after having tested negative.”