People’s CDC COVID-19 Weather Report


The Weather: Transmission levels remain high, with 98.3 percent of the population living in areas with substantial or higher transmission. Rates are particularly high along the East Coast & Southeast, with lower levels in the West.

Map and table show COVID transmission levels by US county as of 1/5/23 based on the number of COVID cases per 100,000 population and percent positivity in the past 7 days. Low to Moderate transmission levels are pale yellow, Substantial is orange, High is red, Very High is brown, and Extremely High is black. Most of the map is red. The midwest region shows more pale yellow and orange, and North Carolina and Alabama are primarily blackn. Text in the bottom right reads: 98.3 percent of the US population lives in an area with substantial or higher transmission. A Transmission Level table shows 6.0 percent of counties (4.7 percent by population) as Extremely High, 9.0 percent of the counties (10.5 percent by population) as Very High, 59.5 percent of counties (74.2 percent by population) as High, 14.9 percent of counties (8.9 percent by population) as Substantial, and 10.7 percent of counties (1.7 percent by population) as Low to Moderate. The People's CDC created the graphic from CDC data.

On Variants: The most common variants (55%) remain BQ1/1.1. Last week, a new variant, XBB1.5 (Kraken) was first reported. These variant reports use models to estimate each variant – this week’s model suggests 28% of cases are due to XBB1.5.  It is dominant in the Northeast.

A stacked bar chart with weeks on the x-axis shows weeks from 10/8/2022 to 1/7/2023 and y-axis as percentage of viral lineages among infections. The recent 3 weeks are labeled as Nowcast projections. A table on the left lists specific lineages, percent totals, and 95 percent PIs for the most recent week.  BQ1.1 (teal) continues as the most prevalent lineage at 34.4 percent as of 1/7/23. XBB.1.5 (dark purple) became the second-most prevalent lineage at 27.6 percent as BQ1 (dark teal) decreased to 21.4 percent. XBB.1.5 was barely visible in November weeks’ data and has grown significantly since then. XBB (periwinkle purple) is fourth most prevalent at 4.9 percent, followed by BA.5 (light teal) which is now at just 3.7 percent.
Graphic source: CDC COVID Data Tracker: Variant Proportions

What we know:
– XBB1.5 was first detected in New York state
– It spreads faster than other variants & will likely reach the entire US shortly
– It evades prior immunity – but there is likely still benefit from the bivalent booster

What we know:
– While monoclonal treatment/prevention no longer works against newer variants, Paxlovid still should work.
– High quality masks, ventilation, & testing all still  reduce risk of infection.

What we don’t know:
– Whether XBB1.5 causes more severe disease. It’s worth remembering that variants with high transmission can put more people in the hospital even if they are not more severe.

There are large differences regionally – which may explain differences in hospitalizations – with XBB1.5 (dark purple) the most common variant in the Northeast and growing in the South. Most other regions have BQ1/1.1 (teal greens) as the most common.

Regional difference map of the US with 10 regions each with roughly 3 or 4 states depicted as shades of gray. Title reads “United States: 1/1/2023 - 1/7/2023 Nowcast.” Each region has a colored pie chart showing variant proportions. Legend at bottom right reads “Regional proportions from specimens collected the week ending 1/7/2023” and “US Territories not shown are included in HHS regions: PR, VI - Region 2. AS, FM, GU, MH, MP, PW - Region 9.” XBB1.5 (dark purple) makes up about three-quarters of the pie in regions 1 and 2 (Northeast), about one third in region 3 (Mid-Atlantic), and a smaller slivers in midwestern and western regions. BQ1.1 (teal) and BQ1 (dark teal) are the most common in the rest of the country, ie regions 4 through 10. Bottom text reads: “Updated January 6, 2023” and  “Lineages called using pangolin v4.1.3, pangolin-data v1.17 and user v.0.5.4.”
Graphic source: CDC COVID Data Tracker: Variant Proportions

Wastewater Monitoring: National wastewater levels remain high – again, higher than any winter peak before Omicron.

Graph shows weekly wastewater viral concentration and daily clinical cases since the beginning of the pandemic and ending on January 4, 2023. Top text says “Data last updated January 05, 2023 from samples collected during the week of January 02, 2023.” A dark blue line represents viral concentration in copies per milliliter of sewage, and a light blue line represents the average of daily new clinical cases. Since about March 2022, the light blue case line is somewhat erratic and relatively plateaued at well less than 100K. Over the same time, the dark blue wastewater line is persistently higher. It peaked above 1,000 copies per mL in late July 2022 and was decreasing until the end of October. A significant increase occurs and numbers now rival the July numbers at 1,079 copies/mL on January 4. Bottom text reads: “Source: Wastewater data from Biobot Analytics, Inc; Clinical data from USAFacts.”
Graphic source: Biobot Analytics

Regionally, wastewater levels are highest in the Northeast, with increasing levels in the South. Levels are the lowest in the West – though data appears to be missing for this week.

Title reads “Wastewater: Effective SARS-Cov-2 virus concentration (copies/mL of sewage), powered by Biobot Analytics.” Line graph shows the levels of COVID detected in wastewater by US region, each region with a different color trend line, over the last 6 weeks. A legend map of the US on the right shows the West region as green, South as pink, Midwest as purple, and Northeast as orange. The y axis shows copies per mL of sewage and the x-axis shows time between late November 2022 to January 4, 2023 with weekly dates labeled on the axis. Northeast (orange) has the highest virus concentration over the past 6 weeks, increasing from November through December with a slight decline in the last week, still above 1,500 copies per mL. South (pink) has increased from the lowest concentration to now being above 1,000 copies per mL and second highest. West (green) data is missing for the most recent week.  Source: Wastewater data from Biobot Analytics, Inc.
Graphic source: Biobot Analytics

Hospitalizations: Hospitalizations are increasing, with particularly high rates among those over 70, rivaling the peak of the Delta wave.

Two line graphs representing new admissions to hospitals of patients with confirmed COVID in the United States with the left graph representing all ages and right graph showing ages 70 years and older. Both graphs have labels of January 2021 to January 2023 on its x-axis and New Admissions per 100,000 Population (all subsequent rates are reported per 100,000) on its y-axis. On the left, y-axis ranges from 0 to 8 and on the right, y-axis ranges from 0 to 25. Among all ages, new admissions peak above 6 in January 2022, with other peaks in January 2021 near 5, August 2021 at 3.7, July 2022 near 2. The line gradually decreases in Fall 2022 to around 1 with a recent increase to near 2. Among older adults, new admissions peak at about 20 in January 2021 and 21.5 in January 2022, with other peaks happening in August 2021 near 8 and July 2022 near 7.5. The line gradually decreases in Fall 2022 to around 5. Numbers have increased for the last five weeks to 9.4.
Graphic source: CDC COVID Data Tracker: New Hospital Admissions

Hospitalizations are also increasing in the Northeast (for example Region 1) and the South (Region 4).

Two line graphs representing new admissions to hospitals of patients with confirmed COVID in the United States, all ages, with the left graph showing HHS Region 1 and right graph showing HHS Region 4. Both graphs have labels of January 2021 to January 2023 on its x-axis and New Admissions per 100,000 Population (all subsequent rates are reported per 100,000) on its y-axis. On the left, y-axis ranges from 0 to 7 and on the right, y-axis ranges from 0 to 8. In Region 1, new admissions peak near 6 in January 2022, with a smaller peak in January 2021 near 3.5. Since summer 2022, admissions stayed between 1 and 2 until the past few weeks, where admissions increase to around 2.5. In Region 4, August 2021 and January 2022 both had peaks above 7, with a January 2021 peak around 6. August 2023 had a more gradual peak around 2.5, and in recent weeks, admissions are increasing again, currently just above 2.
Graphic source: CDC COVID Data Tracker: New Hospital Admissions

Deaths: The week of January 4, at least 2,731 people died of COVID nationally. At least 254,124 people died of COVID in 2022. This was the third year of the pandemic – a year when we supposedly had “the tools necessary” to control COVID. 

COVID is clearly NOT the flu – 254,124 deaths is 5 times more than the worst year of flu deaths in the last decade. Over the course of the entire pandemic, 1,600 children have died of COVID.

Globally, the U.S. has a higher rate of COVID-19 deaths than many of our peer nations, yet there is no sense of urgency from the federal government to do much other than rely exclusively on vaccines. Universal booster shots, masking, and clean air are critical.

Title and subtitle read “Cumulative confirmed COVID-19 deaths per million people. Due to varying protocols and challenges in the attribution of the cause of death, the number of confirmed deaths may not accurately represent the true number of deaths caused by COVID-19.” Graph shows a y-axis of cumulative deaths ranging from 0 to 3,000 and an x axis of dates ranging from Mar 1, 2022 through Jan 5, 2023. 11 colored trend lines show cumulative deaths by country, with country labels at the end of each line. Of countries shown, the UK had the highest cumulative deaths up until Spring 2021. Brazil then took the lead for most deaths until the past few weeks when the US slightly surpassed them. US, Brazil, and UK’s death counts are all clearly above 3,000 per million, followed by Mexico, France, Sweden, and Germany with counts between around 2,000-2,600, then Denmark, Canada, and Israel all around 1,250 and Norway below 1,000. Note reads “Source: Johns Hopkins University CSSE COVID-19 Data”
Graphic source: Our World in Data

Long COVID: A comprehensive meta-analysis of Long COVID was published & shows 45% of COVID survivors, regardless of hospitalization, were experiencing unresolved Long COVID symptoms after 4 months. Similar symptoms are being reported whether from Omicron or Delta variant.

Our kids are not okay. The findings in the aforementioned meta-analysis show a “significant proportion of seropositive children, particularly adolescents, experiencing persistent COVID symptoms.”

Another study states “The majority of children who develop persistent dyspnea after COVID infection exhibit reversible peripheral airway obstruction and lung hyperinflation despite normal spirometry.”

As peripheral airways cannot always be seen with standard pulmonary tests, there is an extra need to watch out for this to make sure our kids are diagnosed and treated correctly.

Speaking of treatments, a new study offers some insight into Long COVID, finding that there are four major subtypes of Long COVID, a critical piece of information as clinicians try to prescribe relevant treatments. They are as follows:

  • 34% have heart, kidney, & circulation-based symptoms; risk of heart failure post-COVID is almost doubled
  • 33% have respiratory & sleep problems, anxiety, headache & chest pains
  • 23% have musculoskeletal & nervous system symptoms
  • 10% have combined digestive & respiratory symptoms

Forecast: There is no room for complacency on COVID in 2023. The global community must invest in and strengthen our public health systems to handle the dramatic increases in hospitalizations, reduce COVID transmission, and protect people from Long COVID.

A recent study post-Omicron has demonstrated that vaccines have a small effect on reducing transmission. While the study was done in a prison setting, it is noteworthy because there have been few studies on transmission in the era of Omicron.

Paxlovid is a critical treatment yet its distribution and usage remain structurally limited: Black and Hispanic populations are 30-36% less likely to be prescribed Paxlovid than white populations. Health officials must do better.

Title and subtitle read “The Northeast leads in Paxlovid use. In September and October, 1.1 million people took Paxlovid, a covid treatment pill. Northeastern states had the highest treatment rates even though they didn’t have the highest covid burden.” A gradient legend defines Paxlovid courses per 10,000 residents, with lightest blue being 20 per 10,000 residents, light blue between 20-30, medium blue between 30-40, dark blue between 40-50, and darkest blue above 50 per 10,000. NJ and all states Northeast of NY are darkest blue. NY, PA, MD, and MI are all dark blue. OH, WV, VA, NC, AR, MN, NM, CA, and WA are medium blue. MS, ID, MT, WY, ND, SD, NV, UT all are lightest blue, with the rest of the country as light blue. Bottom text reads “Note: Paxlovid use data is from Sept 4 through Oct 30, 2022. Covid deaths data is from Sept 1 through Nov 2, 2022. Source: U.S. Department of Health and Human Services, CDC, U.S. Census Bureau 2021 population estimates. Credit: Hannah Recht/KHN”
Graphic source: San Francisco Chronicle

For example, now is not the time to remove Paxlovid subsidies, yet by mid-2023, Paxlovid will hit the private market and cost hundreds of dollars, making it significantly less accessible to those who need it most.

Take Action: The updated booster is still an important layer – yet, nationally, only 15% of the public and 38% of seniors have gotten the bivalent vaccine – with particularly low rates in the South. Please get your bivalent vaccine booster now to protect you and your loved ones.

Title reads “Percent of the population 5 years of age and older with an updated (bivalent) booster dose reported to CDC by jurisdictions and select federal entities.” A chloropleth map of US states shows bivalent vaccination percentages ranging from light green to dark blue, with data on territories represented as labeled squares below the map. Southern states, IN, PR, and all territories except FM are light green (0 to 9.9 percent). The majority of the map is either light teal (10 to 14.9 percent) or teal (15 to 19.9 percent). HI, WA, OR, CO, AZ, WI, MD, MA, RI, and NH are dark teal (20 to 24.9 percent), and just MN, VT, MA, ME, and DC are dark blue (25 percent or more). Federal entities are listed as white (no data). A note reads “Data for Federal Entities are presented here and are also incorporated into the respective jurisdictional totals.”
Graphic source: CDC COVID Data Tracker: Vaccination Distribution & Coverage

Caring for each other in our communities is essential to surviving this pandemic, and yet pandemic scapegoating has increased hate against Asian Americans and Native Hawaiians, with about 28% experiencing or witnessing a hate incident in 2020-2021.

Report hate crimes and demand that your local representatives uphold resolutions against hate.

Notes: 1) The numbers in this report were current as of 12/23. The CDC updates data frequently as it receives refreshed information. Today’s numbers may be slightly different from the data here. 2) Check out the links throughout & see our website for more!

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