The Weather
The most recent CDC national wastewater map with data from December 1st through December 7th 2024 shows 18 states reporting ‘High’ or ‘Very High’ levels of the virus. Mississippi, Missouri, and South Dakota have limited coverage. No data is available for Guam, the Virgin Islands, Puerto Rico, and North Dakota.
With regard to trends, the CDC has determined national levels are “low,” though the Midwest is experiencing “Moderate” wastewater levels.
Please remember that the determination of the categories of “Very High,” “High,” “Moderate,” “Low,” and “Minimal” is independent of any relationship to community transmission. In other words, these categories do not necessarily reflect one’s risk of getting sick in each region at any given time. Wastewater data is best suited to reveal if levels in your area are increasing or decreasing, or how levels in your area compare with other times throughout the course of the pandemic.
Also notably, while our organization historically has used the CDC wastwater data for this report while encouraging readers to find and use local data whenever it is available, we want to highlight the WastewaterSCAN dashboard this week. The WastewaterSCAN dashboard’s most recent update on December 14th shows a markedly steep increase in wastewater levels, particularly in the Midwest, and a much higher level: nearly two-thirds the level of this summer’s peak. The CDC map updated just two days prior, on the other hand, suggests current midwest levels at less than half that of the summer peak.
In any case, it appears that the holiday surge is here, most obviously in the Midwest, but we expect rates to increase in other regions in the weeks ahead.
As of December 10th, 2024, the CDC’s Epidemic Trends dashboard suggests that COVID infections are increasing or likely increasing in 28 states: most of these states are in the eastern and midwestern parts of the country.
Of note, this model uses emergency department visit data to estimate COVID transmission’s Rt, which is an estimate of the average number of new infections caused by each infectious person. An Rt greater than 1.0 indicates that infections are growing, while an Rt less than 1.0 indicates that they’re declining.
While we usually focus on COVID-19, it is worth noting that rates of RSV are high nationally and that influenza rates are increasing throughout the country. You can protect yourself and your community from all of these viruses through masking, cleaning indoor air, and/or gathering outdoors. Check out our brief, updated version of the Safer Gatherings Guide ahead of the holidays. The full guide will be available shortly. As always, practice multilayered precautions to minimize the risk of transmission.
On Long COVID
A new cross-sectional study in Health Services Research (2024) analyzed the financial impact of COVID across income and education levels using the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. Among the 271,076 respondents, 7.5% reported Long COVID symptoms. Individuals with Long COVID in the lowest income categories experienced a 2-10% increase in the probability of food insecurity, although all income and education groups experienced heightened food insecurity, inability to pay bills, and the threat of losing services. Low income individuals were also disproportionately exposed to COVID at work, and faced loss of hours and employment termination. Widespread financial adversity highlights the necessity of flexible work-from-home employment, equitable access to credit, and increased accessibility in the healthcare system.
Wins
The Researching COVID to Enhance Recovery (RECOVER) initiative, which was launched in 2021 to study and treat Long COVID patients, was allocated $147 million from the National Institutes of Health (NIH). The program’s developments in clinical trials, biospecimen collection, observational studies, and pathobiology studies will help us understand underlying mechanisms of and to help develop treatments for Long COVID. This funding is in addition to the $515 million the NIH provided earlier this year, bringing the 2024 total to $662 million. The NIH launched the RECOVER Treating Long COVID (RECOVER-TLC) for a new phase of clinical trials this July, following backlash from the first-wave studies (where only 15% of funding went towards clinical trials, including a controversial exercise study). Second-wave trials are increasing accessibility by expanding enrollment criteria to non-PCR confirmed infections, the pediatric population, and providing further accommodations for ME/CFS patients. Community representatives and patients are encouraged to submit questions and suggest therapeutics to investigate.
Variants
The CDC’s Variant Proportions Dashboard, most recently updated on December 7th, shows XEC as the dominant variant, followed by KP.3.1.1, and an emerging variant, MC.1. MC.1 is a descendent of KP.3.1.1, and XEC is a recombinant lineage of two JN.1 variants (KS.1.1 and KP.3.3).
It is not too late to get an updated vaccination if you haven’t already. Visit the national vaccine finder to find options in your area. Contact your local health department to ask about free and low-cost COVID and flu vaccine events in your area.
Graphic source: CDC Variant Tracker
H5N1 Updates
The spread of bird flu is progressing rapidly, with one recently confirmed pediatric case in California. The source of exposure remains unknown. Genomic analyses reveal that the virus samples are closely related to those previously identified among dairy workers in California, the current epicenter of most human cases. Over the last 30 days, there have been 303 new outbreaks in livestock, predominantly in California (302) and one in Nevada. Additionally, a presumptive human case has been reported in Louisiana.
To date, 60 confirmed human cases have been reported in the US in 2024.The majority of these cases (37) resulted from exposure to cows, 21 from poultry, and 2 cases of unknown origin from Missouri and California.
On December 6th, 2024, the USDA’s Animal and Plant Health Inspection Service announced its new National Milk Testing Strategy (NMTS) in response to the escalating outbreaks. The NMTS federal order mandates the routine testing of milk siloes nationwide. The NMTS builds upon the Federal Order issued in April 2024, which requires testing of all lactating cows transported over state lines.
While there is no confirmed human-to-human spread yet, each infection increases the risk of new mutations, some of which may cause human transmission. To mitigate the risk of further spread, robust surveillance, contact-tracing, vaccine development, and widespread PPE distribution are essential.
Take Action
Demand the Centers for Medicare and Medicaid Services extend funding for telehealth 2025 and onwards. Beginning January 1st, 2025, the Centers for Medicare and Medicaid (CMS) will end its financial support for telehealth services. Join us in urging Congress to provide indefinite funding for telemedicine by December 18th, 2024.
Reach out to your local and state elected officials using our Action Network campaign or email or call them using their contact information and ask if they have heard of any plans to introduce mask bans in your area, and regardless of their answer, register your dissent. Invite one friend to do the same. Visit our website for more background on the rising threat of mask bans.
Volunteer and find support with a Mask Bloc or other COVID Action group in your area. Taking action together we can create larger and larger waves of change.
We will be taking time to rest during this holiday season, expect our next Weather Report on January 13, 2025.
Notes: 1) The numbers in this report were current as of 12/14/2024. 2) Check out the links throughout & see our website for more at https://peoplescdc.org. 3) Subscribe to our newsletter: People’s CDC | Substack.
The People’s CDC is a coalition of public health practitioners, scientists, healthcare workers, educators, advocates and people from all walks of life working to reduce the harmful impacts of COVID-19.
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