Informe meteorológico de People's CDC COVID-19

El clima: Transmission levels continue to rise as we head into winter, with 93.3% of the population currently living in areas with substantial or higher transmission – compared to 85% last week.

Map and table show COVID transmission levels by US county as of 12/1/22. Low to Moderate transmission levels are pale yellow, Substantial is orange, High is red, Very High is brown, and Extremely High is black. Mountain, Southwest, and Plains states are mostly red with some pale, orange, and black. The South is pale with orange and red spots. West Coast, East Coast, Midwest, and South FL are red and orange. Text reads: 93.3 percent of the US population lives in an area with substantial or higher transmission. A Transmission Level table shows 1.3 percent of counties (0.2 percent by population) as Extremely High, 2.6 percent of the counties (3.7 percent by population) as Very High, 48.8 percent of counties (55.7 percent by population) as High, 28.1 percent of counties (33.6 percent by population) as Substantial, and 29.1 percent of counties (6.7 percent by population) as Low to Moderate. The People's CDC created the graphic from CDC data.

Sobre variantes: The CDC has updated its variant proportions report, better showing the swarm of variants currently circulating; variants are listed even if less than 1 percent. BQ1.1 is the most common (32 percent), followed by BQ1 (31 percent).

Many variants, like BF7 & BA4.6, are already on the decline, but we should keep an eye on those with increasing numbers, like XBB.

On the left, table with different viral lineage including WHO label, US classification, percent total, 95 percent prediction interval, and color coding. On the right, stacked bar chart with weeks on the x-axis shows weeks from 9/3/2022 to 12/3/2022 and y-axis as percent viral lineages among infections. The recent 3 weeks are labeled as Nowcast projections. BA5 (bright teal) was the most common lineage. From its peak around 8/20 of about 86 percent, it has receded to 13.8 percent. BQ1 (dark teal) and BQ1.1 (teal) continue to increase and have reached 30.9 and 31.9 percent, and are now 1st and 2nd most common variants. BF7(sky blue), barely present at the beginning of August, is now 4th, decreasing to 6.3 percent, while BA4.6 (dark yellow) dropped from 9.5 percent to 2.3 percent, after increasing from 3 percent in July to 11 percent in mid-September after which it decreased. Other variants have increased with XBB (periwinkle purple) reaching 5.5 percent.
Graphic source: CDC COVID Data Tracker: Variant Proportions

Regionalmente, we see BQ1 & 1.1 are the most common in all areas except the Central Plains. XBB, in light purple, is most common on the East Coast – a familiar trend for new variants.

Regional difference map of the US with 10 regions (groups of roughly 3 or 4 states), depicted as shades of gray. Title reads: United States: 11/27/2022 - 12/3/2022 Nowcast. Each region has a colored pie chart. Legend at bottom right reads “Regional proportions from specimens collected the week ending 12/3/2022” and “US Territories not shown are included in HHS regions: PR, VI - Region 2. AS, FM, GU, MH, MP, PW - Region 9.” BQ1 (dark teal) and BQ1.1 (teal) are the most common in all regions, followed by BA5 (bright teal). Region 7 remains with the highest BA5 at 28.9 percent. Bottom text reads: “Updated December 2, 2022” and  “Lineages called using pangolin v4.1.3, pangolin-data v1.15.1 and user v.0.5.4.”
Graphic source: CDC COVID Data Tracker: Variant Proportions

Monitoreo de aguas residuales: National wastewater levels are rising after months of high but stable levels; increase is seen in all regions, with the highest numbers seen in the Northeast. This data likely does not reflect cases from recent holiday gatherings.

Title reads Covid-19 Wastewater Monitoring in the US. Top text says Data last updated December 1, 2022 from samples collected during the week of November 28. Graph shows weekly wastewater viral concentration and daily clinical cases since the beginning of the pandemic and ending on November 28, 2022. A dark blue line represents viral concentration in copies per milliliter of sewage, and a light blue line represents clinical cases daily average. 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/mL in late July 2022 and was decreasing until two weeks ago, where a significant increase occurred, from 518 copies/mL on November 2 to 775 copies/mL on November 30. Bottom text reads: “Source: Wastewater data from Biobot Analytics, Inc; Clinical data from USAFacts.”
Graphic source: Biobot Analytics

Biobot also reported on trends over the past 3 years. 2022 (green) has had higher levels than most of either 2020 or 2021. Just relying on vaccinations & low booster rates alone, we are now at higher levels than the same time in 2020.

Title reads Annual nationwide average wastewater effective concentration levels. Graph has a y-axis of effective concentration of SARS-CoV-2 in copies per milliliter and an x-axis displaying a date range from March through December and the following February with three lines representing three years from 2020 to 2022. Legend on the right reads: “Year” and with three lines below, each representing the years 2020 (dark purple), 2021 (light blue), and 2022 (green). A vertical dotted black line representing late November intersects through each of the three lines. It’s labeled “We are here (late November).” Comparing wastewater concentration levels across all three years shows 2020 highest in March through May, at which point 2022 is highest until November. 2021 has the largest large spike from December through February compared to 2020.
Graphic source: Biobot Analytics

Vaccinations:  Booster rates remain low, with most states reporting less than 25% of their population having received the updated bivalent booster.

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. Map of the U.S. by state, showing the % of the vaccinated population with the updated (bivalent) booster. Most states are light green or green, indicating 14.9 percent or lower; the Great Lakes, New England, and Northwest areas are darker blue, indicating 20.0 percent or more.
Fuente: CDC COVID Data Tracker

Hospitalizaciones: Hospitalizations are beginning to rise again, with the greatest increases seen in children & those over 70. These increases are currently being driven mostly by the Central and Western regions of the country.

Two line graphs representing new admissions to hospitals of patients with confirmed COVID in the United States with the first on the left representing ages 0 to 17 years and second on the right representing ages 70 years and older. Both graphs have New Admissions per 100,000 Population (all subsequent rates are reported per 100,000) on its y-axis and labels of January 2021 to July 2022 on its x-axis. Among children, new admissions peak at about 0.25 in January 2021 and 1.3 in January 2022, with other peaks happening in August 2021 at 0.5 and July 2022 at 0.4. The line gradually decreases after July 2022 to 0.2 with a recent increase to 0.3. 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 at 8 and July 2022 at 7.5. The line gradually decreases after the July 2022 minor peak to 5 with recent increases to 6.5.
Graphic source: CDC COVID Data Tracker: New Hospital Admissions

Fallecidos: The week of November 30, 1,780 people died of COVID nationally. That brings the 2022 death total to over 247,600. We cannot let ourselves become numb to these staggering numbers.

Sobre COVID largo: People previously infected with COVID, incluyendo a niños, pueden tener una higher chance of developing diabetes. Researchers also theorize that COVID can alter gene expression, thereby increasing risk of Alzheimer’s disease and diabetes.

The Global Situation: COVID continues to be a global pandemic. CNN shows daily deaths in the US peak higher & last longer than elsewhere; periods of low death are similar to peaks in other countries.

Stacked area chart with monthly death counts due to COVID across the world by regions over time. Chart has a y-axis with 0 to 15,000 deaths and an x-axis with February 2020 to October 2022 reaching November 2022 by month. Top legend shows regions Asia (red), Europe (dark blue), North America (green), Latin America and the Caribbean (blue), Africa (yellow), and Oceania (purple). Months peaked in April 2020, November 2020, January 2021, May 2021, August 2021, December 2021, February 2022, and a smaller peak in August 2022. Death counts varied with blue as highest from early 2020 to Fall 2022, green 2nd highest through early Fall 2022, dark blue as 3rd, red as 4th, yellow as 5th, and purple last. Bottom text reads, “Regions are based on United Nations definitions. Americas have been broken down into subregions (Latin America and the Caribbean and North America). Last updated: December 2, 2022 at 9:45 am ET. Source: Johns Hopkins University Center for Systems Science and Engineering.”
Graphic source: CNN Health: Tracking Covid-19’s global spread

Pronóstico: The FDA has removed approval for the last available monoclonal antibody treatment, as it is not effective for newer variants. This means we have one fewer layer of both prevention against & treatment for COVID.

Combined outbreaks of COVID, RSV, influenza, and other viruses continue to overwhelm pediatric hospitals. Pediatric healthcare organizations are asking Biden to declare a national emergency which would allow hospitals to address capacity issues and access emergency funding.

One theory why these viruses are spiking simultaneously is COVID infection may temporarily suppress immune responses, similar to measles. Recent COVID infection could make RSV symptoms more severe in infants.

CDC tracking of RSV hospitalization shows this season is worse than previous years. 7.5% of all healthcare visits this week were for respiratory illnesses and 9.7% of all deaths were due to pneumonia, influenza, or Covid. Both are above average.

Title reads “Pneumonia, Influenza, and COVID-19 Mortality from the National Center for Health Statistics Mortality Surveillance System. Data as of 12/1/22.” Graph has y-axis on left (% of All Deaths due to PIC with 0 to 34) and right (Number of Deaths with 0 to 26,000) and x-axis labeled as MMWR Week with 10 to 50 and years 2019 to 2022. Legend at top left shows number of Influenza coded deaths (yellow), number of COVID-19 coded deaths (blue), % of deaths due to PIC (red), baseline (black), and threshold (black). Two black lines fluctuate between 5 and 7% as seasonal baseline and epidemic threshold. Red line initially follows two black lines during 2019, increases with large peaks in early 2020 to early 2022, drops then plateaus above epidemic threshold with an increase, drop and recent increase. Yellow curve reaches 1% and 500 deaths in 2019 and early 2020. Blue curve begins in early 2020, follows the same red line peaks until week 15 of 2022 where it is below epidemic threshold line.
Graphic Source: National Center for Health Statistics (NCHS) Mortality Surveillance

Tome accion: Get your flu shot & bivalent booster!!! Wear high quality masks, use ventilation, test & stay home when feeling sick.

Notes: 1) The numbers in this report were current as of 12/2. 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! https://bej.gbh.mybluehost.me.

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