By Fenit Nirappil and Lena H. Sun
The United States is in the throes of another covid-19 uptick, cementing a pattern of the virus surging around the holidays as doctors and public health officials brace for greater transmission after Americans return to school and work this week.
Coronavirus samples detected in wastewater, the best metric for estimating community viral activity, suggests infections could be as rampant as they were last winter. A smattering of health facilities around the country, including every one in Los Angeles County, are requiring masks again. JN.1, the new dominant variant, appears to be especially adept at infecting those who have been vaccinated or previously infected.
While photos of positive coronavirus tests are once again proliferating across social media, fewer people are going to the hospital than a year ago. The Centers for Disease Control and Prevention reported 29,000 covid hospitalizations in the week before Christmas, the most recent data, compared with 39,000 the previous year. The agency has reported an average of 1,400 weekly deaths since Thanksgiving, less than half of the fatalities at the same point last year.
Even so, covid remains one of the leading causes of death as well as the top driver of respiratory virus hospitalizations — worsening the strain on hospitals also seeing influxes of flu and RSV cases.
“Of the three major viruses, it is still the virus putting people in the hospital most and taking their life,” CDC Director Mandy Cohen said in an interview Wednesday.
Even mild cases can lead to the lasting complications inflicted by long covid.The CDC still recommends people isolate for five days after testing positive, though many Americans have stopped doing so and free tests are harder to come by, making it easier for the virus to keep spreading if people don’t know their cold is actually covid.
“As with any public health advice, getting people to adhere to policies is always challenging,” said Simbo Ige, commissioner of the Chicago Department of Public Health who is urging residents to follow that guidance. “Appealing to people’s desire to be part of the solution to ending covid or reducing the impact of covid is what we have seen be most effective.”
Michihiko Goto, an infectious-disease specialist who has seen a modest uptick in covid patients at the Department of Veterans Affairs in Iowa City, worries that the return of college students will seed more infection in the coming weeks. The CDC guidance for isolation makes sense, he said, but the reality is that many people do not have the flexibility at work to do so. “People without paid sick leave may not be able to [isolate] because they have to feed their families,” he said.
While coronavirus cases have surged every winter since the pandemic began, the CDC says it is not yet considered a seasonal disease like influenza. The coronavirus fluctuates throughout the year, and the typical winter waves could be influenced by other factors such as holiday travel, cold weather pushing people indoors and the evolution of the virus. The JN.1 variant that is now the most common in the United States has significantly more mutations than its predecessors, which could explain why people who had dodged infections during the summer surge are getting sick. “If you look at the different peaks in cases since the beginning of the pandemic, every one of them coincided with the emergence of a new variant,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Too many people are attributing this to seasonality.”
Few Americans are staying up to date on their coronavirus vaccines to train their immune systems to keep up with an evolving virus. According to CDC estimates, just 19 percent of Americans have received the latest version of the vaccine that lab experiments show offer better protection against the JN.1 variant than the previous formula. “That’s not doing enough to suppress the virus from evolving, getting stronger and more evasive,” said Jessica Malaty Rivera, an epidemiologist and senior science communication adviser at the de Beaumont Foundation, a public health organization.
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