Story by Fenit Nirappil, Lena H. Sun<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Coronavirus samples detected in wastewater<\/a>, 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<\/a>, appears to be especially adept at infecting those who have been vaccinated or previously infected.<\/p>\n\n\n\n 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<\/a>, compared with 39,000 the previous year. The agency has reported an average of 1,400 weekly deaths<\/a> since Thanksgiving, less than half of the fatalities at the same point last year.<\/p>\n\n\n\n Even so, covid remains one of the leading causes of death as well as the top driver of respiratory virus hospitalizations \u2014 worsening the strain on hospitals also seeing influxes of flu and RSV cases.<\/p>\n\n\n\n \u201cOf the three major viruses, it is still the virus putting people in the hospital most and taking their life,\u201d CDC Director Mandy Cohen said in an interview Wednesday.<\/p>\n\n\n\n Even mild cases can lead to the lasting complications inflicted by long covid<\/a>.When you have covid, here’s how to know if you’re no longer contagious<\/a><\/p>\n\n\n\n The CDC still recommends <\/a>people isolate for five days after testing positive, though many Americans have stopped doing so and free tests are harder to come by<\/a>, making it easier for the virus to keep spreading if people don\u2019t know their cold is actually covid.<\/p>\n\n\n\n \u201cAs with any public health advice, getting people to adhere to policies is always challenging,\u201d said Simbo Ige, commissioner of the Chicago Department of Public Health who is urging residents to follow that guidance. \u201cAppealing to people\u2019s desire to be part of the solution to ending covid or reducing the impact of covid is what we have seen be most effective.\u201d<\/p>\n\n\n\n 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.<\/p>\n\n\n\n \u201cPeople without paid sick leave may not be able to [isolate] because they have to feed their families,\u201d he said.<\/p>\n\n\n\n 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<\/a> of the virus. The JN.1 variant<\/a> 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.<\/p>\n\n\n\n \u201cIf 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,\u201d said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. \u201cToo many people are attributing this to seasonality.\u201d<\/p>\n\n\n\n Medical professionals and public health officials say they\u2019re facing growing skepticism of coronavirus vaccines, particularly among conservatives. The latest pushback came Wednesday from Florida\u2019s top health official, who urged people to\u00a0stop receiving mRNA coronavirus vaccines<\/a>, citing controversial claims that they could contaminate patients\u2019 DNA.<\/p>\n\n\n\n Wastewater tracking<\/a>\u00a0by the firm Biobot Analytics shows that the most recent coronavirus levels were slightly lower than the same point last year, except in the Midwest. The difference could be driven by changes in vaccines and variants affecting how much virus people shed, said Marisa Donnelly, a Biobot epidemiologist.<\/p>\n\n\n\n Donnelly said wastewater data is best used as a warning sign when levels rise.<\/p>\n\n\n\n \u201cRight now as I\u2019m seeing really high rates of covid-19 in wastewater, I start to worry about people who are immunocompromised or have risk factors that put them at greater risk of developing severe covid,\u201d Donnelly said.<\/p>\n\n\n\n While the CDC had flagged New York and New Jersey in mid-December as among the first states with the highest share of infections caused by the new variant and high respiratory virus levels<\/a>, hospitals in those states say those trends did not translate to crises in their wards.<\/p>\n\n\n\n \u201cIt\u2019s not uncontrollable, and it\u2019s nothing like it was last year,\u201d said Cathy Bennett, president and CEO of the New Jersey Hospital Association.<\/p>\n\n\n\n Hospital leaders now talk about the coronavirus in the context of the broader respiratory virus season. RSV, most often seen in infants and toddlers in pediatric wards, has already peaked nationally. The flu season started later than normal and is now accelerating, with 136,000 emergency department visits for influenza last week compared with 79,000 for covid.<\/p>\n\n\n\n Northwell Health, New York\u2019s largest health-care system, has seen a surge in people coming to the emergency room and outpatient facilities testing positive for the coronavirus, which was expected after Thanksgiving. Those patients are typically discharged quickly and rarely end up severely ill.<\/p>\n\n\n\n \u201cIf you are looking at very sick people in the ICUs, it\u2019s more likely flu than covid,\u201d said Bruce Farber, an infectious disease physician and the system\u2019s chief of public health and epidemiology. \u201cIf you are looking at total population in the hospital with people with some respiratory illness, it\u2019s overwhelmingly covid.\u201d<\/p>\n\n\n\n