February 27, 2024
Last night, the CDC released its COVID-related data for the week ending February 17. The national data for new hospital admissions and wastewater activity show a continuing gradual improvement in both categories. However, the data in parts of the South, and particularly in Alabama, are not so encouraging. Unlike in past winters, we are seeing a February spike in both the incidence and severity of Covid in Alabama and other pockets of the South that should be concerning.
I will first discuss the comparative presence of the SARS-CoV-2 virus in wastewater, as measured by over 1,100 wastewater monitoring stations throughout the United States (See footnote below for how to interpret wastewater data). In the U.S. on average, wastewater activity registered 5.77 during the most recent week, which is a slight increase from 5.46 last week. In the West Region, wastewater activity declined significantly last week (from 5.28 to 3.76). In the East Region, it declined modestly (from 4.97 to 4.93). And in the Midwest Region, it ticked up (from 5.46 to 5.77). Note that in each of those regions, the wastewater activity level is at or below the national average.
Wastewater activity in the South Region, however, is 67% higher than the national average and is nearly twice the level produced in the South during this same week one year ago. Wastewater readings tend to be rather volatile from week to week; yet, the activity level in the South Region has remained persistently high since late December whereas the activity level in other regions of the country has rapidly declined throughout the same time period.
The seven wastewater monitoring sites in Alabama registered 11 during the most recent week, which is the 10th consecutive week of average readings between 10 and 13. By way of comparison, the average wastewater activity level of the nation as a whole has declined from 12 to 5.77 during the last eight weeks.
I will now turn to weekly Covid-related hospital admissions, which is the best way to measure Covid severity in a locality. On average in the United States, new hospital admissions declined 5.7% compared to the week ending February 10. However, in Alabama, new hospital admissions rose 33% during the same week - from 324 to 431. Alabama’s hospitalization rate of 8.79 per 100K population was the highest in the nation for the week of February 17 and its 33% rate of change was also the highest in the nation. Drilling down to the county level, 16 of Alabama’s 67 counties had per capita rates of hospitalization for the week which exceed 10.0 per 100K. All but one of those counties are located in north or central Alabama.
Other pockets of the South are also seeing a spike in hospitalizations. Together with Alabama, the states of Georgia, South Carolina, Florida, Louisiana, Virginia and North Carolina collectively comprise 7 of the top 8 states for per capita rates of new hospital admissions during the most recent week. Tennessee’s 25.8% increase in admissions was the 2nd largest percentage increase for the week after Alabama.
I cannot explain why we are seeing this particular February spike in the South - other than to point out that the South lags the rest of the country in terms of vaccinations and many studies have established that vaccination is directly correlated to the prevention of severe cases. Although this spike is frustrating, it is important to keep it in perspective. Even with 431 new admissions, Alabama is still below the 455 admissions it experienced during the same week in 2023. And, we have not reached even 15% of the record 2,945 new admissions registered during the week of January 9, 2021, which coincidentally was the week of the January 6 insurrection.
We now have the tools to stay safe. Let’s do this.
Footnote: “Wastewater Viral Activity Level is a calculated measure that allows the CDC to aggregate wastewater sample data to get state/territorial, regional, and national levels and see trends over time. Most simply, the value associated with the Wastewater Viral Activity Level is the number of standard deviations above the baseline, transformed to the linear scale. The current Wastewater Viral Activity Level for each state and territory is categorized into minimal, low, moderate, high, or very high as follows: a Wastewater Viral Activity Level less than 1.5 is categorized as minimal, greater than 1.5 and up to 3 is low, greater than 3 and up to 4.5 is moderate, greater than 4.5 and up to 8 is high, and greater than 8 is very high.” Source: Centers for Disease Control and Prevention.