January 10, 2024
According to the latest CDC report for the week ending December 30, 2023, the 2023-24 wintertime Covid surge is now officially in high gear. National wastewater data shows the viral activity rate in the U.S. for the week was 12.85, higher than anything seen since January 2022 when the Omicron wave slammed onto our shores. Alabama’s latest wastewater viral activity rate was 15.0, slightly higher than the national average but lower than the 20.0 level reached in Alabama at the same time last year. During the peak of the Omicron wave two years ago, the national wastewater viral activity rate reached a high of 22.78 on January 15, much higher than it is now.
The latest surge is attributable to the emergence of the variant JN.1, a fast-growing variant that came to the U.S. from Europe. The big question is whether hospitalizations will follow wastewater trends, especially in places like the U.S., which has such a low vaccination rate. The U.K. and Singapore, which have high vaccination rates, are seeing a steep increase in hospitalizations now that JN.1 has become dominant.
The latest CDC report provides a partial answer to this question. For the week ending December 30, 2023, there were 34,798 patients admitted to hospitals throughout the United States, which is more than at any time since January 2023 when there were 44,500 patients admitted. Those numbers seem high but they are dwarfed by the numbers recorded in January of 2022, when as many as 150,650 patients were admitted with Covid in a single week.
According to the latest report, 540 patients were admitted to Alabama hospitals. Aside from the three-week period between December 20, 2022 and January 14, 2023, you would have to go back to early September of 2022 to find that many Covid hospitalizations recorded in Alabama during a single week. By comparison, there were (1) as many as 2,684 patients admitted in a single week during January 2022, (2) as many as 736 patients admitted in a week in January, 2023, and (3) as few as 93 weekly patients admitted last July.
On a per capita basis, Alabama’s latest weekly hospitalization rate was 11 patients per 100K population, slightly higher than the national average of 10.5 per 100K. Alabama’s per capita rate ranks 19th among all states but it was the second highest weekly rate among Southern states, slightly lower than Virginia.
Drilling to the county level, the per capita hospitalization rate was highest (22.2 per 100K) in the northern counties of Madison (including Huntsville), Limestone and Jackson. In central Alabama, including the Birmingham metro area, the rate was 11.1 per 100K. And in south Alabama, including Mobile and Baldwin Counties, the rate was 9.9 per 100K.
I have thrown a lot of numbers at you. Here is my take. The Covid surge is on pace to be more pervasive than last winter. That is to say, more people will likely test positive this winter than last winter. JN.1 has more mutations, and it is therefore more infectious, than the variant that preceded it. It remains to be seen, however, if the severity of this surge will match last winter. We are not there yet, but we still have several more weekly CDC reports to go in January. It would not be surprising to see peak hospitalizations exceed the numbers recorded last year. Having said that, I am confident this winter will not come close to matching the winter of 2021-22 or 2020-21 in terms of either pervasiveness or severity. There is no reason to panic, especially if you have received the updated booster.
If you are a senior citizen or immunocompromised, it is time to become more cautious and consider masking if you expect to be in a crowded public place like an airplane or an enclosed sporting event. Prudence is not only an appropriate response to Covid, but it also can help ward off the flu. I expect to monitor the data and I will report my findings.