Michael Ejercito
2024-12-29 16:00:25 UTC
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PermalinkA ‘silent’ COVID surge may hit the US over the holidays, experts warn —
here's what that means
This year's winter COVID-19 wave is off to a late start, and experts
expect cases to keep rising. Here's what to know.
Christmas shopping with covid mask
Person wearing mask COVID surgeGetty Images / iStockphoto
Dec. 23, 2024, 4:09 PM EST / Updated Dec. 27, 2024, 3:30 PM EST /
Source: TODAY
By Caroline Kee
The United States is approaching 2025 with COVID-19 on the rise across
the country. COVID cases were already starting to tick up before the
start of the holidays, and large, indoor gatherings are likely to make
the virus spread even faster, experts say.
Some experts are warning this winter COVID wave, starting later in the
year than usual, could lead to a "silent" surge in transmission over the
holidays and into the new year.
They're calling it "silent" because the wave follows a long period of
unusually low COVID activity this fall, so many people are unaware that
COVID levels have risen sharply over the past two weeks, the most recent
wastewater surveillance data from the U.S. Centers for Disease Control
and Prevention show.
What's more, wastewater viral activity of SARS-CoV-2 — the virus that
causes COVID-19 — is currently “high” or “very high” in 28 states, per
CDC data for the week ending Dec. 21.
Despite these signs, people may not know their risk of infection is
increasing or not test if they only have mild symptoms, which can allow
the virus to spread at holiday events, during travel, and more.
“There’s a good chance that a lot of people are going to get sick in the
next couple of weeks and be unaware of it. Most people are not tracking
CDC data, and so their only way of knowing whether we’re in a wave is if
they’ve gotten sick,” Michael Hoerger, Ph.D., associate professor at
Tulane University School of Medicine and public health expert on
tracking COVID-19 trends, tells TODAY.com.
While the data do not yet show the U.S. is in a large COVID surge, the
country is entering its 10th COVID wave since the pandemic started,
Hoerger adds.
But there's a great deal of uncertainty about how bad this year's winter
wave will be and how long it will last. “This is a very risky time in
terms of lots of people interacting indoors, so we don’t really know how
quickly transmission can pick up,” Hoerger says.
A risk of "silent" transmission over the holidays
Wastewater levels of COVID-19 are lower than they were at this point
last winter, but they have risen sharply in recent weeks. And cases will
likely continue to increase, experts say.
As of Friday, Dec. 26, COVID-19 viral activity levels in wastewater are
high nationally, per the latest CDC data. The week prior, COVID levels
were “moderate” nationally. Just three weeks ago, they were considered
"low."
“Nationally, COVID-19 levels in wastewater have been increasing through
the month of December, following a period of low levels in October and
November,” Dr. Jonathan Yoder, deputy director of the CDC Division of
Infectious Disease Readiness and Innovation, tells TODAY.com.
Currently, COVID wastewater levels are highest in the Midwest, data show.
Where COVID is spreading in the U.S.
National and regional trends of wastewater viral activity levels of
SARS-COV-2CDC
The CDC no longer tracks the total number of new COVID cases in the
U.S., instead estimating transmission levels using wastewater
surveillance, test positivity and emergency department visits.
COVID test positivity is at 7.5%, up 1.9% from the previous week, per
the latest CDC data. COVID-related emergency room visits and deaths are
also increasing slightly.
“The issue with this winter’s wave is it’s a lot different than previous
ones," Hoerger explains. In past years, COVID has followed a similar
pattern: Cases ramp up in November, increase steadily and peak around
late December or early January.
This wave is coming on late and “out of nowhere,” Hoerger wrote in a
post on X on Dec. 16.
“Normally people would have had a month or so of warning by now, seeing
friends and family getting infected,” Hoerger explains. "Transmission
was freakishly low for November, and so people are kind of lulled into a
false sense of security."
COVID-19 levels are ticking up about a month later than usual, which
puts the country into “uncharted territory," according to Hoerger.
“You can think of the start of the wave as kind of a silent transmission
period where people aren’t really aware of it, and that’s coinciding
with the start of holiday travel,” he explains.
Hoerger, the director of the Pandemic Mitigation Collective, uses the
PMC COVID-19 forecasting model, which projects there could be an average
of 900,000 new daily infections by January. The PMC New Year's Eve
forecast estimates that, if no one is testing or isolating, there is a 1
in 4 chance of COVID exposure at a party of 20 and a 1 in 2 chance at a
party of 40-50.
Other experts agree that infections are expected to go up in the coming
weeks.
"We anticipate that these holiday gatherings and traveling and all that
will provide opportunities for an increase in COVID, as well as
(influenza) and RSV,” Dr. William Schaffner, professor of infectious
diseases at Vanderbilt University Medical Center, tells TODAY.com.
“It’s silent (transmission) because most of these infections are quite
mild so people are not testing, or they’re blowing them off as a cold,"
Schaffner adds.
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While this year's late summer COVID surge provided the U.S. population
with some immunity, it's likely starting to wane, the experts say. And
the current variants circulating, including XEC and the decedents of the
FLiRT family, are highly transmissible.
"These current variants are causing a lot of milder infections, which
are going largely undetected," says Schaffner, adding that people with
mild or no symptoms can still spread the virus to others.
"The communicability of these viruses is contributing to a silent
epidemic, if you will," he says.
Where COVID is spreading in the U.S.
Where COVID is spreading in the U.S.
Current wastewater viral activity level of SARS-CoV-2 by state in the
U.S.CDC
As of Dec. 21, wastewater viral activity of COVID is currently "very
high" in 14 states, according to the latest CDC data. These are:
Arizona
Kentucky
Massachusetts
Minnesota
Missouri
Montana
Nebraska
New Hampshire
New Mexico
Oklahoma
Oregon
Pennsylvania
South Dakota
Wyoming
As of Dec. 21, COVID wastewater levels are "high" in 14 states:
Arkansas
Connecticut
Delaware
Idaho
Indiana
Iowa
Kansas
Maine
Michigan
Ohio
Rhode Island
South Carolina
Utah
Wisconsin
“If you see increased COVID-19 wastewater viral activity levels in your
area, it might indicate that there is a higher risk of infection,” says
Yoder.
However, regional variation in wastewater data also depend on the number
and specific location of wastewater surveillance sites that are
monitoring, says Hoerger. Some states have no data, and others only have
limited coverage. “Take regional variation with a grain of salt,” he adds.
Overall, decreases in testing and lags in reporting can make it
challenging to accurately track COVID-19 levels, the experts note.
COVID-19 symptoms in 2024
The symptoms caused by the dominant variants circulating, XEC and
KP.3.1.1, are very similar to those caused by previous omicron
subvariants, according to experts.
Common COVID-19 symptoms include:
Sore throat
Congestion
Runny nose
Cough
Fatigue
Headache and body aches
Fever or chills
Shortness of breath
Nausea or loss of appetite
Diarrhea
Loss of sense of taste or smell
Symptoms will vary from person to person. Even milder infections can be
"debilitating" for several days, says Schaffner.
Although the latest COVID-19 variants appear to be causing milder
disease, they can still cause severe illness requiring hospitalization.
Certain people are at higher risk of developing severe disease. These
include people over the age of 65, people with underlying medical
conditions and people who are immunocompromised.
Every time a person is infected with COVID, they are at risk of
developing long COVID, which can cause symptoms that persist and
reemerge for weeks or months after infection, per the CDC.
Are new COVID boosters effective?
The updated COVID-19 vaccine for 2024–2025 is recommended by the CDC for
everyone ages 6 months and older.
The new mRNA COVID vaccine is monovalent, which means it targets one
variant — in this case, the KP.2 "FLiRT" variant. The strains currently
circulating are closely related to KP.2, and the new booster should
provide good protection, TODAY.com previously reported.
However, uptake of the new vaccine has been low so far — just 21% of
adults in the U.S. have gotten the shot, per the latest CDC data.
“The best protection is to get vaccinated. Although vaccinated people
sometimes get infected with the virus that causes COVID-19, staying up
to date on COVID-19 vaccines significantly lowers the risk of getting
very sick, being hospitalized, or dying from COVID-19," says Yoder.
How to protect yourself against COVID-19
When COVID-19 levels are rising, it's important for people to take steps
to protect themselves and their families, according to the CDC.
You can take the following actions to avoid infection and prevent
spreading COVID-19 to others:
Stay up to date on COVID-19 vaccinations.
Test if you have symptoms or an exposure.
Stay home when sick.
Seek treatment for COVID-19 if you are at high risk.
Wear a mask.
Practice social distancing.