People's CDC, July 23, 2024, COVID-19 Weather Report

COVID wastewater levels are nationally at high levels, Long COVID affects multiple body systems, and ask Congress to support no cost COVID vaccines and the Airborne Act.

Jul 23, 2024

The Weather

On Wednesday July 17, President Joe Biden tested positive for COVID, his second reported infection. Subsequently, Biden did not mask when exiting his motorcade or while boarding and exiting Air Force One, despite being surrounded by Secret Service agents and aides. This lack of basic precautions is disappointing. The CDC, under the Biden administration’s direction, has done considerable damage to public understanding of the risks of transmission with their dramatic rollback of isolation guidelines, which has been alluded to by the press. Masking with well-fitting respirators is currently inappropriately listed as an “additional” precaution rather than a “core” precaution, unnecessarily stoking confusion about whether masks are necessary or effective during an active COVID infection. As soon as a COVID infection is identified, strong isolation measures should be taken to keep the infection from spreading. If someone with COVID must be around others, the infected person and all others who may share air should wear well-fitting respirators. Over 400 experts signed our letter asking the CDC to revise their isolation guidance to a minimum isolation of 7-10 days to better reflect the infectious period. We urge President Biden to isolate for at least 7-10 days to avoid unnecessary infections among his contacts.

Wastewater levels are higher than previous months. As reported via the CDC’s National Wastewater Surveillance System (NWSS) dashboard, viral activity on July 18 is currently “High” throughout the US. A total of 22 states are at “Very High” levels, 14 at “High” levels, 13 at “Moderate” levels, and one at “Low” levels. No data are available for North Dakota, Guam, Puerto Rico, or the US Virgin Islands.

We do not have definitive case-level COVID data due to the loss of testing and case reporting resources. But, during this time of high levels of COVID viral activity, the risk of transmission is higher than the previous few months. There are ways to mitigate the spread of COVID by practicing layers of protection. As people gather, remember that there are ways to have safer in-person gatherings: Move your gathering outdoors, mask with high quality respirators, and test. For indoor gatherings, also maximize ventilation and air filtration. Use and share our guide on what to do if you have COVID. Do not wait to seek treatment. Treatment options are available for those with a COVID infection. For more information on current actions to protect public health and make our communities safer, see “Take Action” below.

A map of the United States color-coded in shades of orange and gray displaying SARS-CoV-2 Wastewater Viral Activity level as of July 18, 2024, where deeper tones correlate to higher viral activity and gray indicates “Insufficient,” or “No Data.” Viral activity is shown as “Very High” or “High” in 36 states, and “Moderate” in Ohio, Pennsylvania, Nebraska, Illinois, Oklahoma, Rhode Island, Michigan, New Jersey, Iowa, Mississippi, Indiana, South Dakota, and Wisconsin. No data is available for North Dakota, Puerto Rico, the U.S. Virgin Islands, or Guam. Text above the map reads “”Very High " or "High" levels in 36 states. People’s CDC. Source: CDC.”

Graphic source: CDC

As per the CDC’s Wastewater COVID-19 National and Regional Trends dashboard, COVID wastewater levels are increasing nationally, with the highest increase in the West from June 8, 2024. According to provisional data for the weeks ending in July 13, 2024, wastewater levels continue to dramatically increase across all four regions. If you would like to assess what the COVID situation is like in your area, you can view the CDC’s state/territory trends page, the WastewaterSCAN’s interactive viewer, or state/local public health wastewater trackers, if they are available.

A line graph with the title, “COVID-19 Wastewater Trends as of July 18, 2024” with “Wastewater Viral Activity Level” indicated on the left-hand vertical axis, going from 0-12, and “Week Ending” across the horizontal axis, with date labels ranging from 01/20/24 to 6/15/24, with the graph extending through 7/06/24. A key at the bottom indicates line colors. National is black, Midwest is orange, South is purple, Northeast is light blue, and West is green. Overall, levels are trending upward in all regions, with the West showing the greatest increase with a slight dip. Within the gray-shaded provisional data provided for the last 2 weeks, wastewater levels in the West and South appear to be significantly rising, while there is an increase in all other areas. Text above the graph reads “Viral activity increasing nationally and Highest in the West. People’s CDC. Source: CDC.”

Graphic source: CDC

As of July 16, 2024, the CDC Center for Forecasting and Outbreak Analytics predicts that COVID infections “are growing or likely growing” in 42 states and territories, 6 states are “stable or uncertain,” and 3 states are not estimated. No states and territories have “declining” rates of infection. This model utilizes emergency department visit data to estimate COVID transmission’s R_t, which is an estimate of the average number of new infections caused by each infectious person. An R_tgreater than 1.0 indicates that infections are growing, while an R_t less than 1.0 indicates that they’re declining. It is also important to note that this is very likely an undercount, as beginning May 1st of this year, hospitals are no longer required to report COVID-19 Hospital Data.

A map of the United States color-coded in shades of purple and gray displaying the CDC COVID Model: Current Epidemic Growth Status based on emergency department visits as of July 16, 2024, where deeper tones correlate to higher rates of growth and gray indicates “Stable or Uncertain.” States without predictions are represented in white. 42 States are “Growing” or “Likely Growing.” All other states and territories are either “Stable or Uncertain” or did not receive estimates. Text above the map reads “CDC Predicts transmission is “Growing” or “Likely Growing” in 42 states” People’s CDC. Source: CDC.”

Graphic source: CDC

Variants

According to the CDC’s variant tracking dashboard, KP.3 remains the most prevalent variant as of June 22, 2024. Nowcast modeling projects by July 20, 2024, the prevalence of KP.3 has stopped growing, decreasing to 32.9% of all circulating variants. KP.2 and KP.1.1 are also predicted to be at 7.6% and 3.8%, respectively. Variant KP.3.1.1 has been estimated to increase to be the second most dominant variant at 17.7% and KP.2.3 as the third most dominant variant at 12.8%.

Two stacked bar charts with two-week periods for sample collection dates on the horizontal x-axis and percentage of viral lineages among infections on the vertical y-axis. Title of the first bar chart reads “Weighted Estimates: Variant proportions based on reported genomic sequencing results” with collection dates ranging from 4/13/2024 to 6/22/2024. The second chart’s title reads “Nowcast: model-based projected estimates of variant proportions,” dates ranging from 7/6/24 to 7/20/2024. In the Nowcast Estimates for the period ending on 7/20/24, KP.3 (mauve) is predicted to remain the most prevalent variant at 32.9 percent. KP.3.1.1 is projected at 17.7 percent, while KP.2.3 (teal) is projected at 12.8 percent. JN.1 (dark purple) is projected at 0.6 percent. Other variants are at smaller percentages represented by a handful of other colors as small slivers. The legend with a list of variants, proportions, and their associated colors is on the far right of the bar charts.

Graphic source: CDC Variant Tracker

Long COVID

“Long COVID affects multiple body systems” as per the National Academies of Science in a recent report from June 2024. The report says that many people with Long COVID may not have previously received a formal diagnosis of a COVID infection even though they had a COVID infection. As a result, a positive test for COVID should not be required for a Long COVID diagnosis. According to this report, Long COVID can lead to the inability to work or participate in school, and can lead to a poor quality of life.

A study examining Long COVID among Department of Veterans Affairs patients between 2020 and 2022 was recently published in the New England Journal of Medicine. It reported that Long COVID occurred in nearly 8 to 10 people per 100 persons with a COVID infection. The study also found that vaccination was associated with a slightly lower incidence of Long COVID, but that the risk remained substantial even among those with a vaccination. A limitation of this study is that it attempts to compare people with a previous COVID infection to people without a COVID infection. But, of course, some of those who were categorized and analyzed in the “without a COVID infection” group may have actually had an undiagnosed COVID infection. It is also not unexpected that reported rates of Long COVID may vary across different studies, as the definition of Long COVID continues to evolve, and there is no objective laboratory testing for a Long COVID diagnosis. Previous studies have indicated Long COVID rates within the 10-20% range following a COVID infection (such this 2022 CDC publication and this 2023 report from the NIH RECOVER study, which also affirmed a reduced risk of Long COVID following vaccination). Even though this study suggests lower rates of Long COVID in 2022 compared to 2020 and 2021, Long COVID remains a significant concern, given the lack of governmental support for multilayered COVID protections amid ongoing transmission.

Take Action

Universal masking in healthcare settings remains an important step in preventing unnecessary COVID infections especially during COVID surges. During this current increase in COVID transmission in the community, some healthcare systems have started to strongly recommend masking and reinstate masking in patient facing settings. Other recently published studies show the value of universal masking in healthcare settings: this study showed a reduction in healthcare associated COVID infections, and this study suggests that admission screening for COVID using rapid antigen tests in combination with N95 respirators among staff is cost-effective.

As local and state governments consider policies against masking, we encourage you to speak up against them. Mask restrictions threaten public health! Review our No Masks Ban page for action steps to fight these policies, and spread the word to people you know — we also have a printable flier you can circulate, which can be found at the bottom of this page.

Thanks to your impactful public comments to the CDC, the fall COVID vaccines are recommended for everyone aged 6 months and up! Unfortunately, no cost access to COVID vaccines for uninsured adults will be limited starting August 2024. As of April 2024, the CDC announced the premature end of the COVID Bridge Access program in August 2024 due to a lack of funding. Uninsured adults must not lose access to free COVID vaccines. COVID vaccine access for uninsured and underinsured adults could be accomplished through ongoing maintenance of the Bridge Access program or the proposed Vaccines for Adults program, which would cover all CDC-recommended vaccines. Join us in urging Congress to fund no cost COVID vaccines for underinsured and uninsured adults. You can submit a letter to Congress asking them to provide funding by July 31, 2024. We provide specific step-by step-instructions to submit your letter to Congress asking for funding to support no cost vaccines through our Action Network Campaign.

Last but not least, improving indoor air quality, specifically through air filtration and ventilation will help reduce the risk of COVID transmission. A member of the House of Representative, Don Beyer of Virginia, has reintroduced the Airborne Act, legislation that provides financial support for non-residential buildings to monitor indoor air quality, upgrade ventilation and air filtration systems to meet the minimal standards of ASHRAE Standard 62.1-2022, and ensure air filter systems of MERV rating of 13 or better. Write to your elected officials and let them know you support enhancing indoor air quality standards.

Notes: 1) The numbers in this report were current as of 7/19/2024. 2) Check out the links throughout & see our website for more at https://peoplescdc.org. 3) Subscribe to our newsletter: People’s CDC | Substack.