People's CDC, September 16, 2024, COVID-19 Weather Report

COVID wastewater levels remain high, more deaths, free rapid tests available to order from HHS at end of September, take action for COVID vaccine access and healthcare masking.

Sep 17, 2024

The Weather

As of September 13, 2024, national wastewater levels remain high. The CDC’s national wastewater map has contracted viral activity levels from ten grades of color to five grades of color while our map below maintains the original ten grades of color based on CDC data. We will adjust to the five grades in future reports. With schools in full session and the weather transitioning in northern regions to cooler temperatures, transmission continues to occur. Wastewater activity is either “High” or “Very High” in 37 states according to the Wastewater Surveillance System (NWSS) dashboard. Activity is “Moderate” in 8 states and the District of Columbia, and there is no data available for New Hampshire, North Dakota, Oregon, the U.S. Virgin Islands, and Guam.

A map of the United States color-coded in shades of maroon, orange, and gray displaying SARS-CoV-2 Wastewater Viral Activity level as of September 14, 2024, where deeper tones correlate to higher viral activity and gray indicates “Insufficient,” or “No Data.” Text above the map reads “Very High” or “High” levels in 37 states. Viral activity is “Low” in Michigan and Rhode Island, and data is unavailable for Guam, New Hampshire, South Dakota, North Dakota, Oregon, Puerto Rico, and the U.S. Virgin Islands. At the bottom, text reads People’s CDC. Source: CDC.

Graphic source: CDC

According to the Wastewater COVID-19 National and Regional Trends dashboard, COVID wastewater levels have plateaued, remaining between high and very high in all regions except for the West, which is having a slight increase. The highest levels remain in the West as of 9/7/2024 (data captured on 9/13/2024).

In order to access local COVID wastewater levels, you can refer to the CDC’s state/territory trends page as well as the WastewaterSCAN dashboard. State and local public health wastewater trackers may also be available for example in Illinois, they are reporting over 80 locations. Also, the National Academies of Medicine recently published a second report stressing the importance of a robust wastewater surveillance system and its invaluable role in infectious disease surveillance. They recommend improving the consistency and quality of wastewater surveillance for COVID and other infectious diseases.

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A line graph with the title, “COVID-19 Wastewater Trends as of September 14, 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 9/9/23 to 8/10/24. Text above the graph reads “Viral activity very high nationwide, and Highest in the West.” 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 the West, while levels are trending downward in the Northeast and South. There is no change in the Midwest or National levels over the displayed time frame. Text at the bottom reads “People’s CDC. Source: CDC.”

Graphic source: CDC

As of September 10, 2024, COVID levels are “likely growing” in 3 states and territories according to the CDC Center for Forecasting and Outbreak Analytics dashboard. Thirteen states have reached “stable or uncertain” levels, and 31 states are seeing “declining” or “likely declining”, while levels are “not estimated” in 4 states.

Note, 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.

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 September 10, 2024, where purple tones indicate growing or likely growing, teal tones indicate declining or likely declining, and gray indicates “Stable or Uncertain.” States without predictions are represented in white. Text above the map reads “CDC Predicts transmission is ‘Growing’ or ‘Likely Growing’ in 3 states.” Thirty one states are light to dark teal and have “Declining” or “Likely Declining” status. Three states are light purple and have “Likely Growing” Status. All other states and territories are either “Stable or Uncertain” or did not receive estimates. Text at the bottom reads “People’s CDC. Source: CDC.”

Graphic source: CDC

According to the CDC's COVID Data Tracker, there has been an increase to nearly 1,000 deaths and slightly more than 1,000 deaths per week from COVID during the entire month of August 2024. The last time this occurred was during the winter months of 2024. This total count of weekly COVID deaths is likely to be an underestimate due to limited COVID testing and reporting. The loss of these lives could have been prevented if layers of protections were consistently implemented in preventing infections.

A recent study published in the Annals of Internal Medicine highlights the importance of preventing infections especially during periods of high rates of transmission. It notes that COVID death rates were higher when healthcare systems faced a larger strain as a result of increased levels of transmission. Comprehensive policies that protect people and prevent healthcare-acquired COVID infections are needed to prevent healthcare system overload.

Variants

According to the CDC’s variant tracking dashboard, KP.3.1.1 remains the dominant variant of all currently circulating strains. Nowcast modeling projects that KP.3.1.1 will increase to 52.7% by 9/14/2024, followed by KP.2.3 at 12.2%, followed by LB.1 at 10.9%, and KP.3 at 10.6%, respectively. The most prevalent circulating variants are JN.1-derived, and closely related to both JN.1 and KP.2. Updated vaccination with any of the available options (Pfizer, Moderna, or Novavax) is recommended to better match current variants.

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 6/8/2024 to 8/17/2024. The second chart’s title reads “Nowcast: model-based projected estimates of variant proportions,” dates ranging from 8/31/24 to 9/14/2024. KP.3.1.1 (light teal) is projected to grow to 52.7% and remain the dominant variant by 9/14/2024, according to Nowcast modeling. KP.2.3 (blue) is projected to decrease to 12.2%. LB.1 (brown) is predicted to decrease to 10.9%, along with KP.3 (dark pink) at 10.6%. 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

Vaccines and Treatment

Although the Bridge Access Program, covering the updated vaccines for uninsured and underinsured adults, has ended, several states including California’s Bridge Access Program and other departments of health have taken steps to partially address this major gap by either providing funding for no-cost access to COVID vaccines or using budgets to acquire a limited supply for their residents. Ultimately, the federal government must contribute resources to ensure no-cost access for all who are uninsured or underinsured. We continue to demand from the federal government to provide continued funding for the Bridge Access Program as well as the Vaccines for Adults Program. As people access the updated COVID vaccines, it is notable that a longer 1.5 inch needle may be needed for adults with higher body weights, in order to pass through subcutaneous tissue into muscle. Complete guidelines for vaccine administration in consideration of age, weight, and injection site can be found on the CDC's website.

It is important to seek treatment when facing a COVID infection. A recent study, reviewing population data of nonhospitalized individuals ages 18 and older during the period of January 2022 and December 2023, showed that nirmatrelvir/ritonavir (Paxlovid)—treatment for COVID—was less commonly used among those who identified as non-Hispanic Black and Latinx/e patients. Although the Test-to-Treat program prematurely ended, there continue to be programs available to ensure financial access to Paxlovid.

Wins

This is a reminder that another batch of no-cost COVID rapid antigen tests can be ordered and sent to your home address at the end of September 2024. Through the CDC’s Increasing Community Access to Testing (ICATT) program, no-cost access to COVID testing access is limited to those who are uninsured or underinsured at places including CVS, Walgreens, eTrueNorth, and other local sites as well as in New York City, which is supported by the NY Department of Public Health.

We are eagerly awaiting news on updates from the Centers for Medicare and Medicaid on mandatory reporting of COVID infections in healthcare systems, which begins November 1 thanks to our community’s advocacy. It is invaluable that all healthcare systems participate as case data is paramount for keeping track with current COVID trends and understanding the volume of healthcare acquired COVID infections.

Take Action

The National Institutes of Health (NIH) is seeking public comment and feedback on the next phase of RECOVER clinical trials, which focus on Long COVID. Meetings will be held virtually and on-site between September 23 and 25 to solicit feedback and comments. Register to attend these virtual or on-site sessions by September 25, 2024. It is very important to participate and ask NIH to commit to studies that will result in developing a better understanding of Long COVID, effective treatments for Long COVID, and key approaches to preventing Long COVID.

Amid ongoing COVID spread, masking in healthcare remains central to safe access to healthcare. As we await implementation of COVID hospitalization reporting and prepare for CDC’s next Healthcare Infection Control Practices Advisory Committee meeting in November, you can use this letter campaign to ask your elected officials to take action for healthcare masking.

And finally, because all of us need access to the updated COVID vaccines regardless of our insurance status or ability to pay, use our letter template to demand free COVID vaccines for uninsured and underinsured adults nationally.

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Notes: 1) The numbers in this report were current as of 9/14/2024. 2) Check out the links throughout & see our website for more at https://peoplescdc.org. 3) Subscribe to our newsletter: People’s CDC | Substack.