We are in the middle of an infection surge.
United States epidemic
In the U.S., we are clearly in an infection surge right now, although you wouldn’t really know it due to underreporting, lack of communication, and pandemic fatigue. Using rough estimates, I plotted “true” case estimates against reported case numbers in the graph below. While we’re not close to the Omicron peak, we are already higher than the first two waves.
Cases are increasing in all states. If we assume uniform testing behaviors (and thus underreporting) across states, our case leader is Puerto Rico, which is getting hammered with infections but recently reached their peak. This is followed by Rhode Island and Massachusetts. Interestingly, if we compare U.S. states to 195 countries, 18 of them would currently be among places with the highest new cases per capita in the world.
Source: Pandem-ic
Case accelerations are not regional, but occurring across the country. The acceleration leader is Mississippi (+224%) followed by Missouri (+211%), Utah (+169%), South Carolina (+152%), Arizona (+134%), and Louisiana (+131%). To me, the lack of regional patterns is a sign of a true national wave.
The current surge is at least partially due an increase in reinfections, as Omicron is getting better and better at dodging our first line of defense. The CDC's last update on reinfections was in January, but the story is very clear among local jurisdictions tracking this data closely. In Colorado, for example, 82% of reinfections have occurred since Omicron with the majority among unvaccinated. Starting in March 2022, North Carolina reported an increase in reinfections. In Indiana and Idaho, reinfections account for 12-18% of reported cases.
Increasing case counts are reflected by wastewater surveillance systems across the nation (see first graph below). On a local scale, San Francisco wastewater levels are skyrocketing. In Boston, wastewater finally found a consistent pattern and is on the upswing due to BA.2.12.1.
Hospitalizations are also increasing with a +23% change in the past 14 days. It will be very interesting to see how the rate soon changes (or doesn’t change) as hot spots move to less vaccinated parts of the U.S. As seen in the graph below from New York City, there continues to be a large discrepancy between unvaccinated and vaccinated.
Unfortunately, severe disease is not the only outcome. While evidence continues to show that vaccinations reduce risk of long COVID by ~50%, the most recent UK Health Security report found even those boosted aren’t spared. Among the triple vaccinated, 8-9% of people report long COVID (at least 4 weeks) after their first infection; 5-6% are reporting activity-limiting symptoms. There doesn’t seem to be a statistical difference between variants.
Bottom line
We are in the middle of an infection surge. If you’re vaccinated and healthy, there is a very small chance of landing in the hospital, but severe disease isn’t the only outcome, vulnerable pockets around you may not be protected by their vaccine, and more cases means more variants. We don’t need to be alarmed, but we certainly can’t be complacent. We need the will and the heart to beat this virus, as it’s certainly not done with us.
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, biostatistician, wife, and mom of two little girls. During the day she works at a nonpartisan health policy think tank, and at night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well equipped to make evidence-based decisions. This newsletter is free thanks to the generous support of fellow YLE community members. To support the effort, please subscribe to her newsletter: