US flu and COVID levels climb higher as RSV remains elevated

Doctors visits and hospitalizations for flu and COVID continue to rise across much of the country, and though respiratory syncytial virus (RSV) levels are still high, activity is dropping in some areas, the Centers for Disease Control and Prevention (CDC) said today in updates that take stock of the week between Christmas and New Years.

Emergency department (ED) visits for flu and COVID are elevated for all age-groups except for school-age children, the CDC said in a respiratory virus snapshot. However, it said holiday-related school closures and related changes in health-seeking behaviors may be impacting those trends. The group added that ED visits for RSV dipped slightly.

Inpatient and intensive care unit (ICU) bed occupancy, another closely watched metric, remained stable for patients admitted for any reason, as well as those admitted for flu and COVID.

Doctors visits and hospitalizations for flu climb higher

In its weekly FluView update, the CDC said the percentage of outpatient visits for flulike illness rose to 6.9%, up from 6.1% the previous week. At clinical labs, the percentage of respiratory samples that were positive for flu rose to 17.5%, up from 16.1% the week before. The 2009 H1N1 virus is still dominant, though both H3N2 and influenza B continue to circulate.

The CDC’s flu map shows that the southeast is still experiencing the most intense activity, followed by the eastern and western regions. Minnesota is the only state where flu activity is listed as minimal.

Flu hospitalizations continue to rise and remain highest in seniors, followed by adults ages 50 to 64 years and children as old as 4.

Overall, deaths from flu rose to 0.9% of all deaths, up from 0.5% the previous week. The CDC reported seven more pediatric flu deaths, raising the season’s total to 27. All seven of the new deaths were reported in December. Five were linked to influenza A viruses, and of three subtyped viruses, all were H1N1.

COVID trends show year-to-year differences

For COVID, wastewater levels and test positivity are tracking higher than at the same time last year, 27% and 17%, respectively. However, the CDC said illnesses needing medical attention are lower this year, 21% less than a year ago.

In its data updates, the CDC reported more steady rises in its severity markers, with hospitalizations up 20.4% from a week ago and deaths up 12.5%. Hospitals in the Midwest and Northeastern regions had more counties at moderate and high levels for COVID hospitalizations than other parts of the country.

The percentage of deaths from COVID rose 12.5% compared to the previous week, with COVID making up 3.6% of all deaths in the nation. Percentages were highest in Missouri, New Jersey, and Massachusetts.

Meanwhile, one of the CDC’s early indicators—ED visits—trended higher and were up 12.8%. ED visits for COVID were highest in children younger than 2 years and in seniors. Test positivity was down slightly and is at 12.4% nationally and highest in the Midwest, followed by the Northeast and Northwest.

In its latest variant proportion update today, the CDC said JN.1 levels rose sharply again, 2 weeks after it became the dominant Omicron variant. It now makes up 61.6% of samples, up from 38.8% 2 weeks ago.

CDC updates Beyfortus guidance

In another RSV development today, the CDC updated guidance for health providers regarding the use of nirsevimab (Beyfortus), the new monoclonal antibody preventive treatment for young children. In October, due to short supply caused by high demand for the new tool for protecting infants, the CDC had urged doctors to prioritize doses for certain groups.

However, now that manufacturers plan to release 230,000 more doses in January, the CDC urged health providers to return to its original recommendation that infants and children who are recommended to receive it get their doses as soon as possible.