COVID-19: November 2023 insights

At a Congressional hearing on November 30, CDC Director Dr. Mandy Cohen highlighted a post-Thanksgiving rise in COVID-19 cases, a trend supported by wastewater monitoring. 

The innovative wastewater reporting dashboard, rolled out in November,  revamped by the CDC team "Poo's Clues," using SARS-CoV-2 viral RNA concentrations in wastewater, offer insights into the virus's spread, covering over 100 million people across 700+ sites. 

A 12% increase in COVID-19 cases was observed from mid- to end of October, with regional variations. The Midwest and West saw significant surges, contrasting with the relative stability in the Northeast and South. By the end of November, West seemingly peaked but then continued upward, Northeast started catching up with Midwest, and numbers kept climbing nationwide (another 11% increase by the end of November). (Biobot data show even larger growth in SARS Cov-2 number, ILInet also reports increasing levels of influenza-like illness, especially (H1N1)pdm09 of influenza A).

CDC uses viral genomic surveillance to quickly identify and track COVID-19 variants. 

The predominant variants in the US is HV.1 (XBB.1.5+L452R+F456L), descendent of EG.5, but  the newly emerging JN.1 (Pirola), is rapidly gaining ground in Europe and the rest of the world (It was already dominant in France and Spain in November). Eris EG.5.1 was raising since this summer but peaked in the end of September and is decreasing. HV.1 (XBB.1.5+L452R+F456L) become predominant variant in October but seems to be losing its dominance to JN.1 demonstrating strong resistance to monovalent XBB.1.5 vaccine sera, even more so than BA.2.86.  JN.1 is considered one of the most immune-evading variants to date, with the S:L455S mutation contributing significantly to its increased immune evasion and higher Re (effective reproductive number).

New hospital admissions peaked in September 2023, but are increasing again. There were 16, 609 hospital admissions from November 4 to November 10, 17,682 admissions Nov.11-Nov.17  and 19,444 admissions the week of November 25. 

Hospitalization data shows a 10.6% increase in emergency room visits and a 10% rise in hospitalizations for the week ending November 25. The test positivity rate also increased by 1.2%. Weekly deaths are still over a thousand representing 2.5% of all deaths in the US. The number slightly decreased in October, to about 1,300 but is projected to be at least as high as in the end of September and keeps increasing (note that data from the most recent two weeks is usually incomplete due to delays in data reporting)

Before the onset of COVID-19, the life expectancy in the United States was nearly 80 years. However, in the initial two years of the pandemic, there was a significant decline of almost 2 1/2 years, primarily due to COVID-related deaths. While life expectancy is now showing signs of improvement, it is still only 77 1/2 years, a level last seen in 2003, representing approximately 20 years of lost progress. Heart disease continues to top the list, followed by cancer. Presently, the third leading cause is unintentional injuries, encompassing incidents like car accidents, drownings, and drug overdoses, the latter being a significant contributor to the rising death toll in recent years.

Data from Ireland are similar, cancer and circulatory diseases continue to be the predominant causes of death. In the second quarter of 2023, they accounted for 57.5% of deaths, totaling 5,028, as opposed to 55.2% in the same period of 2022, where the figure was 5,152.

Amid the statistics, it's essential to remember the individual lives affected. Recent losses include Jody Wiltsey, aged 68, and Alan L. Jensen, aged 76, both succumbing to COVID-19 complications. Paulette Ann Penney, aged 88, passed away on November 28, 2023, due to respiratory complications of Covid-19.


REFERENCES

CDC COVID Data Tracker: Wastewater Surveillance

COVID-19 NWSS Wastewater Monitoring in the U.S. | National Wastewater Surveillance System | CDC

U.S. life expectancy is recovering from COVID-19, but still lags : NPR

https://www.legacy.com/us/obituaries/elk_river_star_news/name/jody-wiltsey-obituary?id=53554620

https://www.dailypress.net/obituaries/2023/11/alan-l-jensen/

https://www.lastingmemories.com/memorial/paulette-ann-penney

Updates from our ongoing study: The COVID-19 Back-to-Normal Study (aurametrix.com)

Yu Kaku, Kaho Okumura, Miguel Padilla-Blanco, Yusuke Kosugi, Keiya Uriu, Alfredo Amolong Hinay Jr., Luo Chen, Arnon Plianchaisuk, Kouji Kobiyama, Ken J Ishii, The Genotype to Phenotype Japan (G2P-Japan) Consortium, Jiri Zahradnik, Jumpei Ito, Kei Sato Virological characteristics of the SARS-CoV-2 JN.1 variant  bioRxiv 2023.12.08.570782; doi: https://doi.org/10.1101/2023.12.08.570782








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