Last week I reported mostly stable infections and hospitalizations with perhaps the suggestion of a decrease starting, but I was hesitant to put much meaning on the small decrease - I was worried it was a "blip" and not a real trend. I am really pleased to say that it wasn't a blip and that we have a very clear downward trend in infections and hospitalizations. This is excellent news in the context of approaching holidays and indoor gatherings, and in the context of early high flu and RSV activity.
Speaking of which - the CDC tracks flu activity weekly and compares this year's flu activity to previous years and has released information that this year's flu season has started six weeks earlier than usual at that a key indicator of activity, percentage of visits for influenza-like illnesses, is already at a level not seen since since the 2009 H1N1 swine flu. This year's RSV activity is also unusually high. This is the "triple-demic" epidemiologists have been worried about. All to say - it's a relief to see a reduction in COVID-19 activity. There's no weekly data on hospitalization usage in general (for any cause), but data from COVID-19 tracking indicates that local hospitals are not at capacity. I'm not saying that they're not extremely busy! Wait times can be long and healthcare providers are pushed to the max.
We also don't have specific data on pediatric vs. non-pediatric hospital capacity, but data from hospitals in other nearby states indicate that while there are hospital beds in general, we are closer to full capacity of pediatric beds. For example, Rhode Island recently released data indicating that all pediatric hospital beds are currently full. This is due to a combination of factors, including but not limited to COVID-19, the flu, and RSV. This is an "easier" phase of the pandemic for many, but children, older adults, and those who are immunocompromised are still in a much higher risk phase because of all three viruses.
With that in mind, to get through this stretch, the public health advice is to plan your mitigation strategies around the highest-risk person involved in your plan. A group of relatively healthy teens or young adults can reasonably make essentially normal plans. As higher risk individuals are included in the activity, you'll want to consider adding things that make sense like testing before getting together, increasing ventilation, perhaps quarantining before getting together, and depending on the context, masking. Being fully vaccinated and boosted helps break the chain of transmission, too. If you feel sick at all, being around high-risk individuals is not a good idea. I know that's a really sad way to approach the holiday season. I wish I had something more positive to say about that! This is very much a phase of individual decision making, and the best advice I can give is to plan around your highest-risk person.
The BQ.1.1 continues to increase in prevalence more than other subvariants in the US and is currently responsible for about 19% of cases. The Public Health Nurse for the City of Easthampton let me know last week that Biobot Analytics, the organization that tracks wastewater data, can't differentiate BQ.1.1 from other BA.5 subvariants right now, but they are working quickly towards the ability to differentiate. Right now local BQ.1.1 cases are included in the BA.5 count.
Megan W. Harvey, PhD (she/her)