US flu surge continues amid jump in COVID activity

Hospital patient pulse oximeter

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The nation's flu activity remained at very high levels last week, as hospitalizations soared and states reporting seven more pediatric deaths, the Centers for Disease Control and Prevention (CDC) said today in its latest update.

Meanwhile, the nation's COVID-19 markers reflect substantial increases in cases and deaths, with hospitalizations also on the rise, according to the latest daily averages. Also today, the CDC signed off on a recommendation for emergency use of the updated bivalent COVID-19 boosters in children as young as 6 months old.

Flu hospitalization rates climb

Most flu markers such as outpatient visits for flulike illness and percentage of respiratory samples positive for flu remained at high levels, similar to the previous week. Forty-six states reported flu at high or very high levels.

In California, flu activity rose from medium to high, and, given the rise in multiple respiratory viruses, the California Department of Public Health today announced that it is expanding its no-cost testing program at the state's testing sites to include testing for flu. It said results take 30 minutes and will help people determine the best steps to feel better.

Hospitalizations continue to rise steadily, with Department of Health and Human Services surveillance showing that 25,906 people were hospitalized with lab-confirmed flu infections last week, up from more than 19,000 reported the week before. The cumulative hospitalization rate is 9.6 times higher than the highest cumulative rate for this point of the year since the 2010-11 season. Most hospitalizations were due to influenza A, and, of subtyped samples, 80% were H3N2.

Seniors continue to be the hardest-hit group for hospitalizations, followed by children ages 0 to age 4. Looking at the level by ethnicity, non-Hispanic Black people had the highest level, followed by Native American groups.

Seven more pediatric flu deaths were reported, raising the national total to 21. The deaths occurred between late October and the first week of December. All were due to influenza A, and of the four subtyped samples, all were the H3N2 strain.

The CDC's tracking of overall deaths from pneumonia, flu, and COVID-19 shows most mortality is caused by COVID-19, but the proportion of deaths due to flu is increasing.

The Association for Professionals in Infection Control and Prevention (APIC) today said in an email press release that, with flu hospitalizations at the highest level in a decade and with other viruses circulating, a key priority is to protect seniors and kids, especially with holiday socializing and crowded indoor gatherings.

APIC recommends three basic steps to protect loved ones, including getting vaccinated and seeing health providers as soon as symptoms develop. Also, it said hygiene steps are vital, including keeping hands clean, covering coughs, and masking in crowded indoor settings. "When in doubt, take the mask out," APIC said.

Notable rise in COVID activity

After several weeks of fluctuating cases punctuated by small rises, the 7-day average for new daily COVID-19 cases increased nearly 50% compared to the previous week and is at 65,569, the CDC said today in its weekly synopsis. The average for hospitalizations increased 13.8%, while deaths jumped by 61.7%.

Other markers are also on the rise, with COVID community levels reported as medium or high in 48 of 52 jurisdictions. Test positivity also shows an increasing trend, with 38% of wastewater sampling sites reporting their highest levels since Dec 1, 2021.

The CDC also released its latest Omicron variant proportion projections today, which show further increases in BQ.1 and BQ.1.1, which are predominant at 31.1% and 36.8%, respectively. Proportions of other lineages, including XBB, decreased this week.

In another development today, the CDC—following Food and Drug Administration action this week—expanded the use of the updated bivalent (two-strain) COVID vaccines in children ages 6 months through age 5. Young children who have completed the Moderna series can receive the updated Moderna vaccine 2 months after the last primary dose. Meanwhile, kids ages 6 months through age 4 who are completing the primary Pfizer-BioNTech series can receive the new Pfizer booster as their third dose.

The CDC said the vast majority of kids haven't received any COVID-19 vaccine doses. "CDC is working to increase parent and provider confidence in COVID-19 vaccines and improve uptake among the 95% of children who are not vaccinated or who have not completed the COVID-19 vaccine primary series," it said.

In other COVID developments:

  • The White House yesterday detailed steps to improve ventilation across the federal government to prevent the spread of respiratory diseases, which includes a requirement that federal buildings use MERV (minimum efficiency reporting value) 13 filtration and verify ventilation.
  • In other global regions, COVID-19 cases in Europe are still declining in seniors but are up 4% in other age-groups, the European Centre for Disease Prevention and Control (ECDC) said today in an update. In Africa, cases returned to low levels after a rise in November, with vaccine uptake at about 26%, officials from the World Health Organization Africa regional office said yesterday, urging countries to integrate COVID-19 measures into routine health services.

When in doubt, take the mask out.

Association for Professionals in Infection Control and Prevention (APIC)

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