Another Covid wave hits the US as JN.1 becomes the dominant variant

The US is in the throes of another Covid-19 outbreak After Americans return to school and work this week, a form of the virus is on the rise over the holidays as doctors and public health officials prepare for more outbreaks.

Corona virus samples detected in wastewater, the best metric for assessing community virus activity, suggests that epidemics may be as widespread as last winter. Some healthcare facilities across the country, including every one in Los Angeles County, are again requiring masks. JN.1, the new dominant variant, appears to be particularly efficient at infecting vaccinated or previously infected individuals.

As photos of positive coronavirus tests resurface on social media, fewer people are going to the hospital than a year ago. Centers for Disease Control and Prevention 29,000 Covid hospitalizations in the week before Christmas Latest data, compared to 39,000 the previous year. The company reported an average of 1,400 Weekly deaths Since Thanksgiving, fewer than half the deaths were at the same point last year.

Even so, Covid remains one of the leading causes of death and the primary driver of respiratory virus hospitalizations — exacerbating the strain on hospitals seeing an influx of flu and RSV cases.

“Of the three big viruses, this is still the virus that puts people in the hospital and takes their lives,” CDC Director Mandy Cohen said in an interview Wednesday.

Even mild cases can lead to long lasting complications caused by prolonged covid.

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The The CDC still recommends People are quarantined for five days after testing positive, though many Americans have stopped doing so and free tests are hard to come by, making it easier for people to spread the virus if they don't know their cold is actually Covid.

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“As with any public health advice, it's always a challenge to get people to follow the guidelines,” said Chicago Department of Public Health Commissioner Chimbo Ike, who is urging residents to follow that guidance. “We've found that reducing the impact of Covid has to be part of the solution to end the disease or is more effective.”

Michihiko Koto, an infectious-disease specialist at the Department of Veterans Affairs in Iowa City who has seen a moderate increase in Covid patients, worries that the return of college students could seed more infections in the coming weeks.

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CDC guidance for isolation makes sense, but the reality is that many people lack flexibility at work.

“People who don't have paid sick leave can't [isolate] Because they have to feed their families,” he said.

Although coronavirus cases have increased each winter since the pandemic began, the CDC says it is not yet considered a seasonal illness like the flu. The coronavirus fluctuates throughout the year, and typical winter waves can be influenced by other factors, such as holiday travel, cold weather forcing people indoors, and the evolution of the virus. The JN.1 variant, now most common in the United States, has significantly more mutations than its predecessors, which explains why it tends to make people sick during summer outbreaks.

“If you look at the different peaks from the beginning of the epidemic, each one coincides with the emergence of a new variant,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. . “Many attribute this to climate.”

Few Americans are staying up-to-date on their coronavirus vaccines, training their immune systems to keep up with the emerging virus. According to CDC estimatesJust 19 percent of Americans have received the latest version of the vaccine Laboratory tests Show offers better protection against the JN.1 variant than the previous formula.

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“It's not enough to suppress the virus from growing, getting stronger, and escaping,” said Jessica Malati Rivera, an epidemiologist and senior science communications advisor at the de Beaumont Foundation, a public health organization.

Medical experts and public health officials say there is growing skepticism about coronavirus vaccines, especially among conservatives. The latest pushback came Wednesday from Florida's top health official, who urged people to stop getting mRNA coronavirus vaccines.

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Primary health officials have encouraged vaccination, especially for people over the age of 65, to reduce the risk of a wave of Covid-19.

Waste water monitoring Biobot Analytics showed that the most recent coronavirus levels were slightly lower than the same point last year, except in the Midwest. The difference may be driven by changes Biobot epidemiologist Marisa Donnelly said vaccines and variants can affect how much virus people shed.

Donnelly said Wastewater data is used as a warning sign when levels rise.

“Now that I'm seeing high rates of Covid-19 in sewage, I'm starting to worry about people who are immunocompromised or have risk factors that put them at risk of developing severe Covid,” Donnelly said.

When the CDC flagged New York and New Jersey were among the first states to have a higher share of infections caused by the new strain and higher respiratory virus levels in mid-December, with hospitals in those states saying those trends have not translated into crises on their wards.

“It's not out of control, it's nothing like last year,” said Kathy Bennett, president and CEO of the New Jersey Hospital Association.

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Hospital leaders are now talking about the coronavirus in the context of the broader respiratory virus season. RSV, often found in infants and children's wards, has already peaked nationally. The flu season started later than usual and is now accelerating, with 79,000 cases of Covid compared to 136,000 emergency room visits last week.

Northwell Health, New York's largest health care system, has seen an increase in emergency room and outpatient visits testing positive for the coronavirus, which was expected after Thanksgiving. Those patients are usually discharged quickly and rarely become seriously ill.

“If you're seeing very sick people in ICUs, it's probably the flu rather than Covid,” said Bruce Farber, the agency's head of public health and epidemiology. “If you look at the total population in the hospital with people with some respiratory illness, it's overwhelmingly Covid.”

But adding Covid to the usual winter cycle of respiratory viruses has strained other hospitals — including one in Minnesota, where wastewater volumes increased tenfold in the week before Christmas.

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“Every hospital that does pediatric care is full,” said John Hick, an emergency physician at Hennepin Healthcare in downtown Minneapolis, which has 25 pediatric beds.

For the past month, hospital officials across the state have been making coordination calls three times a week to determine whether pediatric beds and some patients can be moved to adult units, Hick said. Last week, the hospital began requiring patients and doctors to wear masks again when interacting.

On Hick's last ER shift, a few days before Christmas, half the patients had Covid or the flu. Given low vaccination rates, he expects to see more cases of Covid in the coming weeks.

What's even more shocking is that many of those cases are preventable.

Teddy Amenabar contributed to this report.

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