Deaths are back above the epidemic threshold and increasing. A new variant with Delta mutations is spreading faster than other variants. Long COVID's burden on society grows.
Why is the southern U.S. seeing a greater increase in outpatient doctor visits and hospitalizations than the Northeast U.S.?
Deaths from pneumonia, influenza, and COVID-19 (PIC) are up above the epidemic threshold and increasing. Flu is still very low, while COVID is widespread. COVID and/or pneumonia, likely caused by COVID, is increasing the number of deaths.
Flu cases, reported by the CDC through September 9, 2023 are still quite low.
The map of the U.S., below, shows where outpatient respiratory visits are more prevalent. Notably increasing more in the southern states where schools opened earlier in August and not in the Northeast where almost all the schools opened after August 28th.
When we look at the age breakdown of outpatient respiratory visits, we see that the majority of the increase is occurring in children.
In other words, COVID is sending children to the doctors office. That isn't a mild cold. These are sick children whose parents are worried.
Looking at the year over year comparison, below, we see that respiratory infections are on track with 2021/2022. Increasing well above the pre-COVID years.
Sadly, many of these preventable infections will become long-term persistent infections, leading to Long COVID.
"Estimates of Long COVID incidence among non-hospitalized adults with COVID-19 range from 7.5% to 41%" (CDC)
“More than 1 in 4 adults with long COVID reported significant activity limitations during June 7–19, 2023, and prevalence did not change over time.”
Long COVID hurts the economy, education and destroys peoples quality of life. Ultimately, shortening lives by years & decades. Tens of thousands more people are going to suffer from Long COVID everyday as the unmitigated transmission continues.
RSV cases are still well below 2022 at this time, so we are seeing respiratory infections driven, primarily, by the latest COVID variants.
Rotavirus, metapneumovirus, and respiratory adeno virus are all at very low levels. We see by looking at this data that COVID is making children sick and they spread it to their parents and siblings. COVID is a highly contagious airborne disease. If we take steps to mitigate airborne transmission we can prevent illness, loss of education, and loss of work, helping families' health & finances.
People are being hospitalized, and many are dying.
Children are links in the chain of transmission. The virus doesn’t stop at schools, it finds the people with weaker immune systems. COVID also weakens immune systems. (see Immune Dysfunction below)
The southern states are where more are being hospitalized. (yellow counties below)
It’s not that it was hotter in the south. Most the U.S. saw very hot weather keeping people indoors for the past month or longer. It is likely because schools have been open longer. According to the Pew Research Center, in Texas and other west south central states and the east south central states, nearly all schools are open by August 14th. In the South Atlantic states more than half are open by August 15th. It is unlikely a coincidence that in the densely populated Northeast and Mid-Atlantic, where almost all the schools reopen between Aug 28th and Sept 5th, there are very few counties in yellow.
Immune Dysfunction
The acute infection may be one reason to not want to keep getting infected with SARS-CoV-2 over & over again, but the idea that it can increasingly cause damage to the immune system should be a significant reason. ⬇️
A fairly comprehensive guide to COVID immune dysfunction by one of the U.S.'s largest cancer centers is linked here.
Children infected now could end up being at greater risk for reinfection of COVID or of being infected by influenza, RSV, and other respiratory spread pathogens due to weakened immune systems. Keep in mind that coinfections of COVID and other viruses are often more severe.
Variants Update
Lastly, the latest update on the variant proportions shows that EG.5, FL.1.5.1, XBB.1.16.11 and HV.1 gaining in prevalence. Notably, HV.1, has nearly doubled, from 4.8% to 8.4% between Sept 2nd and Sept 16th, while the others only gained a little over the Sept 2nd update so HV.1 clearly has an advantage.
According to NY variant proportions, HV.1 was at 1.6% Aug 19th. It rose to 3.1% prevalence by Sept 2. It will likely be at over 6% in NY at the next update.
HV.1 has been sequenced in at least 15 countries and 38 U.S. States. Worldwide it is most prevalent in Aruba, Costa Rica, Ecuador and the United States.
In the U.S. the map below shows prevalence at the state level.
Unmitigated transmission allows for faster evolution. That means it can evolve around vaccines, treatments, and our immune system faster. HV.1 evolved from EG.5.1 (Eris).
HV.1, like EG.5.1, has many of the same mutations as the Delta variant, now including L452R. “The L452R mutation not only evades the HLA-A24 cellular immunity but can also enhance the infectivity of the virus," said the leader of immunology in the study, Dr. Chihiro Motozono back in 2021. The loss of smell and taste may be become a more prevalent symptom again.
Ignoring airborne transmission aids the speed of evolution and creates more opportunities for large jumps like we recently saw with BA.2.86 (Pirola). We are helping this virus every day by ignoring airborne transmission.
We can protect the health, quality of life and the longevity of people while bringing down expenditures on healthcare. That money can be invested in schools and towards the betterment of individuals lives. Billions of people could have a better quality of life if we simply understood that providing Clean Air for Kids is absolutely essential. We must work Together Against COVID Transmission.
Hi TACT...
The hospitalization graphic does not seem to be reflecting what the hospitals are actually experiencing, but perhaps encouraged not to report (at least in my local area). Many of the local hospitals in my area have been in 'Red Alert' status off and on for over a month. 'Red Alert' status means there are no telemetry beds available. Some states make this information publicly available, while other states hide it behind password protected log-ins. Perhaps the hospital graphic in your report comes from the CDC (Center for Disease Circulation).