Influenza-like illness

Influenza activity is drifting up in the Northeast, though it remains lower than in the South and West. Outpatient influenza-like illness rose from 2.3% to 2.5% and flu test positivity ticked up from 3.4% to 4.2%. The hospital admission rate for influenza increased from 1.3 to 1.5 per 100,000 this week.

Despite the slower start, flu is about four to five weeks ahead of last season. Hospital admissions for influenza are at a level the Northeast didn’t reach until late November last year.

New Jersey is rising fastest among the region’s larger states. Its hospital admission rate rose from 1.0 to 1.7 per 100,000, and it has the region’s highest outpatient influenza-like illness, at 3.5%. (Pennsylvania’s hospitalization rate is higher, but it runs consistently higher year-round, so I’m setting that aside for now.)

COVID-19

Covid-19 indicators are pointing in different directions. As I’ve said before, this is the time of year when Covid-19 stays elevated compared to the off season; activity never fully declines coming out of the summer season. Indicators may bounce around (up and down) through autumn months before increasing to a second peak around the turn of the new year.

Wastewater levels moved up from low to moderate, while ED visits have fallen for four straight weeks, to 0.3%. Hospital admissions are flat this week at 1.4 per 100,000.

CDC estimates that Covid-19 activity is growing or likely growing in 6 of the 8 Northeastern states with estimates, so I’ll keep a close eye on the data.

RSV and other respiratory pathogens

RSV activity remains very low in the Northeast. Wastewater levels are very low, ED visits for RSV are basically zero, and hospital admissions are about 0.3 per 100,000. Looking ahead, CDC estimates that RSV activity is growing in all 5 Northeastern states with estimates, so we may see higher levels in the weeks to come.

Stomach Bugs

I have decided to move stomach bugs to a monthly reporting schedule. I have been unhappy with the quality of the weekly data. It’s often delayed, and the numbers can change quite a bit retrospectively once new data come in. A monthly look will give a more reliable picture.

In Other News

• Pennsylvania has reported 1,426 measles cases this year as of October 30, including 88 in the past seven days, and 268 people have been hospitalized. The state counts five measles-associated deaths, and a sixth death reported by the Franklin County coroner remains unconfirmed by the state. The state’s secretary of health has called the direction of the outbreak “promising.“

State by State

Connecticut

Flu: Mixed. Outpatient influenza-like illness ticked up to 1.7%, while flu test positivity is about flat at 2.8%. Hospital admissions fell from 1.5 to 0.8 per 100,000, but fewer hospitals reported this week, so I wouldn’t read much into that.

Flu accounted for 0.5% of emergency department visits in the week ending October 24, up from 0.3% two weeks earlier.

Covid-19: Elevated. Wastewater concentration remains high, and hospital admissions are flat at 1.5 per 100,000. ED visits dipped to 0.4%.

RSV: Very low.

Maine

Flu: Low and steady. Flu test positivity is 4.9%, among the highest in the Northeast. ED visits are flat at 0.6%, and outpatient influenza-like illness is 1.0%. Hospital admissions are low.

Covid-19: Wastewater concentration jumped from low to high, though other indicators remain low. ED visits ticked up to 0.3%, and hospital admissions decreased, though the numbers are small.

RSV: Very low.

Massachusetts

Flu: Picking up. Outpatient influenza-like illness rose from 1.7% to 2.0%, and wastewater concentration increased from low to moderate. Flu test positivity is 5.0%, and ED visits ticked up to 0.6%. Hospital admissions rose from 0.5 to 0.7 per 100,000.

Covid-19: Wastewater concentration rose from moderate to high, while ED visits are flat at 0.4% and hospital admissions are flat at 0.8 per 100,000.

RSV: Very low.

New Hampshire

Flu: Rising from a low level. Outpatient influenza-like illness increased from 0.9% to 1.4%, and ED visits rose from 0.5% to 0.7%. Hospital admissions increased, mostly among adults 75 and older, though the numbers are small. Wastewater concentration is very low. No lab data.

Covid-19: Wastewater concentration jumped from very low to moderate, but ED visits dipped to 0.3%, and hospital admissions decreased from 1.1 to 0.9 per 100,000.

RSV: Very low.

New Jersey

Flu: Rising quickly. Outpatient influenza-like illness increased to 3.5%, the highest in the Northeast, and flu test positivity rose from 3.9% to 6.1%, also the region’s highest. ED visits rose from 0.6% to 0.8%, and wastewater concentration moved from very low to low. Hospital admissions increased from 1.0 to 1.7 per 100,000.

Covid-19: Wastewater concentration rose from low to moderate. ED visits are flat at 0.4%, and hospital admissions are flat at 1.5 per 100,000.

RSV: Low but ticking up. Hospital admissions rose from 0.2 to 0.3 per 100,000, about half of them young children, and RSV accounts for 0.1% of ED visits.

New York

Flu: Rising. Flu test positivity increased from 2.1% to 3.8%, ED visits rose from 0.5% to 0.6%, and outpatient influenza-like illness is 2.2%. Hospital admissions ticked up to 1.3 per 100,000, about eight times this time last year.

In New York City, flu accounted for 0.6% of emergency department visits in the week ending October 24, up for the ninth straight week and about five times the level at this point last year. Young children have the highest rates: 1.6% of ED visits among children under 5 and 1.4% among ages 5 to 17.

Covid-19: Easing in hospitals. Admissions decreased from 1.7 to 1.4 per 100,000, and ED visits dipped to 0.3%. Wastewater concentration is very low, though I’m cautious about that reading, since it’s well below New York’s neighbors.

RSV: Very low.

Pennsylvania

Flu: Rising, though still hard to read. ED visits increased from 0.3% to 0.5%, flu test positivity rose from 2.9% to 4.2%, and outpatient influenza-like illness is 1.6%. Hospital admissions rose from 2.1 to 2.5 per 100,000, the highest in the Northeast. Pennsylvania reports high flu admissions year-round, so I’m still cautious in reading these.

The state reported its first two flu outbreaks of the season in the week ending October 24, plus about five Covid-19 outbreaks.

Covid-19: Hospital admissions rose from 1.3 to 1.7 per 100,000, the highest in the Northeast. Wastewater concentration rose from very low to low, and ED visits are flat at 0.2%.

RSV: Very low.

Rhode Island

Flu: Low. ED visits are flat at 0.4%, and outpatient influenza-like illness is 1.3%. Hospital admissions rose from 0.4 to 1.5 per 100,000, but Rhode Island’s small numbers can swing from week to week. No lab data.

Covid-19: Mixed. Wastewater concentration rose from moderate to high, but hospital admissions fell from 2.1 to 1.4 per 100,000 after last week’s jump. ED visits dipped to 0.4%.

RSV: Very low.

Vermont

Flu: Low. Outpatient influenza-like illness rose from 1.0% to 1.4%, and wastewater concentration moved from very low to low. ED visits dipped to 0.5%, and flu test positivity fell from 4.2% to 3.0%. Hospital admissions are low.

Covid-19: Low. Wastewater concentration is low, ED visits dipped to 0.3%, and hospital admissions decreased, though the numbers are small.

RSV: Very low.

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