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Influenza-like illness

Influenza-like illness (ILI) declined across the Northeast this past week, reinforcing my optimism that the region is past peak activity after a late December surge. Around 5.2% of visits to the doctor were for fever and cough or sore throat during the week ending January 13, down from 5.8% the week prior.

Northeast Region: ILI Activity

Percent of doctors visits for ILI symptoms

Outpatient ILI: The percentage of doctors visits for fever and cough or sore throat declined in most states across the region. ILI drops occurred in Vermont (-0.1 to 1.7%), Maine (-0.3 to 2.7%), Rhode Island (-0.5 to 2.6%), Connecticut (-0.6 to 3.4%), Pennsylvania (-0.6 to 2.8%), Massachusetts (-0.8 to 4.3%) and New Jersey (-1.1 to 6.5%). Only New Hampshire saw a slight uptick (+0.1 to 3.1%).

Northeast Region: Change in ILI Activity

Percent of doctors visits for ILI symptoms

Hospitalizations for influenza: In terms of influenza hospitalization rates, Vermont posted an increase this past week (+3.8 new admissions per 100K). Most other Northeastern states posted dramatic declines, including Maine (-1.2 per 100K), Rhode Island (-1.3), Massachusetts (-1.7), Pennsylvania (-1.1), New York (-1.1) and New Jersey (-1.1).

Wastewater concentration: Wastewater data also supports my conclusion that the Northeast has reached peak flu season. Wastewater concentration has declined markedly, after a late December peak.

Spotlight on NY: In New York state, ILI fell to 2.5%, which is fairly low compared to other states in the region. However, there has been an unusual uptick in in the central part of the state, so caution is warranted. In New York City, ILI activity remains very high at 9%. And although the outpatient ILI metric is decreasing, hospitalized cases of influenza actually increased, so again additional caution is warranted.

COVID-19

Overall, Covid-19 activity is easing in the region. Leading indicators like wastewater positivity and ER visits are improving in most states. We aren’t seeing uniform declines in hospitalizations just yet, but I think that will change in the upcoming weeks.

Hospitalizations: The Northeast region saw a mix of increases and decreases in Covid-19 hospitalization admission rates over the past week. Of the 9 states, 1 saw increase and 8 saw decreases. The only increase was in Connecticut, which rose 2.1 per 100,000 population. On the flip side, Maine posted the biggest decrease at 3.2 per 100,000. Other states with drops included New Hampshire (-2.6) and Vermont (-2.3). Marginal declines were seen in Pennsylvania (-1.8), Massachusetts (-1.9), and Rhode Island (-1.7).

Northeast Region: Change in New COVID-19 Hospitalizations

Weekly new hospitalizations per 100,000

Test positivity and emergency department visits: Both test positivity and the percentage of visits to the emergency department that are for Covid-19 dropped across the region.

Spotlight on CT: I checked secondary metrics like test positivity and ER visits in Connecticut specifically, which was the only state to see an increase in hospitalizations. I found that ER visits are falling in the state, so hospitaliations should soon follow.

Wastewater concentration: On the bright side, wastewater concentration dropped quite a bit in the Northeast, after peaking in late December. This gives me additional confidence that the winter wave is receding or will soon.

RSV

RSV activity in the Northeast has fallen for 6 weeks in a row now, with PCR test positivity currently at 6.6%, down from a recent high of nearly 14%. Looking ahead, I expect activity to continue to fall in the weeks ahead, likely dropping below the 5% threshold by the end of this month. Activity should continue to fall and remain low through the remainder of winter and spring until the season resumes in early fall.

Northeast Region: RSV Activity

Test Positivity, Percentage

Norovirus

Norovirus activity has slowed a bit in the northeast, with test positivity dropping below 12%. Test positivity has been in the 10% to 14% range since mid-December. For comparison, last year test positivity peaked at 16% in early March. For this reason, I expect the norovirus season to continue for a while yet, but I am glad for the temporary reprieve.

Northeast Region: Norovirus Activity

Test Positivity, Percentage

Other bugs

• Seasonal coronavirus activity, a frequent cause of the common cold, is increasing rapidly, which is typical for this time of year. Expect some stuffy noses in the weeks ahead.
• Human metapneumovirus and parainfluenza virus, two causes of influenza-like illness, remain low. Adenovirus activity also appears to remain low.

Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New

• Brightfarm Spinach and Salad Kits (more info)
• Charcuterie meats sold by Fratelli Beretta and, newly, Busseto (more info)

Previously reported:

• Tons of different granola and oatmeal products from Quaker — more items were added to the list of contaminated products (more info).
• Ground beef sold by Valley Meats and Scanga Meat (more info, more info)
• Pet food sold by Blue Ridge Beef (more info). Pet food can pose a risk to humans through cross contamination.
• If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

In other news

• Several animals with rabies have been reported in the region. This is not uncommon; the Eastern United States experiences periodic animal cases, especially in raccoon and bat populations. These contribute to the spread of rabies to domestic animals and occasionally to humans. Anyone who received a bite from an unknown animal or comes into any kind of contact with a bat should immediately call the health department or seek medical care to be evaluated for post-exposure prophylaxis (preventive shots).
• The New York State Department of Health has issued a $300,000 penalty to a Nassau County midwife for falsifying immunization records. The scheme affected roughly 1,500 school-aged children from throughout the state. All affected children must be fully up to date with all age-appropriate immunizations, or be in the process of receiving their missing vaccinations, before they can return to school. The vaccination scheme began at the start of the 2019-2020 school year, shortly after the elimination of non-medical exemptions for required school immunizations.