What to Know About the U.S. Winter COVID-19 Wave

The U.S. is in the midst of a winter wave of COVID-19.

COVID-19 is not the problem it once was in the U.S. Americans have access to tests, treatments and vaccines.

However, it’s still killing hundreds of Americans each day, sending tens of thousands to the hospital weekly and threatening everyone it infects with the possibility of developing long COVID.

Here are three things to know about the current COVID-19 surge in the U.S.

COVID-19 Levels in the U.S. Are Elevated

Wastewater viral activity for COVID-19 is “very high” nationally, surpassing last winter’s levels, according to data from the Centers for Disease Control and Prevention. Wastewater data can indicate how much disease is spreading in a community and has become widely used as agencies no longer document the number of national COVID-19 cases.

“All regions show high and increasing levels, with the highest regional levels in the South and Midwest,” the CDC reported last week. It added that there are early indications that activity is starting to slow in the Midwest and Northeast.

COVID-19 hospitalizations are the highest they’ve been in about a year. The numbers are elevated and increasing, but that increase is showing signs of leveling off.

Ultimately, no one knows exactly how much COVID-19 is circulating in the U.S.

“Even if we count test positives, we don’t know about the people who were positive but didn’t test,” says Shishi Luo of Helix, a gene sequencing company. “I think the best thing to look at is: Are things going up and how quickly are they going up?”

The CDC said in an update to its respiratory disease season outlook posted this week that it is uncertain when the season will peak.

“COVID-19 surveillance data, hospital admission forecasts and growth estimates indicate that COVID-19 activity has increased and is likely to continue increasing into January,” the agency said. “Although rates of hospitalization and Emergency Department visits due to COVID-19 are currently lower than this time last season, COVID-19 remains the primary cause of respiratory virus-associated hospitalizations nationally.”

COVID-19 Cases Are Fueled by a New Variant, JN.1

The majority of new coronavirus infections are stemming from the omicron subvariant JN.1.

The strain quickly rose to dominance after being documented in the U.S. in September. It’s the fastest growing variant in the U.S., increasing from 20% of cases in December to more than 60% in January.

COVID-19 tests, vaccines and treatments are expected to work on JN.1. Additionally, JN.1 doesn’t appear to be any more severe than previous COVID-19 strains.

The CDC assesses that “at this time, there is no evidence that JN.1 presents an increased risk to public health relative to other currently circulating variants.”

Updated COVID-19 Vaccine Uptake Is Low

Uptake of the new COVID-19 vaccine has not been as high as public health officials had hoped.

The agency reports that about 21% of U.S. adults have received the shot. Among older adults ages 65 and above, more than 41% have gotten the shot.

The numbers are not where officials had hoped they would be in the middle of winter. They’re also significantly lower than uptake of the flu shot, with nearly 47% of adults reporting receipt of the flu shot.

Luo says that Helix’s data shows that the benefits of COVID-19 vaccines are the greatest among older populations and that future vaccine campaigns might be more targeted to that age group.

“What seems like a likely scenario is that booster campaigns would primarily focus on older adults … and then for the rest of the population, it may not be as high a priority to get boosted every year,” Luo says.