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ILI & RSV is increasing
Covid-19 is decreasing

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Outbreak Outlook - National - February 1

Respiratory Diseases

Force of Infection
After several weeks of declining activity, flu has picked back up. Outpatient influenza-like illness rose to 4.7%. However, while this is an increase over last week, this remains far below the peak several weeks ago, of 8.3%. Similarly ED visits for influenza, also rebounded slightly this past week to 3.4% nationally.
This rise seems to be due in part to an increase in influenza B, while influenza A is holding stable at elevated rates. That said, influenza A still accounts for the majority of flu cases: influenza A accounted for 87% of clinical lab samples and 94% of public health lab data this past week.
Increased activity in school-age children is also driving up overall rates. Those aged 5-24 are seeing the clearest increase, with 8.1% of doctor’s visits due to ILI. Rates have also increased slightly for those aged 0-4 (to 12.4%). All other age groups continue to report declines in outpatient ILI.
Looking ahead, we often see that a rise in kids, as we’re seeing now, is soon followed by an expansion into other age groups. My current hypothesis is that the severe weather that much of the country saw last week will interrupt that pattern, hopefully cutting off chains of transmission and stopping the rise.

Covid-19 wastewater activity continues to decline from its national peak at the beginning of January. Overall activity is moderate.

In the Midwest, wastewater activity is very high, rebounding slightly in the past week. Wastewater concentration also rebounded a bit in the South, but activity there is low. Activity continues to decline steadily in the Northeast, and has fallen to moderate levels. Activity is low but increased a bit this past week in the West.

Test positivity has been holding roughly steady the past few weeks, at a little over 5%, but ED visits continue to gently decline. Nationally, ED visits are at about 0.7%. They remain highest in the Midwest and lowest in the West.

Severe illness is low, at about 0.8 hospitalizations per 100,000 people, or less than half of what it was about a month ago.

RSV has been on a sneaky, gradual increase for the past several months and we are finally hitting quite elevated levels, with the epidemic estimated to be growing in a little less than half the country. Test positivity is up to 6.3%, its highest so far this season.

Nationally, about 0.5% of ED visits are due to RSV. ED visits continue to be highest in the South (~0.7%) and lowest in the West (~0.4%).

Hospitalizations have decreased a bit over the past few weeks, to about 1.5 hospitalizations per 100,000 people nationally.