COVID activity rises in 2 world regions as US declines continue

Drop going into COVID test

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COVID flare-ups continue in parts of Southeast Asia and the Western Pacific, though, as a whole, global cases and deaths continue to drop, the World Health Organization (WHO) said yesterday in its latest weekly update.

In the United States, federal data reporting changed yesterday when the national public health emergency expired, with the new main markers—hospitalizations and deaths—showing continued downward trends.

Regional hot spots, variant diversity

Globally, COVID-19 infections declined 14% and deaths fell 17% over the past 4 weeks compared to the previous 4 weeks. Cases, however, rose sharply in Southeast Asia, with a more modest rise in the Western Pacific.

The WHO's Eastern Mediterranean region had been experiencing a spike in activity over the past several weeks, but activity over the past 4 weeks has stabilized.

Hot spots in the WHO's Southeast Asia region, include India, Indonesia, Thailand, Myanmar, and Maldives. Meanwhile, the rising activity in the Western Pacific is led by increases in Vietnam, Mongolia, Laos, Australia, Japan, and South Korea.

The WHO said subvariant dominance varies by region, with XBB.1.16 dominant in Southeast Asia and XBB.1.5 dominant in the Western Pacific.

Globally, XBB.1.5 continues to dominate, but its proportions are steadily dropping. Other subvariants continue to rise, including XBB.1.16, which has now been reported in 46 countries and has increased from 4% to 8.6% of sequences over the past 4 weeks. Other variants under monitoring showing increasing trends include XBB, XBB.1.9.1, and XBB.1.9.2.

In a separate weekly update yesterday, the European Centre for Disease Prevention and Control (ECDC) said country trends over the past several weeks continue to decline or are stable.

Recent rises in transmission and severe disease in Bulgaria, Croatia, Finland, and France appear to be at or past their peaks. Spain's primary care surveillance hints at increased community transmission, which the ECDC said isn't reflected in the country's reported case rates.

Sequencing from a limited number of countries suggests that XBB.1.5 makes up 62.7% of the samples.

US settles into new data reporting as cases ebb

In the United States, health officials are adjusting to a shift in Centers for Disease Control and Prevention (CDC) data reporting, which was announced last week ahead of yesterday's end to the national public health emergency. The new metrics focus less on case rates, which have become less reliable, and lean more heavily on hospital and death data.

Hospitalizations for COVID continue to slow, declining 6.5% last week. Deaths also reflect a slow and steady decline, dropping 5.3% over the past week.

Emergency department visits for COVID also declined, though at a level slightly higher than for flu and respiratory syncytial virus (RSV). They declined for all age-groups and were highest in those ages 0 to 1 and in seniors.

For wastewater, only 2% of sites reflect a modest increase, defined as 10% to 99%, a decrease of 33% over the last week.

For variant proportion projections, the CDC is shifting to every-other-week reporting. This week's report shows that, over the past 2 weeks, XBB.1.5 makes up 64% of samples, down from 76.3% from the previous 2 weeks. Levels of XBB.1.16 rose from 6.6% to 14.3% over the same period, with levels of XBB.1.9.1 rising from 6.5% to 9.2%. Other subvariants reflexing increased proportions include XBB.1.9.2 and XBB.2.3.

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