Headlines are suddenly full of news about the new XBB variant surging in the US. If you read my updates, you first heard about this variant in my post on October 8. The news stories are full of claims that we don't yet know if this variant increases the severity of disease. That isn't quite true, so if you'd like to know the current #COVID19 status in the US and be better informed for activities this weekend, here is a five-minute 🧵 update:
- XBB.1.5 is surging very rapidly, having increased 10x from 4% of US cases to 41% in just three weeks (https://covid.cdc.gov/covid-data-tracker/#variant-proportions). It grew out of NY and has become predominant in the northeast US, and experts predict it will spread across the US in the coming weeks. In the past two years, the first week of January was the peak of holiday surges, but this year, it appears we'll see increased transmission and risks throughout January.
XBB.1.5 is getting so much attention in the news media for two reasons. First, it's the fastest surge of a variant since the first Omicron variant. Also, it's getting more attention in the expert community because it made a rare 2-nucleotide substitution, and studies suggest it is as different from the original 2020 SARS-CoV-2/COVID strain as SARS-CoV-2 was from the 2002 SARS-CoV-1 (https://www.biorxiv.org/content/10.1101/2022.09.15.507787v3.full).
- This variant is the second in a row (behind BQ.1.1) to cause the current surge in the US. COVID in wastewater is in its second-highest surge of the pandemic (but still far behind last year's peak: https://biobot.io/data/). Walgreen's is reporting the highest positive testing rate of the pandemic (https://www.walgreens.com/healthcare-solutions/covid-19-index). The CDC's data on positive rate does not show it at its peak, but it has doubled in the past two months and is rising aggressively.
- The risk of COVID infection is high in much of the country. The CDC Transmission Level map presently shows that 71% of the US is at the highest level of transmission and another 15% are at the substantial level. https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states&list_select_county=all_counties&data-type=Risk
- While news stories about XBB.1.15 frequently claim we don't know if it causes cases of greater severity, that isn't entirely true. The problem with news media is that by the time we have concrete evidence a new variant is more dangerous, it's too late--hospitals are already full. What we do know strongly suggests this variant puts more folks in the hospital at a higher rate than throughout this past year but lower (probably) than past surges.
In New York, for example, COVID hospitalizations are at their highest since February (but still two-third fewer than last holiday's peak): https://coronavirus.health.ny.gov/daily-hospitalization-summary. The same is true, for example, in Connecticut (https://www.ctpublic.org/news/state/2021-06-28/tracking-covid-data-vaccinations-hospitalizations-your-towns-infection-rate). In both states, hospitalizations are still rising rapidly, but they seem unlikely to surpass last year's peak.
- COVID hospitalizations in the US are rising and have just matched the mid-2022 surge (https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions). Risks are greater for older Americans, as has been typical throughout the pandemic: Hospital admissions for people 70+ have doubled in two months and are rising steeply. The situation for children isn't as bad, but that could change very rapidly--hospital admission for kids rose by 28% in the past week.
- All of these risks are manageable, but only if we cared, and most in the US are pretending the pandemic is over. Masks work (https://theconversation.com/as-viral-infections-skyrocket-masks-are-still-a-tried-and-true-way-to-help-keep-yourself-and-others-safe-195788), and many know they should wear them, but they won't because they fear others' judgement. (Risking your health because you care what strangers think feels like messed-up priorities to me.)
While people continue to fly without masks, a recent study in Malaysia found COVID in the wastewater of 96% of the flights (https://www.audacy.com/wwjnewsradio/news/national/coronavirus-found-in-samples-from-96-percent-of-flights). Now, tens of thousands attending CES in Clark County, NV, a county with substantial COVID transmission. The event's COVID policies won't prevent a transmission--masks are recommended “if you are more comfortable,” one complimentary COVID test is available for people who ask, and organizers request people not attend if sick. https://www.ces.tech/logistics/in-person/health-protocols.aspx
@augieray Please don't circulate the Malaysia study. It tells us nothing about contagious COVID prevalence or how safe it is to fly.
* COVID can continue to be present in a person's waste for long after they are contagious.
* They only tested for the presence of COVID in the waste, not its concentration. Without that this says nothing about the risk of infection.
Flying may be a COVID risk, but bad proof like this gives the back-to-normal people ammunition.
@jik I think the study has merit. It suggests almost every flight had one or more people who were COVID positive. While the air in flight might be better, we know CO2 levels during boarding, taxiing, and deplaning can be terrible. Rather than complain about the study, wouldn't someone like you prefer to recommend more people wear masks? XBB.1.5 is spreading rapidly, and nitpicking studies seems to detract from the larger, more important, message.
@augieray
What the study says is that there are traces of COVID in the waste tank of every flight. That is not at all the same as every flight having someone COVID positive on it.
Having said that, I would actually expect most flights to have at least one COVID positive person on them. There's nothing surprising or revelatory about that. 1/3
@augieray Again, that doesn't prove that it's unsafe to fly. Of course I want people to mask, and there's ample good evidence of why people should do that, which is why it's bad to circulate BAD evidence like this study.
Note that the study authors very carefully did not make any claims about what their discovery proves in terms of the safety of flying. It's people—like you—who are circulating the study who are doing that. And that's bad. 2/3
@augieray "Wouldn't you rather focus on x than pick on this study" is a red herring and attempt to change the subject and I expect better from you. That's a ridiculously false dichotomy. I am capable of doing more than one thing at a time. 3/3
@augieray Actually it occurs to me that there are two more points I want to make here.
1) In my opinion, the single biggest danger COVID educators need to avoid is sensationalism. The things we are telling people need to be rock solid, because if any one thing isn't, the people we're fighting will use that to discredit us entirely.
2) If flying were significantly more COVID dangerous than normal life, there would be ample evidence of that by now. There isn't any.
That's incorrect, if you're talking scientific data into the subject. Even the author of the best model says:
“Nobody is screened. Nobody is asked if they’ve come down with COVID. There was no attempt made to figure out where people got it. We have so little data.
...
“If we had actual data from the United States, then maybe we wouldn’t have needed a model.”
Of all places Nerd Wallet did an article on the subject this past summer if you want to take a look as that's where the quote came from.
https://www.nerdwallet.com/article/travel/covid-transmission-on-planes
You're much better off looking at CO2 levels before takeoff when HEPA filters are not running as a proxy. I think you'd have to conclude from that that it's not a very safe place to be sitting, but, you're somewhere between hard scientific data and anecdotal evidence with CO2 alone.
Yuck! That's not healthy outside of COVID, but, I kind of wished we used rebreathed air percent instead of CO2 just to make it a little more personal.
At 2,400 ppm CO2 somewhere around 5.5% of the molecules in the air are freshly out of someone else's lungs(with a few assumptions made).
@nazgul I’m curious what device you use to track CO2 on your phone?
Aranet4. Great device, albeit a bit expensive. Runs on one battery forever (I’ve had mine since July and it’s still in the same battery). Stores a week or so of data.
@nazgul Thanks, appreciate the info! Seems like that device actually provides “meaningful” CO2 numbers, so probably worth the money if you’re looking for accuracy. Thanks again.
@BE @augieray I stand corrected, thank you.
The suspicious part of me wonders if we don't have any hard real-world data is because the airlines won't cooperate with scientists who want to study this because they don't think they'll like the results.
In any case, the rest of what I said still stands: IMO this is a useless study which doesn't tell us anything we don't already know and will only convince people to change their behavior if it's misinterpreted.
@BE @jik @augieray
I’ve been really unhappy with CO2 levels on some planes, especially Alaska. This was a recent flight from Seattle to Hawaii. It was bad enough on the flight, but then we got stuck on the tarmac in Hawaii for 20 minutes and it go so bad we got headaches.