‘Silent’ COVID wave could hit US this holiday season, experts warn

The United States is approaching 2025 with an increase in the number of COVID-19 cases across the country. Cases were already starting to rise before the holidays began, and large indoor gatherings are likely to accelerate the spread of the virus, experts say.

Some experts say this COVID surge, which is starting later than usual in the year, could lead to a “quiet” surge during the holidays and early in the new year.

They call it “silent” because this winter surge follows a long period of unusually low COVID activity this fall, so many people are unaware that COVID levels have risen sharply over the past two weeks, according to the most recent data on wastewater from American centers. for disease control and prevention.

As a result, people may be unaware that their risk of infection is increasing and not test if they have only mild symptoms, which can cause the virus to spread at holiday gatherings, during travel and more. .

As of Dec. 14, wastewater viral activity of SARS-CoV-2 — the virus that causes COVID-19 — was “high” or “very high” in 21 states, according to CDC data.

“There is a good chance that many people will become ill in the coming weeks without realizing it. Most people don’t follow CDC data, and their only way to know if we’re in a surge is if they got sick,” Michael Hoerger, Ph.D., associate professor at the School of Medicine and Public Health from Tulane University. expert in tracking COVID-19 trends, says TODAY.com.

Although data does not yet show that the United States is facing a large COVID surge, the country is entering its 10th COVID wave since the pandemic began, Hoerger adds.

But there is much uncertainty about the severity of this year’s winter surge and how long it will last. “It’s a very risky time because a lot of people are interacting indoors, so we don’t really know how quickly transmission can intensify,” says Hoerger.

A risk of “silent” transmission during the holidays

COVID-19 sewage levels are lower than they were at this point last winter, but there has been a sharp increase over the past two weeks, according to CDC data. And cases will likely continue to rise, experts say.

“As of Friday, Dec. 20, COVID-19 levels in wastewater are moderate nationwide,” Dr. Jonathan Yoder, deputy director of the CDC’s Division of Infectious Disease Preparedness and Prevention, told TODAY.com. innovation. Wastewater data from the previous week was “weak” nationally. Levels are highest in the Midwest.

“Nationally, COVID-19 levels in wastewater increased throughout December, following a period of low levels in October and November,” adds Yoder.

National and regional trends in SARS-COV-2 wastewater viral activity levelsCDC

The CDC no longer tracks the total number of new COVID cases in the United States, but instead estimates transmission levels using wastewater surveillance, test positivity and emergency room visits.

COVID test positivity is 5.6%, up 0.5% from the previous week, according to CDC data. Emergency room visits and COVID-related deaths are also increasing very slightly.

“The problem with this winter’s wave is that it is very different from previous ones,” says Hoerger. Over the past few years, COVID has followed a similar pattern: cases surge in November, rise steadily, and peak around late December or early January.

“Normally, people would have had about a month’s warning by now, if they saw their friends and family infected,” says Hoerger. “Transmission was incredibly low in November, and so people are sort of lulled into a false sense of security.”

COVID-19 levels are rising about a month later than usual, putting the country in “uncharted territory,” according to Hoerger.

“You can think of the start of the wave as a sort of silent transmission period where people aren’t really aware of it, and it coincides with the start of holiday travel,” he explains.

Hoerger, who is the director of the Pandemic Mitigation Collective, which uses the COVID-19 forecasting model, predicts that for New Year’s gatherings, there will be a one in four chance of being exposed to COVID at a holiday party. 20 people and a 1 in 2 chance. Chance at a party is 40-50.

This wave of COVID-19 arrives late and “comes out of nowhere,” he wrote on X.

Other experts agree that infections are expected to increase in the coming weeks.

“We anticipate that these holiday gatherings and these travels and all of that will provide opportunities for an increase in COVID, as well as (flu) and RSV,” Dr. William Schaffner, professor of infectious diseases, told TODAY.com at Vanderbilt University Medical Center. .

“It’s silent (transmission) because most of these infections are pretty mild, so people don’t get tested or think of them as a cold,” Schaffner adds.

Although this year’s late summer COVID surge gave the U.S. population some immunity, that is likely starting to wane, experts say. And the variants currently in circulation, including XEC and the defunct FLiRT family, are highly transmissible.

“These current variants cause many milder infections, which go largely unnoticed,” says Schaffner, adding that people with mild or no symptoms can still transmit the virus to others.

“The transmissibility of these viruses contributes to a silent epidemic, if you like,” he says.

Where COVID is spreading in the United States

Current Level of SARS-CoV-2 Wastewater Viral Activity by State in the United StatesCDC

COVID wastewater viral activity is currently “very high” in 5 states, according to the latest CDC data. These are :

Kansas
Missouri
New Hampshire
New Mexico
South Dakota

CDC data also shows “high” levels in 16 states:

Arizona
Arkansas
District of Columbia
Illinois
Indiana
Iowa
Kentucky
Maine
Massachusetts
Minnesota
Nebraska
Ohio
Pennsylvania
Rhode Island
South Carolina
Wyoming

“If you see increased levels of COVID-19 wastewater viral activity in your area, this could indicate that there is a higher risk of infection,” Yoder says.

However, regional variations in wastewater data also depend on the number and specific location of wastewater monitoring sites that are monitoring, Hoerger says. Some states do not have data and others have limited coverage. “Take regional variations with a grain of salt,” he adds.

Overall, decreased testing and reporting delays can make it difficult to accurately track COVID-19 levels, experts note.

COVID-19 symptoms in 2024

The symptoms caused by the dominant circulating variants, XEC and KP.3.1.1, are very similar to those caused by the previous omicron subvariants, experts say.

Common symptoms of COVID-19 include:

Sore throat
Congestion
Runny nose
Cough
Fatigue
Headaches and body aches
Fever or chills
Shortness of breath
Nausea or loss of appetite
Diarrhea
Loss of sense of taste or smell

Symptoms vary from person to person. Even milder infections can be “debilitating” for several days, Schaffner says.

Although the latest variants of COVID-19 appear to cause milder illness, they can still cause severe illness requiring hospitalization. Some people are at higher risk of developing serious illness. These include people over 65, people with underlying health conditions and people who are immunocompromised.

Anytime a person is infected with COVID, they are at risk of developing long COVID, which can cause symptoms that persist and recur for weeks or months after infection, according to the CDC.

Are the new COVID boosters effective?

The COVID-19 vaccine updated for 2024-2025 is recommended by the CDC for everyone 6 months and older.

The new mRNA COVID vaccine is monovalent, meaning it targets a single variant – in this case, the KP.2 “FLiRT” variant. The strains currently circulating are closely related to KP.2, and the new booster should provide good protection, TODAY.com previously reported.

However, uptake of the new vaccine has been low so far: Only 21% of adults in the United States have been vaccinated, according to the latest CDC data.

“The best protection is to get vaccinated. Although vaccinated people are sometimes infected with the virus that causes COVID-19, staying up to date on their COVID-19 vaccinations greatly reduces the risk of getting very sick, being hospitalized, or dying from COVID-19. , explains Yoder.

How to protect yourself against COVID-19

When COVID-19 levels rise, it is important that people take steps to protect themselves and their families, according to the CDC.

You can take the following steps to avoid infection and prevent the spread of COVID-19 to others:

Stay up to date on COVID-19 vaccinations.
Test if you have symptoms or exposure.
Stay home when you are sick.
Seek treatment for COVID-19 if you are at high risk.
Wear a mask.
Practice social distancing.