Winter usually brings its share of runny noses, and this season has been no exception. What has long been known as cold and flu season now typically includes a surge of COVID-19. But just how big of a surge are we dealing with?
It’s a harder question to answer in 2024 than it was in the pandemic’s early years, when laboratory-confirmed tests for COVID were common. A glance at Austin Public Health’s COVID-19 surveillance dashboard shows low numbers of positive tests in recent months compared to earlier stages of the pandemic. But now that many folks use home tests, laboratory testing data paints a limited picture of COVID activity.
Heather Cooks-Sinclair, the epidemiology and disease surveillance unit manager at APH, said she now uses a patchwork of data sources to assess COVID trends.
“[COVID] isn’t the only disease for which we have a limited amount of data that’s coming in; flu has been with us for years and years,” Cooks-Sinclair said. “We have to have a variety of different metrics that kind of give us a picture of what the overall thing is.”
One metric Cooks-Sinclair says is valuable is something called the “influenza-like illness” rate, or ILI. ILI is the percentage of patients seen by local health care providers who present with a fever of 100 degrees or higher and cough or sore throat — symptoms that could indicate flu, COVID or other respiratory illnesses. In the Austin-Round Rock area, ILI activity is high, according to the most recent Centers for Disease Control & Prevention report from Jan. 13, but on a downward trend from late December.
Wastewater adds context — with caveats
Another important tool is wastewater data, which represents the concentration of COVID found in wastewater samples from various sites. As of Jan. 11, aggregated CDC data shows very high viral activity in wastewater in Texas and many other states. On Jan. 5, the CDC said wastewater activity was 27% higher than it was a year prior, making it the highest activity measured since the initial Omicron surge of early 2022. The most common variant detected now is JN.1, a descendent of the original Omicron variant.
However, there have been challenges over the past couple of months getting useful data from local wastewater collection sites in Travis County. After the CDC contracted with a new wastewater data provider last fall, there was a lag in Travis County data. Several wastewater testing sites run by Austin Water are now active again, but show conflicting trends from the past month.
Cooks-Sinclair said APH needs to see a longer data history before she will consider it reliable.
“I would love to be able to say that I have really great wastewater data and to be able to provide you with trends and what they mean — but that’s just not what we have right now,” she said.
From a public health perspective, Cooks-Sinclair said hospital admission rates are still one of the most valuable metrics. Currently, the CDC considers Travis County hospital admission rates to be low, although Cooks-Sinclair pointed out that rates are rising. And while the CDC notes that deaths associated with COVID have increased in recent weeks, it also reports that COVID hospitalizations and deaths are substantially lower year-over-year.
Recommendations
Regardless of what the data show at a nitty-gritty level, Cooks-Sinclair said her advice is the same as it is during any winter respiratory season.
“Our message for flu season is you stay home if you're sick, you cover your cough, you wash your hands, you get vaccinated for both COVID and flu,” she said.
Updated COVID vaccines from Pfizer and Moderna were released last fall and remain available. In addition to lowering the risk of severe disease from COVID, research suggests that vaccinated individuals are less likely to develop long-term effects from the virus such as long COVID.
Cooks-Sinclair also recommends following CDC guidance for masking and isolating if you are exposed to COVID or test positive for the virus.
A limited number of free tests per household are available for order at USPS.com.
