This winter’s COVID-19 surge wasn’t “mild”

Wastewater surveillance data from Biobot suggests that COVID-19 spread this winter (2022-2023) was higher than all other surges prior to Omicron’s emergence.

You might have seen some headlines like this in the last few weeks: COVID-19 was “mild” this winter. This winter was “better” than previous winters. COVID-19 is becoming “another seasonal virus” like flu and RSV. But is this true?

While it’s accurate that the U.S. reported fewer COVID-19 cases this past winter compared to last year (when the country experienced our first, massive Omicron surge) or the prior year (our biggest surge pre-vaccines), this winter still saw an extraordinary amount of severe illness, death, and potential future disability due to COVID-19. Surges of other respiratory viruses also put enormous strain on the healthcare system.

If we call this winter “mild,” we run the risk of believing this level of disease is acceptable. Such portrayals of COVID-19 seek to make us think future surges will be nothing to worry about, despite clear evidence to the contrary.

Let’s go through some numbers. Since the beginning of November, the U.S. has reported:

  • More than 5 million new COVID-19 cases (reported). Note that cases are likely underreported by 10 to 20 times in our era of under-testing, so the true number may be closer to 100 million.
  • More than 400,000 new COVID-19 hospitalizations, piling on top of hospitalizations for the flu, RSV, and other diseases, and coming as hospitals deal with staff shortages and worker burnout.
  • More than 40,000 new COVID-19 deaths, amounting to more than 400 new deaths per day. This number is also likely an undercount, as death certificates can take a long time to be processed.
  • The majority of COVID-19 deaths were among vaccinated people. A report from the Kaiser Family Foundation found that breakthrough deaths started to outnumber those among unvaccinated people in summer 2022, a trend that has continued with low booster uptake.
  • Coronavirus levels in wastewater were higher than all surges prior to Omicron, including the winter surge in 2020-2021 and the Delta surge in summer 2021, according to data from Biobot.
  • XBB.1.5, the latest and most contagious Omicron subvariant, evolved in the U.S. this winter, likely in New York State. Unchecked COVID-19 spread makes it easier for the virus to keep mutating.
  • More than 5% of American adults are currently experiencing Long COVID. This number has ranged from 5.5% to 7% since September 2022, according to the CDC and Census’ Household Pulse Survey.
  • Almost 80% of adults with Long COVID report activity limitations due to the condition, including about 25% who report “significant” activity limitations, per the Household Pulse Survey.

In an average week this winter, the U.S. reported more deaths from COVID-19 than the number of casualties on September 11, 2001. The latter event was a horrific tragedy that inspired lasting changes to national security, while the former has been written off as “mild.”

Past surveys from many sources—including the CDC itself—have suggested that, when people know COVID-19 is spreading widely in their communities, they’re willing to take basic safety precautions. But when government leaders and mainstream media outlets downplay the risks, people don’t have the information they need to make informed choices. We’ve seen this pattern at a large scale this winter, and I worry that the trend will only continue.

And here’s what concerns me even more: in previous winters, cases went up over the holidays, then declined through January and February. This year, however, the decline isn’t really happening. Transmission has gone down a bit from its peak, but it’s now plateaued at a level higher than the peaks of previous surges, per Biobot’s data.

So, not only did we have a bad surge this winter, we’re now stuck at a high-COVID baseline that seems very difficult to shake, in the era of many new variants and few public health precautions. The situation reminds me of a Twitter thread from the evolutionary biologist T. Ryan Gregory, which I shared when writing about XBB.1.5 in early January:

That “area under the curve” is what the U.S. is seeing now, as COVID-19 spread stays at high levels. Thousands of cases a day, thousands of hospitalizations a day, hundreds of deaths a day.

As a journalist and as an individual capable of taking precautions, I resist the narrative that any of this is acceptable. If you’re reading this, I hope you can, too.

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