COVID-19 cases, hospitalizations resume upward rise; CDC classifies numerous Northeast counties as 'high' risk

Reported cases of COVID-19 and hospitalizations for the disease are on the rise across most of the U.S., with the Centers for Disease Control and Prevention (CDC) recently shifting many counties in the Northeast to medium or high levels of community risk.

Per public data published on the CDC’s website, daily reported cases are moving upward and reached a seven-day average of 66,564 as of May 8. According to a New York Times state-level breakdown of government data updated Tuesday, 46 states have seen their daily case counts increase over the last two weeks.

The average of newly reported cases had bottomed out in late March at just under 25,000 daily cases after exceeding more than 800,000 during January’s omicron surge.

COVID-19 hospitalizations—which have become the CDC and other public health experts’ preferred metric for decisionmaking—have similarly begun to tick upward over the past month.

After reaching a seven-day average low of 1,426 daily admissions in early April, national admissions have continually increased and exceeded the seven-day average of 2,400 daily hospitalizations late last week. These new admissions represented an 11% increase over the previous week’s seven-day average, according to the agency, but were still nearly 90% below the January peak of more than 21,500 average daily admissions.

Per the NYT, 37 states have seen their daily COVID-19 hospitalizations rise over the past 14 days with the largest percentage increases recorded in Montana (88% increase), Hawaii (81% increase) and Maine (68% increase). More than 19,000 people across the U.S. are reported to be currently hospitalized with COVID-19, a 20% 14-day increase.

National daily COVID-19 deaths are roughly flat at a seven-day average of about 330 as of late last week, according to the CDC. These had been on the decline since early February and generally lag trends seen in the other two COVID-19 metrics.

The shift in cases and hospitalizations has led the CDC to adjust its masking and prevention guidance for dozens of U.S. counties.

Under its COVID-19 community level tracker—a tool unveiled in late February that incorporates community transmission, new hospitalizations and healthcare facility capacity—2.45% of U.S. counties are now considered to be high risk and 9.86% are considered to be medium risk as of a May 5 weekly update. Although patches of medium- or high-risk counties are scattered across the country, the majority are clustered in Northeast states including New York, Massachusetts, Vermont, Maine and Connecticut.

Counties that are designated as high risk are projected to see a decline in intensive care unit capacity and increases in hospitalizations and deaths within the coming three to six weeks, CDC leaders said when introducing the tracker. CDC recommends indoor masking rules and other prevention measures for counties designated as high risk.

Federal public health leaders including National Institute of Allergy and Infectious Diseases Director Anthony Fauci, M.D., and White House Coronavirus Response Coordinator Ashish Jha, M.D., have recently said they expect cases and hospitalizations to rise in the coming weeks, albeit not to the extent of January’s omicron surge.

At that time, many hospitals and health systems faced their largest burden of COVID-19 patients to date, leading to greater utilization of contract labor services, higher costs and, in some cases, service line shutdowns.

The public health leaders' greater concern, especially during the later part of the year, are the states outside of the Northeast where testing is more limited and vaccination rates are lower, they said.

Federal health agencies and the Biden administration continue to warn Congress that the long-term pandemic response, such as an additional booster shot for the broader population, will be in jeopardy without additional funding.

Democratic lawmakers had recently looked to pair the next round of COVID-19 money with more widely supported funds for Ukraine, but ultimately split the two at the urging of President Joe Biden.

“However let me be clear: As vital as it is to help Ukraine combat Russian aggression, it is equally vital to help Americans combat COVID,” the president said in a statement Monday.

“Without timely COVID funding, more Americans will die needlessly.  We will lose our place in line for America to order new COVID treatments and vaccines for the fall, including next-generation vaccines under development, and be unable to maintain our supply of COVID tests. In the fall, if we are hit by new variants, it will be too late to get the tools needed for protection,” he said.

As cases and hospitalizations creep upward, the healthcare industry’s eyes are also on whether the Department of Health and Human Services (HHS) will again decide to renew the public health emergency.

Should it be allowed to expire, millions of Americans could lose coverage through Medicaid and other public programs, providers would again be required to meet various licensure and reporting requirements that had been waived, and other aid funding directed toward the industry would run dry.

HHS Secretary Xavier Becerra has promised stakeholders that his department would provide at least 60 days of notice should it decide to let the public health emergency expire. With the emergency currently slated to run through mid-July, that 60-day deadline is set to pass at the end of this week or early next.