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  • #16
    1. CASES, DATA & SURVEILLANCE
    COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


    Updated July 10, 2020
    Print
    Download Weekly Summary pdf icon[13 Pages, 1 MB]
    Key Updates for Week 27, ending July 4, 2020


    Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) activity continue to increase overall. The percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, decreased slightly from last week; however, this past week included a holiday, which could impact both testing and reporting. Mortality attributed to COVID-19 decreased compared to last week and is currently at the epidemic threshold but will likely increase as additional death certificates are processed.
    Virus

    Public Health, Commercial and Clinical Laboratories


    The overall percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from week 26 (9.2%) to week 27 (8.8%) nationally but increased in five regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory:
    • Public health laboratories – decreased from 6.4% during week 26 to 6.0% during week 27;
    • Clinical laboratories – increased from 5.7% during week 26 to 8.0% during week 27;
    • Commercial laboratories – decreased from 9.9% during week 26 to 9.4% during week 27.
    Outpatient and Emergency Department Visits

    Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


    Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
    • Nationally, levels of ILI activity remain below baseline for the twelfth week and in all 10 surveillance regions for the past ten to thirteen weeks. However, most regions reported increases in percentage of visits for ILI, which is atypical for this time of year, and some parts of the country are seeing activity levels higher than levels seen in March and April. CLI also increased this past week.
    • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
    Severe Disease

    Hospitalizations


    Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 107.2 per 100,000, with the highest rates in people aged 65 years and older (316.9 per 100,000) and 50-64 years (161.7 per 100,000).
    Mortality


    Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 6.9% during week 26 to 5.5% during week 27, representing the eleventh week of a declining percentage of deaths due to PIC. The percentage is currently below the epidemic threshold but will likely change as more death certificates are processed, particularly for recent weeks.

    All data are preliminary and may change as more reports are received.

    A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
    Key Points
    • There are increases in the percentage of specimens testing positive for SARS-CoV-2 and percentage of visits for ILI or CLI in multiple parts of the country. Three HHS regions (Regions 4 [South East], 6 [South Central] and 9 [South West/Coast]) are reporting percentage of visits for CLI and/or percentage of specimens testing positive for SARS-CoV-2 at higher levels than was seen in March/April.
    • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased slightly from week 26 (9.2%) to week 27 (8.8%).
      • Increases were reported in five of ten HHS surveillance regions: Regions 2 (NY/NJ/Puerto Rico), 4 (South East), 5 (Midwest), 6 (South Central), and 7 (Central).
        • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (14.1%), 6 (16.8%) and 9 (11.3%).
      • Five regions (Regions 1 [New England], 3 [Mid-Atlantic], 8 [Mountain], 9 [South West/Coast] and 10 [Pacific Northwest] reported a stable or decreasing percentage of specimens testing positive for SARS-CoV-2.
    • The percentage of outpatient and emergency department visits for ILI are below baseline nationally and in all regions of the country; however, increases in the percentage of visits for ILI and/or CLI were reported in seven of ten HHS surveillance regions, with the largest increases in Regions 4 (South East), 6 (South Central) and 9 (South West/Coast).
      • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing.
    • The overall cumulative COVID-19 associated hospitalization rate is 107.2 per 100,000, with the highest rates in people 65 years of age and older (316.9 per 100,000) followed by people 50-64 years (161.7 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
      • Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.7 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.7 times that of non-Hispanic White persons, and Hispanic or Latino persons have a rate approximately 4.6 times that of non-Hispanic White persons.
      • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
      • For people 65 years and older, current cumulative COVID-19 hospitalization rates at this time are higher than cumulative end-of season hospitalization rates for influenza for 4 of the 5 past influenza seasons; lower only than rates observed during the 2017-18 season.
      • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
    • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 6.9% during week 26 to 5.5% during week 27, representing the eleventh consecutive week during which a declining percentage of deaths due to PIC has been recorded. The percentage is currently below the epidemic threshold but will likely change as additional death certificates for deaths during recent weeks are processed.

    *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

    U.S. Virologic Surveillance


    The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
    1,723,770 22,622,762
    227,484 2,693,456
    134,818 2,194,464
    1,361,468 17,734,842
    151,949 (8.8%) 2,176,626 (9.6%)
    13,589 (6.0%) 233,973 (8.7%)
    10,837 (8.0%) 136,501 (6.2%)
    128,077 (9.4%) 1,806,152 (10.2%)
    * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
    Public Health Laboratories


    resize iconView LargerView Data Table

    Clinical Laboratories


    resize iconView LargerView Data Table

    Commercial Laboratories


    resize iconView Larger


    * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
    View Data Table


    Additional virologic surveillance information: Surveillance Methods


    Outpatient/Emergency Department Illness


    Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
    ILINet


    The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

    Nationwide during week 27, 1.2% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but is increasing, which is atypical for this time of year compared to previous influenza seasons. The pattern of increasing percentage of visits for ILI was reported for all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

    resize iconView Larger


    * Age-group specific percentages should not be compared to the national baseline.

    On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 2.2% during week 27. All ten regions are below their region-specific baselines; however, Region 4 (South East) increased from 1.7% during week 26 to 2.1% during week 27, Region 6 (South Central) increased from 1.9% to 2.2%, Region 7 (Central) increased from 0.8% to 0.9%, and Region 10 (Pacific Northwest) increased from 0.7% to 0.8%; Regions 2 (NY/NY/PR) and 8 (Mountain) also reported slight increases.

    Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
    Overall Percentage of Visits for ILI | Age Group ILI Data

    ILI Activity Levels


    Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

    The number of jurisdictions at each activity level during week 26 and the change compared to the previous week are summarized in the table below and shown in the following maps.
    Activity Level Number of Jurisdictions
    Week 27
    (Week ending
    July 4, 2020)
    Compared to Previous Week
    Very High 0 No change
    High 0 No change
    Moderate 0 No change
    Low 3 +2
    Minimal 50 -2
    Insufficient Data 1 No change
    *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
    National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


    NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

    Nationwide during week 27, 3.2% of emergency department visits captured in NSSP were due to CLI and 1.0% were due to ILI. This is the third week of an increasing percentage of visits for CLI and ILI nationally since activity peaked in early April. Compared to week 26, 5 of 10 HHS regionsexternal icon (Regions 4 [South East], 6 [South Central], 7 [Central], 9 [South West/Coast] and 10 [Pacific Northwest]) reported increases in the percentages of visits for both CLI and ILI during week 27. Region 3 (Mid-Atlantic) reported a slight increase in percentage of visits for ILI during week 27, and Region 5 (Midwest) reported an increase in the percentage of visits for ILI during week 27.



    Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


    Hospitalizations


    The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

    A total of 34,791 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and July 4, 2020. The overall cumulative hospitalization rate was 107.2 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged ≥ 65, followed by adults aged 50-64 years and adults aged 18-49 years.

    resize iconView Larger
    Overall 107.2
    0-4 years 9.4
    5-17 years 4.4
    18-49 years 66.7
    18-29 years 37.8
    30-39 years 66.3
    40-49 years 104.4
    50-64 years 161.7
    65+ years 316.9
    65-74 years 230.6
    75-84 years 381.5
    85+ years 590.3
    Among the 34,791 laboratory-confirmed COVID-19-associated hospitalized cases, 32,766 (94.2%) had information on race and ethnicity while collection of race and ethnicity was still pending for 2,025 (5.8%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.8 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.7 times that of non-Hispanic White persons, and Hispanic or Latino persons have a rate approximately 4.6 times that of non-Hispanic White persons.



    When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic white persons in the same age group, crude hospitalization rates were 8.7 times higher among Hispanic or Latino persons aged 0-17 years; 11.2 times higher among non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 9.9 times higher among non-Hispanic Black persons aged 50-64 years; and 7.0 times higher among non-Hispanic Black person aged ≥65 years. Additional data on race and ethnicity by age are available.
    Age Category Non-Hispanic
    American Indian or Alaska Native
    Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
    Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2
    0-17y 5.9 4.5 6.4 4.9 11.3 8.7 3.4 2.6 1.3 1.0
    18-49y 185.4 11.2 110.5 6.7 132.7 8.0 28.4 1.7 16.5 1.0
    50-64y 474.2 8.1 583.2 9.9 201.2 3.4 92.8 1.6 58.8 1.0
    65+y 584.2 3.1 1328.6 7.0 209.7 1.1 212.5 1.1 189.5 1.0
    Overall rate3 (age-adjusted) 270.5 5.8 221.5 4.7 215.8 4.6 60.5 1.3 47.0 1.0
    1COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
    2For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
    3Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

    Non-Hispanic White persons and non-Hispanic Black persons represent the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
    1.6% 32.6% 22.4% 4.7% 32.2%
    0.7% 17.7% 14.0% 8.8% 58.8%
    2.3 1.8 1.6 0.5 0.5
    1 Persons of multiple races (0.2%) or unknown race and ethnicity (5.8%) are not represented in the table but are included as part of the denominator.
    2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

    Among 9,130 hospitalized adults with information on underlying medical conditions, 90.9% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease. Among 186 hospitalized children with information on underlying conditions, 51.6% had at least one reported underlying medical condition. The most commonly reported were obesity, asthma, and neurologic conditions.

    resize iconView Larger


    Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

    Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


    Mortality Surveillance


    The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on July 9, 2020, 5.5% of all deaths occurring during the week ending July 4, 2020 (week 27) were due to pneumonia, influenza or COVID-19 (PIC). This is the eleventh consecutive week of a declining percentage of deaths due to PIC. The percentage is below the epidemic threshold of 5.8% for week 27, but above the baseline of 5.4%. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

    Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

    resize iconView Larger


    *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
    View Data Table


    Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

    More Information
    View Page In:pdf icon 13 Pages, 1 MB
    Page last reviewed: July 10, 2020
    Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

    https://www.cdc.gov/coronavirus/2019...iew/index.html
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #17
      1. CASES, DATA & SURVEILLANCE
      COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


      Updated July 17, 2020
      Print
      Download Weekly Summary pdf icon[14 Pages, 1 MB]
      Key Updates for Week 28, ending July 11, 2020


      Nationally, levels of influenza-like illness (ILI) are low overall, but high for this time of year. Changes in indicators that track COVID-19-like illness (CLI) and laboratory confirmed SARS-CoV-2 were inconsistent during the most recent week, with some increasing but others decreasing. This could be due to changes in healthcare seeking behavior around the holiday that occurred during week 27. However, in several regions, those indicators increased compared to the previous week (week 26), suggesting an increasing trend in many areas of the country. Hospitalizations rates, which typically lag behind illness indicators, show an increasing trend. Mortality attributed to COVID-19 decreased compared to last week but is currently above the epidemic threshold and will likely increase as additional death certificates are processed.
      Virus

      Public Health, Commercial and Clinical Laboratories


      Nationally, the overall percentage of respiratory specimens testing positive for SARS-CoV-2 decreased slightly from week 27 (9.4%) to week 28 (9.2%) but increased in four regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory:
      • Public health laboratories – increased from 6.0% during week 27 to 7.9% during week 28;
      • Clinical laboratories – increased from 6.7% during week 27 to 8.1% during week 28;
      • Commercial laboratories – decreased from 10.2% during week 27 to 9.6% during week 28.
      Outpatient and Emergency Department Visits

      Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


      Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
      • Nationally, ILI activity remains below baseline for the thirteenth week but has increased for 5 weeks now and is atypically high for this time of year. During week 28, most regions reported increases in the percentage of visits for ILI, and several regions also reported increases in CLI activity.
      • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
      Severe Disease

      Hospitalizations


      Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 113.6 per 100,000, with the highest rates in people aged 65 years and older (321.8 per 100,000) and 50-64 years (171.8 per 100,000). From June 20 – July 4, there was a two week consecutive increase in overall weekly hospitalization rates, the first multiple-week increase seen since early April.
      Mortality


      Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 8.1% during week 27 to 6.4% during week 28, representing the twelfth week of a declining percentage of deaths due to PIC. The percentage is currently above the epidemic threshold and will likely change as more death certificates are processed, particularly for recent weeks.

      All data are preliminary and may change as more reports are received.

      A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
      Key Points
      • There are increases in the percentage of specimens testing positive for SARS-CoV-2 and percentage of visits for ILI and/or CLI in multiple parts of the country. Three HHS regions (Regions 4 [South East], 6 [South Central] and 9 [South West/Coast]) are reporting percentage of visits for CLI and/or percentage of specimens testing positive for SARS-CoV-2 at higher levels than were seen in March/April.
      • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased slightly from week 27 (9.4%) to week 28 (9.2%).
        • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 14.0%), 6 (South Central, 17.1%) and 9 (South West/Coast, 11.2%).
        • Increases were reported in four of ten HHS surveillance regions: Regions 2 (NY/NJ/Puerto Rico), 5 (Midwest), 7 (Central) and 8 (Mountain).
        • Six HHS regions (Regions 1 [New England], 3 [Mid-Atlantic], 4 [South East], 6 [South Central], 9 [South West/Coast] and 10 [Pacific Northwest]) reported a stable or decreasing percentage of specimens testing positive for SARS-CoV-2 during week 28 compared to week 27. However, the percentage of specimens testing positive for SARS-CoV-2 in Regions 4 (South East) and 6 (South Central) were higher during week 28 than week 26. Week 27 included a holiday that could have affected both testing and reporting practices during that week.
      • The percentage of outpatient and emergency department visits for ILI are below baseline nationally and in all regions of the country; however, increases in the percentage of visits for ILI and/or CLI were reported in seven of ten HHS surveillance regions when compared to week 27 and in nine surveillance regions when compared to week 26. This could be due to changes in healthcare seeking behavior around the holiday that occurred during week 27.
        • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing.
      • The overall cumulative COVID-19 associated hospitalization rate is 113.6 per 100,000, with the highest rates in people 65 years of age and older (321.8 per 100,000) followed by people 50-64 years (171.8 per 100,000). Hospitalization rates are cumulative and will increase as the pandemic continues.
        • From week 25 – week 27 (June 20 – July 4), there was a two consecutive week increase in overall weekly hospitalization rates. This is the first time since early April that an increase in weekly hospitalization rates has been observed over a multiple-week period.
        • Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.6 times that of non-Hispanic White persons and non-Hispanic Black persons and Hispanic or Latino persons have a rate approximately 4.6 times that of non-Hispanic White persons.
        • Overall cumulative hospitalization rates for COVID-19 at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons. However, for children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates during recent influenza seasons.
      • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 8.1% during week 27 to 6.4% during week 28, representing the twelfth consecutive week during which a declining percentage of deaths due to PIC has been recorded. The percentage is currently above the epidemic threshold and will likely change as additional death certificates for deaths during recent weeks are processed.

      U.S. Virologic Surveillance


      The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
      1,650,622 25,502,956
      249,261 3,002,829
      141,569 2,507,197
      1,259,792 19,992,930
      151,503 (9.2%) 2,461,009 (9.6%)
      19,680 (7.9%) 256,823 (8.6%)
      11,512 (8.1%) 158,150 (6.3%)
      120,311 (9.6%) 2,046,036 (10.2%)
      * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
      Public Health Laboratories


      resize iconView LargerView Data Table

      Clinical Laboratories


      resize iconView LargerView Data Table

      Commercial Laboratories


      resize iconView Larger


      * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
      View Data Table


      Additional virologic surveillance information: Surveillance Methods


      Outpatient/Emergency Department Illness


      Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
      ILINet


      The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥ 100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

      Nationwide during week 28, 1.4% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but is increasing, which is atypical for this time of year compared to previous influenza seasons. The pattern of increasing percentage of visits for ILI was reported for 0-4 year olds and persons 25 years of age and older.

      resize iconView Larger


      * Age-group specific percentages should not be compared to the national baseline.

      On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 2.3% during week 28. All ten regions are below their region-specific baselines; however, compared to week 27, the percentage of visits for ILI during week 28 increased in seven of the ten regions (Regions 2 [NY/NJ/PR], 3 [Mid-Atlantic], 4 [South East], 5 [Midwest], 7 [Central], 8 [Mountain], and 9 [South/West Coast] and remained stable in two regions (Regions 1 [New England] and 10 [Pacific Northwest]). In Regions 6 (South Central) and 10 [Pacific Northwest), the percentage of visits for ILI reported during week 28 was less than or the same as the percentage reported during week 27 but greater than the percentage reported for week 26. This could be due to changes in healthcare seeking behavior around the holiday that occurred during week 27.

      Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
      Overall Percentage of Visits for ILI | Age Group ILI Data

      ILI Activity Levels


      Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

      The number of jurisdictions at each activity level during week 28 and the change compared to the previous week are summarized in the table below and shown in the following maps.
      Activity Level Number of Jurisdictions
      Week 28
      (Week ending
      July 11, 2020)
      Compared to Previous Week
      Very High 0 No change
      High 0 No change
      Moderate 2 +2
      Low 3 No change
      Minimal 46 -4
      Insufficient Data 3 +2
      *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
      National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


      NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

      Nationwide during week 28, 3.5% of emergency department visits captured in NSSP were due to CLI and 1.1% were due to ILI. In comparison to week 27, this week there was a slight decrease in the percentage of visits for CLI and ILI remained steady. However, both CLI and ILI percentages during week 28 were higher than they were in week 26. This could be due to changes in healthcare seeking behavior around the holiday that occurred during week 27.

      During week 28, five of 10 HHS regionsexternal icon (Regions 3 [Mid-Atlantic], 4 [South East], 5 [Midwest], 7 [Central], and 8 [Mountain]) reported a stable or increasing percentages of visits for both CLI and ILI compared to week 27. Three regions (Regions 6 [South Central], 9 [South/West Coast], and 10 [Pacific Northwest] reported a decreasing percentage of visits for CLI and ILI during week 28 compared to week 27 but the week 28 percentage of visits for CLI and/or ILI was higher than what was reported for week 26. This could be due to changes in healthcare seeking behavior around the holiday that occurred during week 27. Regions 1 (New England) and 2 (NY/NJ/PR) have not reported an increase in CLI or ILI in recent weeks.



      Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


      Hospitalizations


      The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

      A total of 37,052 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and July 11, 2020. The overall cumulative hospitalization rate was 113.6 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and 65 years age groups, the highest rate of hospitalization is among adults aged 65, followed by adults aged 50-64 years and adults aged 18-49 years.

      resize iconView Larger
      Overall 113.6
      0-4 years 10.6
      5-17 years 5.3
      18-49 years 72.4
      18-29 years 42.7
      30-39 years 70.9
      40-49 years 112.5
      50-64 years 171.8
      65+ years 321.8
      65-74 years 236.1
      75-84 years 382.1
      85+ years 607.3
      From June 20 (MMWR week 25) – July 4 (MMWR week 27), there was a two consecutive week increase in overall weekly hospitalization rates. This is the first time since early April that an increase in weekly hospitalization rates has been observed over a multiple-week period. Data for week ending July 11 (MMWR week 28) currently show a decline; however, those data are likely to change as more data for admissions occurring during that week are received.

      resize iconView Larger
      Among the 37,052 laboratory-confirmed COVID-19-associated hospitalized cases, 34,669 (93.6%) had information on race and ethnicity while collection of race and ethnicity was still pending for 2,383 (6.4%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.6 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons were approximately 4.6 times the rate among non-Hispanic White persons.



      When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic white persons in the same age group, crude hospitalization rates were 8.1 times higher among Hispanic or Latino persons persons aged 0-17 years; 10.6 times higher among non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 7.6 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black person aged ≥ 65 years.
      Age Category Non-Hispanic
      American Indian or Alaska Native
      Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
      Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2
      0-17y 7.8 4.6 8.2 4.8 13.8 8.1 3.6 2.1 1.7 1.0
      18-49y 201 10.6 107.7 5.7 177.7 9.4 31.9 1.7 18.9 1.0
      50-64y 491.8 7.6 353.8 5.5 387.4 6.0 102.8 1.6 64.9 1.0
      65+y 593 3.0 743.1 3.8 474.6 2.4 196.1 1.0 196.3 1.0
      Overall rate3 (age-adjusted) 273.0 5.6 227.1 4.6 224.2 4.6 62.7 1.3 49.0 1.0
      1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
      2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
      3 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

      Non-Hispanic White persons and non-Hispanic Black persons represent the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
      1.5% 32.6% 22.7% 4.8% 32.0%
      0.7% 17.7% 14.0% 8.8% 58.8%
      2.1 1.8 1.6 0.5 0.5
      1 Persons of multiple races (0.2%) or unknown race and ethnicity (6.1%) are not represented in the table but are included as part of the denominator.
      2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

      Among 9,736 hospitalized adults with information on underlying medical conditions, 90.9% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease and cardiovascular disease. Among 199 hospitalized children with information on underlying conditions, 51.3% had at least one reported underlying medical condition. The most commonly reported were obesity, asthma and neurologic conditions.

      resize iconView Larger


      Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

      Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


      Mortality Surveillance


      The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on July 16, 2020, 6.4% of all deaths occurring during the week ending July 11, 2020 (week 28) were due to pneumonia, influenza or COVID-19 (PIC). This is the twelfth consecutive week of a declining percentage of deaths due to PIC. The percentage is above the epidemic threshold of 5.7% for week 28. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

      Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

      resize iconView Larger


      *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
      View Data Table


      Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

      More Information
      View Page In:pdf icon 14 Pages, 1 MB
      Page last reviewed: July 17, 2020
      Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillanceemail_03Get Email Updates

      To receive email updates about COVID-19, enter your email address:
      Email Address
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      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #18
        1. CASES, DATA & SURVEILLANCE
        COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


        Updated July 24, 2020
        Print
        Download Weekly Summary pdf icon[14 Pages, 1 MB]
        Key Updates for Week 29, ending July 18, 2020


        Nationally, levels of influenza-like illness (ILI) are below baseline, but higher than typically seen at this time of year. Indicators that track COVID-19-like illness (CLI) and laboratory confirmed SARS-CoV-2 showed decreases from week 28 to week 29 nationally; however there were regional differences. Areas of the country with high levels of CLI and laboratory confirmed SARS-CoV-2 in recent weeks (Regions 4 [South East], 6 [South Central] and 9 [South West/ Coast]) are starting to show signs of decreasing activity whereas other parts of the country (Regions 7 [Midwest], 5 [Central] and 8 [Mountain]) are increasing. Hospitalization rates show an increasing trend. Mortality attributed to COVID-19 remains above the epidemic threshold and increased slightly during the first two weeks of July after declining for 11 weeks since mid-April.
        Virus

        Public Health, Commercial and Clinical Laboratories


        Nationally, the overall percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from week 28 (9.3%) to week 29 (8.6%) but increased in four regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory:
        • Public health laboratories – increased from 7.5% during week 28 to 8.0% during week 29;
        • Clinical laboratories – decreased from 7.2% during week 28 to 5.7% during week 29;
        • Commercial laboratories – decreased from 9.9% during week 28 to 9.1% during week 29.
        Outpatient and Emergency Department Visits

        Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


        Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
        • Nationally, ILI activity remains below baseline for the fourteenth week but is higher than typically seen at this time of year.
        • During week 29, most regions had only slight changes in the percentage of visits for ILI or CLI; however, Regions 4 (South East), 6 (South Central) and 9 (South West/ Coast) reported a decrease in the percentage of visits for CLI.
        • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
        Severe Disease

        Hospitalizations


        Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 120.9 per 100,000, with the highest rates in people aged 65 years and older (338.2 per 100,000) and 50-64 years (182.3 per 100,000). From June 20 – July 11, overall weekly hospitalization rates increased for three consecutive weeks.
        Mortality


        Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (June 27 – July 11) for the first time since mid-April. The percentage for week 29 is 9.1% and currently lower than the percentage during week 28 (11.5%); however,the percentage remains above the epidemic threshold. These percentages will likely change as more death certificates are processed.

        All data are preliminary and may change as more reports are received.

        A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
        Key Points
        • There are increases in the percentage of specimens testing positive for SARS-CoV-2 and the percentage of visits for ILI and/or CLI in multiple parts of the country. Three HHS regions (Regions 4 [South East], 6 [South Central] and 9 [South West/Coast]) are reporting percentage of visits for CLI and/or percentage of specimens testing positive for SARS-CoV-2 at higher levels than were seen in March/April, but these regions are starting to show evidence of declines in activity following the early July peak.
        • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from week 28 (9.3%) to week 29 (8.6%).
          • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 13.9%), 6 (South Central, 15.7%) and 9 (South West/Coast, 9.7%).
          • Increasing trends in the percentage of specimens testing positive for SARS-CoV-2 were reported in four of ten HHS surveillance regions: Regions 2 (NY/NJ/Puerto Rico), 5 (Midwest), 7 (Central) and 8 (Mountain).
        • The percentage of outpatient and ED visits for ILI are below baseline nationally and in all regions of the country; however, ILI activity is above what is typical for this time of year. The percentage of visits to EDs for CLI decreased nationally and in the 3 regions (Region 4 [South East], 6 [South Central] and 9 [South West/ Coast] that were previously reporting the highest levels of CLI activity. CLI remained stable in the remaining areas of the country.
          • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing.
        • The overall cumulative COVID-19-associated hospitalization rate is 120.9 per 100,000; rates were highest in people 65 years of age and older (338.2 per 100,000) followed by people 50-64 years (182.3 per 100,000). Hospitalization rates are cumulative and will increase as the pandemic continues.
          • From week 25 – week 28 (weeks ending June 20 – July 11), overall weekly hospitalization rates increased for three consecutive weeks.
          • Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.3 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons are approximately 4.7 and 4.6 times the rate among non-Hispanic White persons, respectively.
          • Over a period of time similar to the length of an influenza season, overall cumulative hospitalization rates for COVID-19 are higher than cumulative end-of-season hospitalization rates for influenza for each of the past 5 influenza seasons. However, for children (0-17 years), cumulative COVID-19 hospitalization rates are lower than cumulative influenza hospitalization rates during recent influenza seasons.
        • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (weeks ending June 27 – July 11) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 29 is 9.1%, lower than the percentage during week 28 (11.5%), but above the epidemic threshold. These percentages will likely change as more death certificates are processed.

        U.S. Virologic Surveillance


        The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
        1,796,223 28,745,587
        246,839 3,342,648
        168,389 2,834,547
        1,380,995 22,568,392
        155,204 (8.6%) 2,762,464 (9.6%)
        19,771 (8.0%) 285,259 (8.5%)
        9,615 (5.7%) 177,956 (6.3%)
        125,818 (9.1%) 2,299,249 (10.2%)
        * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
        Public Health Laboratories


        resize iconView LargerView Data Table

        Clinical Laboratories


        resize iconView LargerView Data Table

        Commercial Laboratories


        resize iconView Larger


        * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
        View Data Table


        Additional virologic surveillance information: Surveillance Methods


        Outpatient/Emergency Department Illness


        Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
        ILINet


        The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥ 100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

        Nationwide during week 29, 1.4% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 28, the percentage of visits for ILI during week 29 was slightly higher for 0-4 year olds but slightly lower for all other age groups.

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        * Age-group specific percentages should not be compared to the national baseline.

        On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 2.2% during week 29. All ten regions are below their region-specific baselines and reported only slight fluctuations in the percentrage of visits for ILI during week 29 compared to week 28.

        Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
        Overall Percentage of Visits for ILI | Age Group ILI Data

        ILI Activity Levels


        Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

        The number of jurisdictions at each activity level during week 29 and the change compared to the previous week are summarized in the table below and shown in the following maps.
        Activity Level Number of Jurisdictions
        Week 29
        (Week ending
        July 18, 2020)
        Compared to Previous Week
        Very High 0 No change
        High 0 No change
        Moderate 2 No change
        Low 3 +1
        Minimal 48 -1
        Insufficient Data 1 No change
        *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
        National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


        NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

        Nationwide during week 29, 3.5% of emergency department visits captured in NSSP were due to CLI and 1.0% were due to ILI. In comparison to week 28, this week there was a decrease in the percentage of visits for both CLI and ILI. However, the percentage of visits for CLI increased from week 23 through week 28, and trends presented this week may change as more ED visit data are received.

        During week 29, seven of ten HHS regionsexternal icon (Regions 1 [New England], 2 [NY/NJ/Puerto Rico], 3 [Mid-Atlantic], 5 [Midwest], 7 [Central], 9 [Mountain] and 10 [Pacific Northwest]) reported only slight fluctuations in percentage of visits for CLI compared to week 28. Three regions (Regions 4 [South East], 6 [South Central] and 9 [South West/Coast]) that have been reporting elevated levels of CLI for several weeks, reported declines in week 29 compared to week 28.



        Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


        Hospitalizations


        The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

        A total of 39,432 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and July 18, 2020. The overall cumulative hospitalization rate is 120.9 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged ≥ 65, followed by adults aged 50-64 years and adults aged 18-49 years.

        resize iconView Larger
        Overall 120.9
        0-4 years 11.2
        5-17 years 5.8
        18-49 years 78.6
        18-29 years 47.1
        30-39 years 77.2
        40-49 years 121.0
        50-64 years 182.3
        65+ years 338.2
        65-74 years 249.6
        75-84 years 400.1
        85+ years 635.1
        From June 20 (MMWR week 25) – July 11 (MMWR week 28), overall weekly hospitalization rates increased for three consecutive weeks. . Data for the week ending July 18 (MMWR week 29) currently show a decline; however, those data are likely to change as more data for admissions occurring during that week are received.

        resize iconView Larger
        Among the 39,432 laboratory-confirmed COVID-19-associated hospitalized cases, 37,108 (94.1%) have information on race and ethnicity, while collection of race and ethnicity is still pending for 2,324 (5.9%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.3 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons are approximately 4.7 and 4.6 times the rate among non-Hispanic White persons, respectively.



        When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic white persons in the same age group, crude hospitalization rates are 7.5 times higher among Hispanic or Latino persons aged 0-17 years; 9.8 times higher among non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 7.4 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥ 65 years.
        Age Category Non-Hispanic
        American Indian or Alaska Native
        Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
        Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2
        0-17y 7.8 3.9 9.2 4.6 14.9 7.5 3.6 1.8 2.0 1.0
        18-49y 205.8 9.8 120.0 5.7 190.8 9.1 34.8 1.7 20.9 1.0
        50-64y 510.4 7.4 381.0 5.5 414.3 6.0 107.0 1.5 69.3 1.0
        65+y 597.2 2.9 784.5 3.8 513.4 2.5 204.5 1.0 206.9 1.0
        Overall rate3 (age-adjusted) 281.0 5.3 246.8 4.7 242.5 4.6 66.7 1.3 53.0 1.0
        1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
        2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
        3 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

        Non-Hispanic Black persons and non-Hispanic White persons represent the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
        1.5% 32.9% 22.8% 4.7% 31.8%
        0.7% 17.7% 14.0% 8.8% 58.8%
        2.1 1.9 1.6 0.5 0.5
        1 Persons of multiple races (0.2%) or unknown race and ethnicity (6.1%) are not represented in the table but are included as part of the denominator.
        2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

        Among 10,227 hospitalized adults with information on underlying medical conditions, 90.9% have at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease. Among 217 hospitalized children with information on underlying conditions, 52.1% had at least one reported underlying medical condition. The most commonly reported were obesity, asthma, and neurologic conditions.

        resize iconView Larger


        Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

        Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


        Mortality Surveillance


        The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on July 23, 2020, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (June 27 – July 11) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 29 is 9.1% and, while lower than the percentage during week 28 (11.5%), remains above the epidemic threshold. These percentages will likely change as more death certificates are processed.

        Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

        resize iconView Larger


        *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
        View Data Table


        Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

        More Information
        View Page In:pdf icon 14 Pages, 1 MB
        Last Updated July 24, 2020
        Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillanceemail_03Get Email Updates

        To receive email updates about COVID-19, enter your email address:
        Email Address
        What's this?
        Submit
        Spanish Resourceshttps://www.cdc.gov/coronavirus/2019...iew/index.html
        Twitter: @RonanKelly13
        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

        Comment


        • #19

          COVIDView Summary ending on July 25, 2020


          Updated July 31, 2020
          Print
          Download Weekly Summary pdf icon[15 Pages, 1 MB]
          Key Updates for Week 30, ending July 25, 2020


          Nationally, levels of influenza-like illness (ILI) are below baseline but higher than typically seen at this time of year. Indicators that track ILI and COVID-19-like illness (CLI) showed decreases nationally from week 29 to week 30, with decreasing or stable levels in nearly all regions of the country. Nationally, the percentage of laboratory tests positive for SARS-CoV-2 remained stable from week 29 to week 30 but increased in six of ten HHS regions. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 30 but may change as more data for admissions and deaths occurring during the most recent weeks are received. Mortality attributed to COVID-19 remains above the epidemic threshold.
          Virus

          Public Health, Commercial and Clinical Laboratories


          Nationally, the overall percentage of respiratory specimens testing positive for SARS-CoV-2 was 8.7% for both weeks 29 and 30; however, increases were seen in six regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
          • Public health laboratories – increased from 7.5% during week 29 to 8.3% during week 30;
          • Clinical laboratories – increased from 6.4% during week 29 to 7.3% during week 30;
          • Commercial laboratories – decreased from 9.2% during week 29 to 8.9% during week 30.
          Outpatient and Emergency Department Visits

          Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


          Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
          • Nationally, ILI activity remains below baseline for the fifteenth week but is higher than typically seen at this time of year.
          • During week 30, the percentage of visits for ILI, but not CLI, increased in Region 2 (NY/NJ/Puerto Rico) compared to week 29; the percentages of visits for ILI and CLI decreased or were stable in all other regions.
          • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
          Severe Disease

          Hospitalizations


          Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 130.1 per 100,000, with the highest rates in people aged 65 years and older (360.2 per 100,000) and 50-64 years (196.3 per 100,000).
          Mortality


          Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (June 27 – July 11) for the first time since mid-April. The percentage for week 30 is 8.6% and currently lower than the percentage during week 29 (12.0%); however, the percentage remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

          All data are preliminary and may change as more reports are received.

          A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
          Key Points
          • The percentage of specimens testing positive for SARS-CoV-2 increased in six of ten HHS regions, but the percentages of visits for ILI and CLI decreased or remained stable in nine of ten regions. The percentage of visits for ILI increased in Region 2 (NY/NJ/Puerto Rico) compared to last week.
          • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay remained stable from week 29 to week 30 at 8.7%.
            • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 13.6%), 6 (South Central, 16.5%) and 9 (South West/Coast, 8.9%); however, the percentages are decreasing in Regions 4 (South East) and 9 (South West/Coast) following peaks seen in weeks 28 and 27, respectively.
            • Increases in the percentage of specimens testing positive for SARS-CoV-2 were reported in six of ten HHS surveillance regions: Regions 2 (NY/NJ/Puerto Rico), 5 (Midwest), 6 (South Central), 7 (Central), 8 (Mountain) and 10 (Pacific Northwest).
          • The percentage of outpatient and ED visits for ILI are below baseline nationally and in all regions of the country; however, ILI activity is above what is typical for this time of year. The percentage of visits to EDs for CLI decreased nationally for the second consecutive week, and compared to the previous week, decreased or remained stable in all ten HHS regions.
            • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing.
          • The overall cumulative COVID-19-associated hospitalization rate was 130.1 per 100,000; rates were highest in people 65 years of age and older (360.2 per 100,000) followed by people 50-64 years (196.3 per 100,000). Cumulative hospitalization rates will increase as the pandemic continues.
            • From week 25 – week 28 (weeks ending June 20 – July 11), overall weekly hospitalization rates increased for three consecutive weeks.
            • Non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5.3 times that of non-Hispanic White persons. Rates among non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.
          • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (weeks ending June 27 – July 11) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 30 is 8.6%, lower than the percentage during week 29 (12.0%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
          • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

          U.S. Virologic Surveillance


          The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
          1,906,631 32,009,840
          255,788 3,709,287
          168,924 3,217,358
          1,481,919 25,083,195
          165,955 (8.7%) 3,057,280 (9.6%)
          21,264 (8.3%) 309,094 (8.3%)
          12,308 (7.3%) 204,488 (6.4%)
          132,383 (8.9%) 2,543,698 (10.1%)
          * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
          Public Health Laboratories


          resize iconView LargerView Data Table

          Clinical Laboratories


          resize iconView LargerView Data Table

          Commercial Laboratories


          resize iconView Larger


          * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
          View Data Table


          Additional virologic surveillance information: Surveillance Methods


          Outpatient/Emergency Department Illness


          Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
          ILINet


          The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥ 100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

          Nationwide during week 30, 1.2% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 29, the percentage of visits for ILI during week 30 was slightly higher for 0-4 year olds but slightly lower for all other age groups.

          resize iconView Larger


          * Age-group specific percentages should not be compared to the national baseline.

          On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 1.8% during week 30. All ten regions are below their region-specific baselines, and in nine of ten regions, the percentage of visits for ILI was lower or stable in week 30 compared to week 29. In Region 2 (NY/NJ/Puerto Rico), the percentage of visits for ILI was slightly higher in week 30 compared to week 29.

          Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
          Overall Percentage of Visits for ILI | Age Group ILI Data

          ILI Activity Levels


          Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

          The number of jurisdictions at each activity level during week 30, and changes compared to the previous week are summarized in the table below and shown in the following maps.
          Activity Level Number of Jurisdictions
          Week 30
          (Week ending
          July 25, 2020)
          Compared to Previous Week
          Very High 0 No change
          High 0 No change
          Moderate 1 -1
          Low 1 -2
          Minimal 49 +1
          Insufficient Data 3 +2
          *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
          National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


          NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

          Nationwide during week 30, 3.1% of emergency department visits captured in NSSP were due to CLI and 0.9% were due to ILI. Compared to week 29, this week there was a decrease in both percentages of visits for CLI and ILI. This was the second consecutive week the percentages of visits for CLI and ILI decreased since week 28.

          During week 30, the percentages of visits for CLI and ILI decreased or remained steady in all ten HHS regions. Compared to week 29, eight of ten HHS regionsexternal icon (Regions 1 [New England], 4 [South East], 5 [Midwest], 6 [South Central], 7 [Central], 8 [Mountain], 9 [South West/Coast] and 10 [Pacific Northwest]) saw a decrease in the percentage of visits for CLI, and five of ten HHS regions (Regions 4 [South East], 6 [South Central], 7 [Central], 9 [South West/ Coast] and 10 [Pacific Northwest]) saw a decrease in the percentage of visits for ILI.



          Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


          Hospitalizations


          The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

          A total of 42,403 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and July 25, 2020. The overall cumulative hospitalization rate was 130.1 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization was among adults aged ≥ 65, followed by adults aged 50-64 years and adults aged 18-49 years.

          resize iconView Larger
          Overall 130.1
          0-4 years 12.3
          5-17 years 6.4
          18-49 years 85.5
          18-29 years 51.6
          30-39 years 84.3
          40-49 years 130.6
          50-64 years 196.3
          65+ years 360.2
          65-74 years 266.4
          75-84 years 427.4
          85+ years 670.5
          From June 20 (MMWR week 25) – July 11 (MMWR week 28), overall weekly hospitalization rates increased for three consecutive weeks. Data for the weeks ending July 18 and July 25 (MMWR weeks 29 and 30) currently show a decline; however, those data are likely to change as more data for admissions occurring during those weeks are received.

          resize iconView Larger
          Among the 42,403 laboratory-confirmed COVID-19-associated hospitalized cases, 39,983 (94.3%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,420 (5.7%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5.3 times that of non-Hispanic White persons. Rates among non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.



          When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic white persons in the same age group, crude hospitalization rates were 7.8 times higher among Hispanic or Latino persons aged 0-17 years; 9.8 times higher among non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 7.2 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥ 65 years.
          Age Category Non-Hispanic
          American Indian or Alaska Native
          Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
          Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2
          0-17y 7.8 3.7 10.5 5.0 16.4 7.8 4.0 1.9 2.1 1.0
          18-49y 221.4 9.8 133.7 5.9 208.5 9.2 38.9 1.7 22.6 1.0
          50-64y 539.7 7.2 407.3 5.5 451.5 6.1 117.9 1.6 74.5 1.0
          65+y 630.9 2.9 830.7 3.8 573.6 2.6 219.3 1.0 219.2 1.0
          Overall rate3 (age-adjusted) 298.6 5.3 265.1 4.7 266.6 4.7 72.8 1.3 56.5 1.0
          1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
          2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
          3 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

          Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios showed a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black and Hispanic or Latino persons.
          1.5% 32.9% 23.2% 4.8% 31.5%
          0.7% 17.9% 14.1% 8.9% 58.5%
          2.1 1.8 1.6 0.5 0.5
          1 Persons of multiple races (0.2%) or unknown race and ethnicity (5.9%) are not represented in the table but are included as part of the denominator.
          2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

          Among 10,687 hospitalized adults with information on underlying medical conditions, 90.8% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease and cardiovascular disease. Among 222 hospitalized children with information on underlying conditions, 52.3% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic conditions and asthma.

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          Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

          Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


          Mortality Surveillance


          The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on July 30, 2020, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 28 (June 27 – July 11) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 30 is 8.6% and, while lower than the percentage during week 29 (12.0%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

          Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

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          *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
          View Data Table


          Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

          More Information
          View Page In:pdf icon 15 Pages, 1 MB
          Last Updated July 31, 2020

          https://www.cdc.gov/coronavirus/2019.../07312020.html

          Comment


          • #20
            1. CASES, DATA & SURVEILLANCE
            COVIDView Summary ending on August 1, 2020


            Updated Aug. 7, 2020
            Print
            Download Weekly Summary pdf icon[14 Pages, 1 MB]
            Key Updates for Week 31, ending August 1, 2020


            Nationally, levels of influenza-like illness (ILI) are below baseline but higher than typically seen at this time of year. Indicators that track ILI and COVID-19-like illness (CLI) showed decreases nationally from week 30 to week 31, with decreasing or stable (change of ≤ 0.1%) levels in all regions of the country. Nationally, the percentage of laboratory tests positive for SARS-CoV-2 decreased from week 30 to week 31 and decreased in nine of ten HHS regions. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 31 but may change as more data for admissions and deaths occurring during the most recent weeks are received. Mortality attributed to COVID-19 remains above the epidemic threshold.
            Virus

            Public Health, Commercial and Clinical Laboratories


            Nationally, the overall percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 8.7% during week 30 to 7.8% during week 31. Decreases were seen in nearly all regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
            • Public health laboratories – decreased from 8.2% during week 30 to 7.8% during week 31;
            • Clinical laboratories – decreased from 7.3% during week 30 to 6.8% during week 31;
            • Commercial laboratories – decreased from 8.9% during week 30 to 7.8% during week 31.
            Outpatient and Emergency Department Visits

            Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


            Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
            • Nationally, ILI activity remains below baseline for the sixteenth week but is higher than typically seen at this time of year.
            • Nationally, during week 31, the percentage of visits reported by ILINet participants for ILI was 1.2%, and the percentage of visits for CLI reported to NSSP was 2.9%. These percentages appear stable with only slight fluctuations seen over the most recent three weeks.
            • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses and increased social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
            Severe Disease

            Hospitalizations


            Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 137.6 per 100,000, with the highest rates in people aged 65 years and older (378.8 per 100,000) and 50-64 years (207.4 per 100,000).
            Mortality


            Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 29 (June 27 – July 18) for the first time since mid-April. The percentage for week 31 is 7.8% and currently lower than the percentage during week 30 (12.6%); however, the percentage remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

            All data are preliminary and may change as more reports are received.

            A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
            Key Points
            • The percentage of specimens testing positive for SARS-CoV-2 decreased in nine of ten HHS regions from week 30 to week 31. Percentages of visits for ILI and CLI decreased or remained stable (change of ≤ 0.1%).
            • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 8.7% during week 30 to 7.8% during week 31.
              • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 12.7%), 6 (South Central, 14.4%) and 9 (South West/Coast, 8.8%); however, the percentages are decreasing in these three regions following peaks seen in weeks 27 and 28.
            • The percentage of outpatient and ED visits for ILI are below baseline nationally and in all regions of the country; however, ILI activity is above what is typical for this time of year. The percentage of visits to EDs for CLI decreased nationally for the third consecutive week, and compared to the previous week, decreased or remained stable in all ten HHS regions.
              • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses and increased social distancing.
            • The overall cumulative COVID-19-associated hospitalization rate was 137.6 per 100,000; rates were highest in people 65 years of age and older (378.8 per 100,000) followed by people 50-64 years (207.4 per 100,000). Cumulative hospitalization rates will increase as the pandemic continues.
              • From week 25 – week 28 (weeks ending June 20 – July 11), overall weekly hospitalization rates increased for three consecutive weeks. Weekly rates have declined during the most recent three weeks but may increase as more data are received.
              • Non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5.2 times that of non-Hispanic White persons. Rates among non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.
            • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 29 (weeks ending June 27 – July 18) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 31 is 7.8%, lower than the percentage during week 30 (12.6%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
            • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

            U.S. Virologic Surveillance


            The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
            1,951,609 34,990,702
            255,628 4,011,003
            137,916 3,391,898
            1,558,065 27,587,801
            151,488 (7.8%) 3,305,091 (9.4%)
            20,026 (7.8%) 332,644 (8.3%)
            9,401 (6.8%) 217,384 (6.4%)
            122,061 (7.8%) 2,755,063 (10.0%)
            * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
            Public Health Laboratories


            resize iconView LargerView Data Table

            Clinical Laboratories


            resize iconView LargerView Data Table

            Commercial Laboratories


            resize iconView Larger


            * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
            View Data Table


            Additional virologic surveillance information: Surveillance Methods


            Outpatient/Emergency Department Illness


            Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
            ILINet


            The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥ 100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

            Nationwide during week 31, 1.2% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 30, the percentage of visits for ILI during week 31 was the same or slightly lower overall and for all age groups.

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            * Age-group specific percentages should not be compared to the national baseline.

            On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 1.6% during week 31. All ten regions are below their region-specific baselines, and only slight fluctuations in the percentage of outpatient visits for ILI have been seen over the most recent three weeks.

            Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
            Overall Percentage of Visits for ILI | Age Group ILI Data

            ILI Activity Levels


            Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

            The number of jurisdictions at each activity level during week 31, and changes compared to the previous week are summarized in the table below and shown in the following maps.
            Activity Level Number of Jurisdictions
            Week 31
            (Week ending
            August 1, 2020)
            Compared to Previous Week
            Very High 0 No change
            High 0 No change
            Moderate 1 No change
            Low 1 No change
            Minimal 49 No change
            Insufficient Data 3 No change
            *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
            National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


            NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

            Nationwide during week 31, 2.9% of emergency department visits captured in NSSP were due to CLI and 0.8% were due to ILI. Compared to week 30, this week there was a decrease in both percentages of visits for CLI and ILI. This was the third consecutive week the percentages of visits for CLI and ILI decreased since week 28. During these three weeks, the percentages of visits for CLI and ILI decreased or remained stable (changes of ≤ 0.1%) in all ten HHS regionsexternal icon.



            Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


            Hospitalizations


            The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

            A total of 44,865 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and August 1, 2020. The overall cumulative hospitalization rate was 137.6 per 100,000 population. Among the 0-4 year, 5-17 year, 18-49 year, 50-64 year and ≥ 65 year age groups, the highest rate of hospitalization was among adults aged ≥ 65 years, followed by adults aged 50-64 years and adults aged 18-49 years.

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            Overall 137.6
            0-4 years 12.9
            5-17 years 7.0
            18-49 years 91.3
            18-29 years 55.9
            30-39 years 90.0
            40-49 years 138.5
            50-64 years 207.4
            65+ years 378.8
            65-74 years 281.3
            75-84 years 451.4
            85+ years 695.0
            From June 20 (MMWR week 25) – July 11 (MMWR week 28), there was an increase in overall weekly hospitalization rates for three consecutive weeks. Data for weeks ending July 18, July 25 and August 1 (MMWR weeks 29, 30 and 31) currently show a decline; however, those data are likely to change as more data for admissions occurring during these weeks are received.

            resize iconView Larger
            Among the 44,865 laboratory-confirmed COVID-19-associated hospitalized cases, 41,989 (93.6%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,876 (6.4%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5.2 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.



            When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic white persons in the same age group, crude hospitalization rates were 8.1 times higher among Hispanic or Latino persons aged 0-17 years; 9.3 times higher among non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 7.1 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥ 65 years.
            Age Category Non-Hispanic
            American Indian or Alaska Native
            Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
            Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2 Rate1 Rate Ratio2
            0-17y 9.7 4.6 11.2 5.3 17.1 8.1 4.0 1.9 2.1 1.0
            18-49y 225.3 9.3 142.4 5.9 218.7 9.1 41.8 1.7 24.1 1.0
            50-64y 553.0 7.1 426.3 5.4 473.7 6.0 124.3 1.6 78.4 1.0
            65+y 651.9 2.9 860.1 3.8 605.3 2.7 233.2 1.0 228.2 1.0
            Overall rate3 (age-adjusted) 306.5 5.2 277.2 4.7 280.2 4.7 77.4 1.3 59.3 1.0
            1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
            2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
            3 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64 and 65+ years.

            Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios showed a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black and Hispanic or Latino persons.
            1.4% 32.8% 23.2% 4.9% 31.4%
            0.7% 17.9% 14.1% 8.9% 58.5%
            2.0 1.8 1.6 0.6 0.5
            1 Persons of multiple races (0.2%) or unknown race and ethnicity (6.1%) are not represented in the table but are included as part of the denominator.
            2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

            Among 11,245 hospitalized adults with information on underlying medical conditions, 90.7% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease and cardiovascular disease. Among 230 hospitalized children with information on underlying conditions, 51.7% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic conditions and asthma.

            resize iconView Larger


            Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

            Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


            Mortality Surveillance


            The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on August 6, 2020, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 29 (June 27 – July 18) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 31 is 7.8% and, while lower than the percentage during week 30 (12.6%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

            Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

            resize iconView Larger


            *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
            View Data Table


            Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

            More Information
            View Page In:pdf icon 14 Pages, 1 MB
            Last Updated Aug. 7, 2020

            https://www.cdc.gov/coronavirus/2019.../08072020.html

            Comment


            • #21
              1. CASES, DATA & SURVEILLANCE
              COVIDView Summary ending on August 8, 2020


              Updated Aug. 14, 2020
              Print
              Download Weekly Summary pdf icon[14 Pages, 1 MB]
              Key Updates for Week 32, ending August 8, 2020


              Nationally, levels of influenza-like illness (ILI) are below baseline but higher than typically seen at this time of year. Indicators that track ILI and COVID-19-like illness (CLI) and the percentage of laboratory tests positive for SARS-CoV-2 have continued to decrease nationally since mid-July. Regionally, from week 31 to week 32, indicators that track ILI and COVID-19-like illness (CLI) were decreasing or stable (change of ≤ 0.1%) in all regions of the country, and the percentage of laboratory tests positive for SARS-CoV-2 decreased or remained the same in nine of ten HHS regions. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 32 but may change as more data for admissions and deaths occurring during recent weeks are received. Mortality attributed to COVID-19 remains above the epidemic threshold.
              Virus

              Public Health, Commercial and Clinical Laboratories


              Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 7.7% during week 31 to 7.0% during week 32 and decreased or remained the same in nine of ten HHS regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
              • Public health laboratories – decreased from 7.9% during week 31 to 7.0% during week 32;
              • Clinical laboratories – decreased from 6.3% during week 31 to 5.8% during week 32;
              • Commercial laboratories – decreased from 7.9% during week 31 to 7.1% during week 32.
              Outpatient and Emergency Department Visits

              Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


              Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
              • Nationally, ILI activity remains below baseline for the seventeenth week but is higher than typically seen at this time of year.
              • Nationally, during week 32, the percentage of visits reported by ILINet participants for ILI was 1.1% and has declined for three consecutive week; the percentage of visits for CLI reported to NSSP was 2.6% and has declined for four consecutive weeks.
              • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
              Severe Disease

              Hospitalizations


              Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 144.1 per 100,000, with the highest rates in people aged 65 years and older (394.2 per 100,000) and 50-64 years (217.0 per 100,000).
              Mortality


              Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 30 (June 27 – July 25) for the first time since mid-April. The percentage for week 32 is 8.1% and currently lower than the percentage during week 31 (12.5%); however, the percentage remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

              All data are preliminary and may change as more reports are received.

              A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
              Key Points
              • Nationally, the percentage of specimens testing positive for SARS-CoV-2 and the percentages of visits for ILI and CLI have continued to decrease since mid-July.
              • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 7.7% during week 31 to 7.0% during week 32.
                • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 also declined or remained the same in nine of ten HHS regions. A small increase of 0.2% was seen in Region 2 (NY/NJ/Puerto Rico).
                • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 11.5%) and 6 (South Central, 12.6%). The percentage is declining in both regions following peaks seen in week 28 and 27, respectively.
              • The percentage of outpatient and ED visits for ILI are below baseline nationally and in all regions of the country; however, ILI activity is above what is typical for this time of year. The percentage of visits to EDs for CLI decreased nationally for the fourth consecutive week and, compared to the previous week, decreased in all ten HHS regions.
                • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing.
              • The overall cumulative COVID-19-associated hospitalization rate was 144.1 per 100,000; rates were highest in people 65 years of age and older (394.2 per 100,000) followed by people 50-64 years (217.0 per 100,000). Cumulative hospitalization rates will increase as the pandemic continues.
                • From week 25 – week 29 (weeks ending June 20 – July 18), overall weekly hospitalization rates increased for four consecutive weeks. Weekly rates have declined during the most recent three weeks but may increase as more data are received.
                • Non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5 times that of non-Hispanic White persons. Rates among non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.
              • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 30 (weeks ending June 27 – July 25) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 32 is 8.1%, lower than the percentage during week 31 (12.5%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
              • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

              U.S. Virologic Surveillance


              The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
              2,020,771 38,026,858
              256,042 4,286,454
              147,862 3,868,206
              1,616,867 29,872,198
              141,923 (7.0%) 3,522,138 (9.3%)
              18,010 (7.0%) 352,735 (8.2%)
              8,609 (5.8%) 244,094 (6.3%)
              115,304 (7.1%) 2,925,309 (9.8%)
              * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
              Public Health Laboratories


              resize iconView LargerView Data Table

              Clinical Laboratories


              resize iconView LargerView Data Table

              Commercial Laboratories


              resize iconView Larger


              * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
              View Data Table


              Additional virologic surveillance information: Surveillance Methods


              Outpatient/Emergency Department Illness


              Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
              ILINet


              The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥ 100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

              Nationwide during week 32, 1.1% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 31, the percentage of visits for ILI during week 32 was slightly lower overall. The percentage was slightly higher among those aged 0-4 years during week 32 compared to week 31, while the percentage in all other age groups was lower or the same.

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              * Age-group specific percentages should not be compared to the national baseline.

              On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 1.4% during week 32. In all ten regions, the percentage of outpatient visits for ILI is below the region-specific baseline and has either declined or remained stable (changes ≤ 0.1%) over the most recent three weeks.

              Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
              Overall Percentage of Visits for ILI | Age Group ILI Data

              ILI Activity Levels


              Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

              The number of jurisdictions at each activity level during week 32 and changes compared to the previous week are summarized in the table below and shown in the following maps.
              Activity Level Number of Jurisdictions
              Week 32
              (Week ending
              August 8, 2020)
              Compared to Previous Week
              Very High 0 No change
              High 0 No change
              Moderate 1 No change
              Low 0 -1
              Minimal 50 +1
              Insufficient Data 3 No change
              *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
              National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


              NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

              Nationwide during week 32, 2.6% of emergency department visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared to week 31, this week there was a decrease in both percentages of visits for CLI and ILI. This was the fourth consecutive week the percentages of visits for CLI and ILI decreased. For the past three weeks, the percentages of visits for CLI and ILI decreased or remained stable (changes of ≤ 0.1%) in all ten HHS regionsexternal icon.



              Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


              Hospitalizations


              The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

              A total of 46,986 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and August 8, 2020. The overall cumulative hospitalization rate was 144.1 per 100,000 population. Among the 0-4 year, 5-17 year, 18-49 year, 50-64 year, and ≥ 65 year age groups, the highest rate of hospitalization was among adults aged ≥ 65 years, followed by adults aged 50-64 years and adults aged 18-49 years.

              resize iconView Larger
              Overall 144.1
              0-4 years 13.6
              5-17 years 7.4
              18-49 years 96.5
              18-29 years 59.5
              30-39 years 95.5
              40-49 years 145.5
              50-64 years 217.0
              65+ years 394.2
              65-74 years 294.0
              75-84 years 467.9
              85+ years 720.8
              From June 20 (MMWR week 25)–July 18 (MMWR week 29), there was an increase in overall weekly hospitalization rates for four consecutive weeks. Data for the weeks ending July 25, August 1, and August 8 (MMWR weeks 30, 31, and 32) currently show a decline; however, this trend may change as more data for admissions occurring during those weeks are received.

              resize iconView Larger
              Among the 46,986 laboratory-confirmed COVID-19-associated hospitalized cases, 44,304 (94.3%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,682 (5.7%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 5 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.



              When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 8.3 times higher among Hispanic or Latino persons aged 0-17 years; 9 times higher among both Hispanic or Latino and non-Hispanic American Indian or Alaska Native persons aged 18-49 years; 6.8 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥ 65 years.
              Age Category Non-Hispanic
              American Indian or Alaska Native
              Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
              Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
              0-17y 9.7 4.4 13.5 6.1 18.2 8.3 4.5 2.0 2.2 1.0
              18-49y 231.2 9.0 154.5 6.0 229.2 9.0 44.7 1.7 25.6 1.0
              50-64y 563.6 6.8 451.3 5.5 494.9 6.0 132.0 1.6 82.7 1.0
              65+y 651.9 2.7 909.4 3.8 634.8 2.7 243.9 1.0 238.6 1.0
              Overall rate4 (age-adjusted) 311.2 5.0 295.2 4.7 293.5 4.7 81.8 1.3 62.3 1.0
              1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
              2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
              3 The highest rate ratio in each age category is presented in bold.
              4 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64 and 65+ years.

              Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
              1.4% 33.2% 23.1% 4.9% 31.3%
              0.7% 17.9% 14.1% 8.9% 58.5%
              2.0 1.9 1.6 0.6 0.5
              1 Persons of multiple races (0.2%) or unknown race and ethnicity (6%) are not represented in the table but are included as part of the denominator.
              2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

              Among 8,777 hospitalized adults with information on underlying medical conditions, 91.5% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 246 hospitalized children with information on underlying conditions, 50.8% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic disease, and asthma.

              resize iconView Larger


              Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

              Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


              Mortality Surveillance


              The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on August 6, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) increased from week 26 – week 30 (June 27 – July 25) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 32 is 8.1% and, while lower than the percentage during week 31 (12.5%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

              Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

              resize iconView Larger


              *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
              View Data Table


              Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

              More Information
              View Page In:pdf icon 14 Pages, 1 MB
              Last Updated Aug. 14, 2020

              https://www.cdc.gov/coronavirus/2019.../08142020.html

              Comment


              • #22
                1. CASES, DATA & SURVEILLANCE
                COVIDView Summary ending on August 15, 2020


                Updated Aug. 21, 2020
                Print
                Download Weekly Summary pdf icon[14 Pages, 1 MB]
                Key Updates for Week 33, ending August 15, 2020


                Nationally, levels of influenza-like illness (ILI) are below baseline but higher than typically seen at this time of year. Indicators that track ILI and COVID-19-like illness (CLI) and the percentage of laboratory tests positive for SARS-CoV-2 have continued to decrease nationally since mid-July. Regionally, from week 32 to week 33, indicators that track ILI were decreasing or stable (change of ≤0.1%) in nine of ten regions of the country, an indicator that tracks CLI decreased in all regions, and the percentage of laboratory tests positive for SARS-CoV-2 decreased or remained the same in nine of ten regions. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 33 but may change as more data for admissions and deaths occurring during recent weeks are received. Mortality attributed to COVID-19 remains above the epidemic threshold.
                Virus

                Public Health, Commercial and Clinical Laboratories


                Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 6.9% during week 32 to 6.3% during week 33 and decreased or remained the same in nine of ten HHS regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
                • Public health laboratories – decreased from 7.1% during week 32 to 6.6% during week 33;
                • Clinical laboratories – decreased from 5.9% during week 32 to 5.7% during week 33;
                • Commercial laboratories – decreased from 7.0% during week 32 to 6.3% during week 33.
                Outpatient and Emergency Department Visits

                Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                • Nationally, ILI activity remains below baseline for the eighteenth week but is higher than typically seen at this time of year.
                • Nationally, during week 33, the percentage of visits reported by ILINet participants for ILI was 1.0% and has declined for four consecutive weeks; the percentage of visits for CLI reported to NSSP was 2.3% and has declined for five consecutive weeks.
                • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                Severe Disease

                Hospitalizations


                Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 151.7 per 100,000, with the highest rates in people aged 65 years and older (412.9 per 100,000) and 50-64 years (228.1 per 100,000).
                Mortality


                Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 33 is 7.8%. This is currently lower than the percentage during week 32 (12.6%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                All data are preliminary and may change as more reports are received.

                A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                Key Points
                • Nationally, the percentage of specimens testing positive for SARS-CoV-2 and the percentages of visits for ILI and CLI have continued to decrease since mid-July.
                • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 6.9% during week 32 to 6.3% during week 33.
                  • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 also declined or remained the same in nine of ten HHS regions. In Region 7 (Central), the percentage of respiratory specimens testing positive for SARS-CoV-2 has been increasing for 10 weeks.
                  • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 10.3%), 6 (South Central, 11.7%), and 7 (Central, 9.2%). The percentage is decreasing in Regions 4 (South East) and 6 (South Central) and increasing in Region 7 (Central).
                • The percentage of outpatient and ED visits for ILI are below baseline nationally and in all regions of the country; however, ILI activity is above what is typical for this time of year. The percentage of visits to EDs for CLI decreased nationally for the fifth consecutive week and, compared to the previous week, decreased in all ten HHS regions.
                  • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased social distancing.
                • The overall cumulative COVID-19-associated hospitalization rate was 151.7 per 100,000; rates were highest in people 65 years of age and older (412.9 per 100,000) followed by people 50-64 years (228.1 per 100,000).
                  • Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.0 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                  • Non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 4.9 times that of non-Hispanic White persons. Rates among non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.
                • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) increased from week 26 – week 30 (weeks ending June 27 – July 25) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 33 is 7.8%, lower than the percentage during week 32 (12.6%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                U.S. Virologic Surveillance


                The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                2,048,398 40,713,070
                244,045 4,581,562
                136,744 4,183,719
                1,667,609 31,947,789
                128,555 (6.3%) 3,692,858 (9.1%)
                16,041 (6.6%) 375,567 (8.2%)
                7,757 (5.7%) 262,436 (6.3%)
                104,757 (6.3%) 3,054,855 (9.6%)
                * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                Public Health Laboratories


                resize iconView LargerView Data Table

                Clinical Laboratories


                resize iconView LargerView Data Table

                Commercial Laboratories


                resize iconView Larger


                * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                View Data Table


                Additional virologic surveillance information: Surveillance Methods


                Outpatient/Emergency Department Illness


                Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                ILINet


                The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                Nationwide during week 33, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 32, the percentage of visits for ILI during week 33 was slightly lower overall and lower or the same in all age groups.

                resize iconView Larger


                * Age-group specific percentages should not be compared to the national baseline.

                On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.4% during week 33. In all ten regions, the percentage of outpatient visits for ILI is below the region-specific baseline. Compared to week 32, the percentage in week 33 was lower or stable (changes ≤0.1%) in nine of ten HHS regions; a slight increase was seen in Region 3 (Mid-Atlantic).

                Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                Overall Percentage of Visits for ILI | Age Group ILI Data

                ILI Activity Levels


                Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                The number of jurisdictions at each activity level during week 33 and changes compared to the previous week are summarized in the table below and shown in the following maps.
                Activity Level Number of Jurisdictions
                Week 33
                (Week ending
                August 15, 2020)
                Compared to Previous Week
                Very High 0 No change
                High 0 No change
                Moderate 1 No change
                Low 0 No change
                Minimal 50 No change
                Insufficient Data 3 No change
                *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                Nationwide during week 33, 2.3% of emergency department visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared to week 32, this week there was a decrease in the percentage of visits for CLI whereas the percentage of visits for ILI remained stable. This was the fifth consecutive week the percentages of visits for CLI and ILI decreased or remained stable. For the past four weeks, the percentages of visits for CLI and ILI decreased or remained stable (changes of ≤0.1%) in all 10 HHS regionsexternal icon.



                Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                Hospitalizations


                The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                A total of 49,451 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and August 15, 2020. The overall cumulative hospitalization rate was 151.7 per 100,000 population. Among the 0-4 year, 5-17 year, 18-49 year, 50-64 year, and ≥65 year age groups, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50-64 years and adults aged 18-49 years.

                resize iconView Larger
                Overall 151.7
                0-4 years 14.7
                5-17 years 8.1
                18-49 years 102.2
                18-29 years 64.1
                30-39 years 100.9
                40-49 years 152.9
                50-64 years 228.1
                65+ years 412.9
                65-74 years 308.6
                75-84 years 490.4
                85+ years 751.2
                Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.0 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                Among the 49,451 laboratory-confirmed COVID-19-associated hospitalized cases, 46,026 (93.1%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 3,425 (6.9%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons had an age-adjusted hospitalization rate approximately 4.9 times that of non-Hispanic White persons. Rates for non-Hispanic Black persons and Hispanic or Latino persons were both approximately 4.7 times the rate among non-Hispanic White persons.




                When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 8.1 times higher among Hispanic or Latino persons aged 0-17 years; 8.8 times higher among both non-Hispanic American Indian or Alaska Native persons and Hispanic or Latino persons aged 18-49 years; 6.6 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥65 years.
                Age Category Non-Hispanic
                American Indian or Alaska Native
                Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                0-17y 9.7 4.0 14.1 5.9 19.4 8.1 5.0 2.1 2.4 1.0
                18-49y 237.0 8.8 160.7 6.0 237.9 8.8 47.4 1.8 26.9 1.0
                50-64y 568.9 6.6 466.2 5.4 514.5 5.9 138.0 1.6 86.8 1.0
                65+y 660.3 2.7 936.7 3.8 665.8 2.7 257.5 1.0 247.2 1.0
                Overall rate4 (age-adjusted) 316.5 4.9 304.9 4.7 305.8 4.7 86.2 1.3 65.0 1.0
                1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                3 The highest rate ratio in each age category is presented in bold.
                4 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

                Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios showed a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons had the highest prevalence ratio, followed by non-Hispanic Black and Hispanic or Latino persons.
                1.3% 33.0% 23.1% 5.0% 31.4%
                0.7% 17.9% 14.1% 8.9% 58.5%
                1.9 1.8 1.6 0.6 0.5
                1 Persons of multiple races (0.2%) or unknown race and ethnicity (6%) are not represented in the table but are included as part of the denominator.
                2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

                Among 9,400 hospitalized adults with information on underlying medical conditions, 90.5% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 254 hospitalized children with information on underlying conditions, 50.8% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic disease, and asthma.

                resize iconView Larger


                Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                Mortality Surveillance


                The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on August 20, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) increased from week 26 – week 30 (June 27 – July 25) after declining for 11 weeks since mid-April. The percentage of deaths due to PIC for week 33 is 7.8% and, while lower than the percentage during week 32 (12.6%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                resize iconView Larger


                *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                View Data Table


                Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                More Information
                View Page In:pdf icon 14 Pages, 1 MB
                Last Updated Aug. 21, 2020
                Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                https://www.cdc.gov/coronavirus/2019.../08212020.html

                Comment


                • #23
                  1. CASES, DATA & SURVEILLANCE
                  COVIDView Summary ending on August 22, 2020


                  Updated Aug. 28, 2020
                  Print
                  Download Weekly Summary pdf icon[14 Pages, 1 MB]
                  Key Updates for Week 34, ending August 22, 2020


                  Indicators that track influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of laboratory tests positive for SARS-CoV-2 have continued to decrease nationally since mid-July. Regionally, from week 33 to week 34, six of ten regions reported decreasing or stable (change of ≤0.1%) ILI, CLI, and percentage of laboratory tests positive for SARS-CoV-2; however, two regions reported an increase in the percentage of specimens testing positive for SARS-CoV-2, and two regions reported an increase in ILI visits. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 34. Mortality attributed to COVID-19 remains above the epidemic threshold.
                  Virus

                  Public Health, Commercial and Clinical Laboratories


                  Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 6.2% during week 33 to 5.7% during week 34 and decreased or remained the same in eight of ten HHS regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
                  • Public health laboratories – decreased from 6.6% during week 33 to 6.1% during week 34;
                  • Clinical laboratories – decreased from 5.7% during week 33 to 5.1% during week 34;
                  • Commercial laboratories – decreased from 6.2% during week 33 to 5.6% during week 34.
                  Outpatient and Emergency Department Visits

                  Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                  Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                  • Nationally, ILI activity remains below baseline for the nineteenth week but is higher than typically seen at this time of year.
                  • Nationally, during week 34, the percentage of visits reported for ILI by ILINet participants was 1.0%, the same as week 33. The percentage of visits for CLI reported to NSSP decreased from 2.6% during week 33 to 2.2% during week 34, the sixth consecutive week of decline.
                  • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                  Severe Disease

                  Hospitalizations


                  Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 156.8 per 100,000, with the highest rates in people aged 65 years and older (425.7 per 100,000) and 50-64 years (235.7 per 100,000).
                  Mortality


                  Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 34 is 7.9%. This is currently lower than the percentage during week 33 (12.3%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                  All data are preliminary and may change as more reports are received.

                  A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                  Key Points
                  • Nationally, the percentage of specimens testing positive for SARS-CoV-2 and the percentage of visits for ILI and CLI have continued to decrease since mid-July; however, there was some regional variation.
                  • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 6.2% during week 33 to 5.7% during week 34.
                    • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 declined or remained the same in eight of ten HHS regions but increased in Regions 7 (Central) and 8 (Mountain).
                    • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 9.3%), 6 (South Central, 10.2%), and 7 (Central, 10.0%). The percentage is decreasing in Regions 4 (South East) and 6 (South Central) and increasing in Region 7 (Central).
                  • The percentage of outpatient visits for ILI is below baseline nationally and in all regions of the country. During week 34, the percentage decreased or was stable in eight of ten regions but increased slightly in Regions 2 (NY/NJ/Puerto Rico) and 5 (Midwest).
                  • The percentage of visits to EDs for CLI decreased nationally for the sixth consecutive week and, compared to the previous week, decreased or was stable (changes ≤1%) in all ten HHS regions. The percent of visits to EDs for ILI was stable nationally and in all ten regions.
                  • The overall cumulative COVID-19-associated hospitalization rate was 156.8 per 100,000; rates were highest in people 65 years of age and older (425.7 per 100,000) followed by people 50-64 years (235.7 per 100,000).
                    • Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.1 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                    • Non-Hispanic American Indian or Alaska Native persons and non-Hispanic Black persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for Hispanic or Latino persons was approximately 4.6 times the rate among non-Hispanic White persons.
                  • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) for week 34 was 7.9%, lower than the percentage during week 33 (12.3%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                  • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                  U.S. Virologic Surveillance


                  The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                  2,021,409 43,204,184
                  249,770 4,890,334
                  145,374 4,522,686
                  1,626,265 33,791,164
                  114,199 (5.6%) 3,836,639 (8.9%)
                  15,185 (6.1%) 395,267 (8.1%)
                  7,459 (5.1%) 282,545 (6.3%)
                  91,555 (5.6%) 3,158,827 (9.3%)
                  * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                  Public Health Laboratories


                  resize iconView LargerView Data Table

                  Clinical Laboratories


                  resize iconView LargerView Data Table

                  Commercial Laboratories


                  resize iconView Larger


                  * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                  View Data Table


                  Additional virologic surveillance information: Surveillance Methods


                  Outpatient/Emergency Department Illness


                  Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                  ILINet


                  The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                  Nationwide during week 34, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but, while low overall, is higher than what is typical for this time of year compared to previous influenza seasons. Compared to week 33, the percentage of visits for ILI during week 34 was the same or lower overall and among all age groups except the 0-4 year age group which saw a slight increase from 2.3% in week 33 to 2.5% during week 34.

                  resize iconView Larger


                  * Age-group specific percentages should not be compared to the national baseline.

                  On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.5% during week 34. In all ten regions, the percentage of outpatient visits for ILI is below the region-specific baseline. Compared to week 33, the percentage in week 34 was lower or stable (changes ≤0.1%) in eight of ten HHS regions; slight increases were seen in Regions 2 (NY/NJ/Puerto Rico) and 5 (Central).

                  Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                  Overall Percentage of Visits for ILI | Age Group ILI Data

                  ILI Activity Levels


                  Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                  The number of jurisdictions at each activity level during week 34 and changes compared to the previous week are summarized in the table below and shown in the following maps.
                  Activity Level Number of Jurisdictions
                  Week 34
                  (Week ending
                  August 22, 2020)
                  Compared to Previous Week
                  Very High 0 No change
                  High 0 No change
                  Moderate 1 No change
                  Low 2 +2
                  Minimal 49 -1
                  Insufficient Data 2 -1
                  *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                  National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                  NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                  Nationwide during week 34, 2.2% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared to week 33, this week there was a decrease in the percentage of visits for CLI whereas the percentage of visits for ILI remained stable. This was the sixth consecutive week the percentages of visits for CLI and ILI decreased or remained stable. For the past three weeks, the percentages of visits for CLI and ILI decreased or remained stable (changes of ≤0.1%) in all 10 HHS regionsexternal icon.



                  Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                  Hospitalizations


                  The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                  A total of 51,114 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and August 22, 2020. The overall cumulative hospitalization rate was 156.8 per 100,000 population. Among the 0-4 year, 5-17 year, 18-49 year, 50-64 year, and ≥65 year age groups, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50-64 years and adults aged 18-49 years.

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                  Overall 156.8
                  0-4 years 15.4
                  5-17 years 8.7
                  18-49 years 105.9
                  18-29 years 66.6
                  30-39 years 105.0
                  40-49 years 157.8
                  50-64 years 235.7
                  65+ years 425.7
                  65-74 years 318.5
                  75-84 years 504.6
                  85+ years 775.0
                  Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.1 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                  Among the 51,114 laboratory-confirmed COVID-19-associated hospitalized cases, 48,921 (95.7%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,193 (4.3%) cases. When examining overall age-adjusted rates by race/ethnicity, non-Hispanic American Indian or Alaska Native persons and non-Hispanic Black persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for Hispanic or Latino persons was approximately 4.6 times the rate among non-Hispanic White persons.




                  When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 8.6 times higher among Hispanic or Latino persons aged 0-17 years; 8.6 times higher among Hispanic or Latino persons aged 18-49 years; 6.3 times higher among non-Hispanic American Indian or Alaska Native persons aged 50-64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥65 years.
                  Age Category Non-Hispanic
                  American Indian or Alaska Native
                  Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                  Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                  0-17y 11.7 4.7 16.0 6.4 21.5 8.6 5.6 2.2 2.5 1.0
                  18-49y 240.9 8.3 175.5 6.0 250.5 8.6 50.8 1.7 29.2 1.0
                  50-64y 590.2 6.3 496.1 5.3 540.0 5.8 146.3 1.6 93.0 1.0
                  65+y 668.7 2.6 996.3 3.8 700.6 2.7 273.7 1.0 261.8 1.0
                  Overall rate4 (age-adjusted) 323.6 4.7 326.7 4.7 322.0 4.6 91.9 1.3 69.3 1.0
                  1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                  2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                  3 The highest rate ratio in each age category is presented in bold.
                  4 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

                  Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios showed a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons and non-Hispanic Black persons had the highest prevalence ratios, followed by Hispanic or Latino persons.
                  1.3% 33.3% 22.9% 5.0% 31.5%
                  0.7% 17.9% 14.1% 8.9% 58.5%
                  1.9 1.9 1.6 0.6 0.5
                  1 Persons of multiple races (0.2%) or unknown race and ethnicity (5.8%) are not represented in the table but are included as part of the denominator.
                  2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

                  Among 9,943 hospitalized adults with information on underlying medical conditions, 90.5% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 270 hospitalized children with information on underlying conditions, 50.4% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic disease, and asthma.

                  resize iconView Larger


                  Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                  Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                  Mortality Surveillance


                  The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on August 27, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 34 is 7.9% and, while lower than the percentage during week 33 (12.3%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                  Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                  resize iconView Larger


                  *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                  View Data Table


                  Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                  More Information
                  View Page In:pdf icon 14 Pages, 1 MB
                  Last Updated Aug. 28, 2020
                  Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                  https://www.cdc.gov/coronavirus/2019.../08282020.html

                  Comment


                  • #24
                    1. CASES, DATA & SURVEILLANCE
                    COVIDView Summary ending on August 29, 2020


                    Updated Sept. 4, 2020
                    Print
                    Download Weekly Summary pdf icon[14 Pages, 1.5 MB]
                    Key Updates for Week 35, ending August 29, 2020


                    After declining since mid-July, the percentage of laboratory tests positive for SARS-CoV-2 nationally increased slightly from week 34 to week 35; seven of ten regions also reported increases in the percentage of laboratory tests positive for SARS-CoV-2 during week 35. Indicators that track influenza-like illness (ILI) and COVID-19-like illness (CLI) continued to decrease or remain stable (change of ≤0.1%) nationally and in all ten regions. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 35. Mortality attributed to COVID-19 remains above the epidemic threshold.
                    Virus

                    Public Health, Commercial and Clinical Laboratories


                    Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly from 5.4% during week 34 to 5.5% during week 35. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
                    • Public health laboratories – increased from 6.2% during week 34 to 6.3% during week 35;
                    • Clinical laboratories – increased from 5.5% during week 34 to 5.9% during week 35;
                    • Commercial laboratories – increased from 5.3% during week 34 to 5.4% during week 35.
                    Outpatient and Emergency Department Visits

                    Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                    Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                    • Nationally, ILI activity remains below baseline for the twentieth week and is at levels typically seen at this time of year.
                    • Nationally, the percentage of visits reported for ILI by ILINet participants decreased from 1.0% during week 34 to 0.9% during week 35. The percentage of visits for CLI reported to NSSP decreased for the seventh consecutive week, from 2.3% during week 34 to 2.0% during week 35.
                    • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                    Severe Disease

                    Hospitalizations


                    Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 161.0 per 100,000, with the highest rates in people aged 65 years and older (436.6 per 100,000) and 50–64 years (241.4 per 100,000).
                    Mortality


                    Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 35 is 6.6%. This is currently lower than the percentage during week 34 (10.7%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                    All data are preliminary and may change as more reports are received.

                    A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                    Key Points
                    • Nationally, the percentage of specimens testing positive for SARS-CoV-2 increased slightly while the percentage of visits for ILI and CLI have continued to decrease or remain stable (change of ≤0.1%) since mid-July; however, there was some regional variation.
                    • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay increased slightly from 5.4% during week 34 to 5.5% during week 35. This is the first week of an increase in the percentage of tests positive for SARS-CoV-2 since mid-July.
                      • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased in seven of ten HHS regions but decreased in Regions 4 (South East), 9 (South West/Coast) and 10 (Pacific Northwest).
                      • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 8.8%), 6 (South Central, 10.6%), and 7 (Central, 10.4%). The percentage is decreasing in Region 4 (South East) and increasing in Regions 6 (South Central) and 7 (Central).
                      • Among persons age 18–49 years, the percentage of specimens testing positive for SARS-CoV-2 increased from 5.5% during week 34 to 5.9% during week 35. The percentage positive decreased for all other age groups.
                    • The percentage of outpatient or ED visits to ILINet providers for ILI is below baseline nationally and in all regions of the country. During week 35, the percentage decreased nationally and decreased or was stable (change of ≤0.1%) in all ten regions.
                    • The percentage of visits to EDs for CLI decreased nationally for the seventh consecutive week and, compared to the previous week, decreased in all ten HHS regions. The percentage of visits to EDs for ILI was stable (change of ≤0.1%) nationally and decreasing or stable in all ten regions.
                    • The overall cumulative COVID-19-associated hospitalization rate was 161.0 per 100,000; rates were highest in people 65 years of age and older (436.6 per 100,000) followed by people 50–64 years (241.4 per 100,000).
                      • Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.2 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                      • Non-Hispanic Black persons and Hispanic or Latino persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.6 times the rate among non-Hispanic White persons.
                    • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 35 was 6.6%, lower than the percentage during week 34 (10.7%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                    • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                    U.S. Virologic Surveillance


                    The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                    1,927,525 44,203,187
                    230,627 5,183,227
                    142,985 4,846,538
                    1,553,913 34,173,422
                    106,909 (5.5%) 3,814,056 (8.6%)
                    14,628 (6.3%) 415,419 (8.0%)
                    8,476 (5.9%) 301,828 (6.2%)
                    83,805 (5.4%) 3,096,809 (9.1%)
                    * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                    Public Health Laboratories


                    resize iconView LargerView Data Table

                    Clinical Laboratories


                    resize iconView LargerView Data Table

                    Commercial Laboratories


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                    * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                    View Data Table


                    Additional virologic surveillance information: Surveillance Methods


                    Outpatient/Emergency Department Illness


                    Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                    ILINet


                    The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                    Nationwide during week 35, 0.9% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and is typical for this time of year compared to previous influenza seasons. Compared to week 34, the percentage of visits for ILI during week 35 was the same or lower overall and among all age groups except the 0–4 year age group which increased slightly for the second consecutive week.

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                    * Age-group specific percentages should not be compared to the national baseline.

                    On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.3% during week 35. In all ten regions, the percentage of outpatient visits for ILI is below the region-specific baseline. Compared to week 34, the percentage in week 35 was lower or stable (changes ≤0.1%) in all ten surveillance regions.

                    Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                    Overall Percentage of Visits for ILI | Age Group ILI Data

                    ILI Activity Levels


                    Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                    The number of jurisdictions at each activity level during week 35 and changes compared to the previous week are summarized in the table below and shown in the following maps.
                    Activity Level Number of Jurisdictions
                    Week 35
                    (Week ending
                    August 29, 2020)
                    Compared to Previous Week
                    Very High 0 No change
                    High 0 No change
                    Moderate 0 -1
                    Low 1 -1
                    Minimal 51 +2
                    Insufficient Data 2 No change
                    *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                    National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                    NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                    Nationwide during week 35, 2.0% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared to week 34, this week the percentage of visits for CLI and the percentage of visits for ILI decreased or remained stable (changes of ≤0.1%) nationally and in in all 10 HHS regionsexternal icon.



                    Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                    Hospitalizations


                    The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                    A total of 52,503 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and August 29, 2020. The overall cumulative hospitalization rate was 161.0 per 100,000 population. Among the 0–4 year, 5–17 year, 18–49 year, 50–64 year, and ≥65 year age groups, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50–64 years and adults aged 18–49 years.

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                    Overall 161.0
                    0-4 years 15.8
                    5-17 years 9.2
                    18-49 years 109.2
                    18-29 years 68.8
                    30-39 years 108.4
                    40-49 years 162.4
                    50-64 years 241.4
                    65+ years 436.6
                    65-74 years 327.8
                    75-84 years 515.9
                    85+ years 793.2
                    Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second peak during the week ending July 18 (MMWR week 29) at 8.2 per 100,000 population. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                    Among the 52,503 laboratory-confirmed COVID-19-associated hospitalized cases, 50,158 (95.5%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,345 (4.5%) cases. When examining overall age-adjusted rates by race/ethnicity, both non-Hispanic Black persons and Hispanic or Latino persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.6 times the rate among non-Hispanic White persons.




                    When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 8.3 times higher among Hispanic or Latino persons aged 0–17 years; 8.6 times higher among Hispanic or Latino persons aged 18–49 years; 6.3 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥65 years.
                    Age Category Non-Hispanic
                    American Indian or Alaska Native
                    Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                    Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                    0-17 years 13.6 5.0 16.7 6.2 22.3 8.3 5.5 2.0 2.7 1
                    18-49 years 243.9 8.1 180.3 6.0 258.0 8.6 51.6 1.7 30.1 1
                    50-64 years 598.2 6.3 505.1 5.3 555.9 5.8 151.0 1.6 95.4 1
                    65+ years 677.1 2.5 1013.1 3.8 720.7 2.7 285.9 1.1 267.9 1
                    Overall rate4 (age-adjusted) 328.0 4.6 333.1 4.7 331.4 4.7 94.9 1.3 71.1 1
                    1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                    2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                    3 The highest rate ratio in each age category is presented in bold.
                    4 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

                    Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons and non-Hispanic Black persons, followed by Hispanic or Latino persons.
                    1.3% 33.2% 23.0% 5.0% 31.5%
                    0.7% 17.9% 14.1% 8.9% 58.5%
                    1.9 1.9 1.6 0.6 0.5
                    1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.8%) are not represented in the table but are included as part of the denominator.
                    2 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

                    Among 10,432 hospitalized adults with information on underlying medical conditions, 90.6% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 288 hospitalized children with information on underlying conditions, 50.7% had at least one reported underlying medical condition. The most commonly reported were obesity, neurologic disease, and asthma.

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                    Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                    Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                    Mortality Surveillance


                    The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on September 3, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 35 is 6.6% and, while lower than the percentage during week 34 (10.7%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                    Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

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                    *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                    View Data Table


                    Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                    More Information
                    View Page In:pdf icon 14 Pages, 1.5 MB
                    Last Updated Sept. 4, 2020
                    Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                    https://www.cdc.gov/coronavirus/2019.../09042020.html

                    Comment


                    • #25
                      1. CASES, DATA & SURVEILLANCE
                      COVIDView Summary ending on September 5, 2020


                      Updated Sept. 11, 2020
                      Print
                      Download Weekly Summary pdf icon[13 Pages, 1.4 MB]
                      Key Updates for Week 36, ending September 5, 2020


                      After declining since mid-July, the percentage of laboratory specimens testing positive for SARS-CoV-2 nationally increased slightly during week 35 but then decreased during week 36. Indicators that track influenza-like illness (ILI) and COVID-19-like illness (CLI) continued to decrease or remain stable (change of ≤0.1%) nationally and in all 10 regions; however, due to COVID-19 activity, one region reported levels of ILI above the region-specific baseline. Weekly hospitalization rates and mortality attributed to COVID-19 declined during week 36. Mortality attributed to COVID-19 remains above the epidemic threshold.
                      Virus

                      Public Health, Commercial and Clinical Laboratories


                      Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 5.5% during week 35 to 5.1% during week 36. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed as follows:
                      • Public health laboratories – decreased from 6.2% during week 35 to 5.4% during week 36;
                      • Clinical laboratories – decreased from 5.4% during week 35 to 4.5% during week 36;
                      • Commercial laboratories – decreased from 5.5% during week 35 to 5.1% during week 36.
                      Outpatient and Emergency Department Visits

                      Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                      Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                      • Nationally, ILI activity remains below baseline for the 21st consecutive week and is at levels that are typicalfor this time of year.
                      • Nationally, the percentage of visits reported for ILI by ILINet participants decreased from 1.0% during week 35 to 0.9% during week 36. The percentage of visits for CLI reported to NSSP decreased for the eighth consecutive week, from 2.1% during week 35 to 1.8% during week 36.
                      • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                      Severe Disease

                      Hospitalizations


                      Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 166.9 per 100,000, with the highest rates in people aged 65 years and older (451.2 per 100,000) and 50–64 years (249.8 per 100,000).
                      Mortality


                      Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 36 is 6.3%. This is currently lower than the percentage during week 35 (9.5%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                      All data are preliminary and may change as more reports are received.

                      A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                      Key Points
                      • Nationally, since mid-July, there has been an overall decreasing trend in the percentage of specimens testing positive for SARS-CoV-2 and a decreasing or stable (change of ≤0.1%) trend in the percentage of visits for ILI and CLI; however, there has been some regional variation.
                      • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 5.8% during week 35 to 5.2% during week 36.
                        • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly in Regions 1 (New England) and 3 (Mid-Atlantic) and decreased or remained stable in the remaining seven regions.
                        • The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 8.1%), 6 (South Central, 9.3%), and 7 (Central, 9.5%), but the percentage is decreasing in all three regions.
                      • The percentage of outpatient or ED visits to ILINet providers for ILI is below baseline nationally and in nine of the 10 regions of the country. Region 7 (Central) reported ILI above the region-specific baseline. This increase is due to visits for ILI associated with COVID-19 activity in Iowa, which resulted in Iowa experiencing “very high” ILI activity.
                        • Compared with week 35, the percentage of visits for ILI during week 36 decreased nationally and decreased or was stable (change of ≤0.1%) in all 10 regions.
                      • The percentage of visits to EDs for CLI decreased nationally for the eighth consecutive week and, compared with the previous week, decreased in all 10 HHS regions. The percentage of visits to EDs for ILI was stable (change of ≤0.1%) nationally and decreasing or stable in all 10 regions.
                      • The overall cumulative COVID-19-associated hospitalization rate was 166.9 per 100,000; rates were highest in people 65 years of age and older (451.2 per 100,000) followed by people 50–64 years (249.8 per 100,000).
                        • Although SARS-CoV-2 viruses have been circulating in the U.S. for slightly longer than a typical influenza season, the cumulative hospitalization rate for COVID-19 among adults 65 years and older is now higher than the end-of-season influenza hospitalization rates for recent influenza seasons, including the high severity 2017–2018 season. Since early in the pandemic, cumulative COVID-19 hospitalization rates for younger adult age groups (18-49 year olds and 50-64 year olds) have been higher than recent end-of-season hospitalization rates for influenza.
                        • From the week ending August 1 (week 31) to the week ending August 29 (week 35), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates initially remained constant for children in the 5–17 year age group and then increased during the week ending August 29 (week 35). Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                        • Hispanic or Latino persons and Non-Hispanic Black persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.6 times the rate among non-Hispanic White persons.
                      • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 36 was 6.3%, lower than the percentage during week 35 (9.5%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                      • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                      U.S. Virologic Surveillance


                      The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                      1,949,226 46,481,561
                      261,282 5,545,867
                      121,654 5,143,112
                      1,566,290 35,792,582
                      99,799 (5.1%) 3,934,090 (8.5%)
                      14,238 (5.4%) 435,007 (7.8%)
                      5,494 (4.5%) 316,682 (6.2%)
                      80,067 (5.1%) 3,182,401 (8.9%)
                      * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                      Public Health Laboratories


                      resize iconView LargerView Data Table

                      Clinical Laboratories


                      resize iconView LargerView Data Table

                      Commercial Laboratories


                      resize iconView Larger


                      * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                      View Data Table


                      Additional virologic surveillance information: Surveillance Methods


                      Outpatient/Emergency Department Illness


                      Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                      ILINet


                      The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                      Nationwide during week 36, 0.9% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and is typical for this time of year compared to previous influenza seasons. Compared with week 35, the percentage of visits for ILI during week 36 was the same or lower overall and among all age groups.

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                      * Age-group specific percentages should not be compared with the national baseline.

                      On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.4% to 2.1% during week 36. Compared with week 35 the percentage was declining or stable (changes of ≤0.1%) in all ten regions. The percentage of outpatient visits for ILI was below the region-specific baseline in nine regions; however, Region 7 (Central) reported ILI above the region-specific baseline for the past two weeks. This increase is due to increased ILI activity in Iowa and is associated with COVID-19 activity.

                      Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                      Overall Percentage of Visits for ILI | Age Group ILI Data

                      ILI Activity Levels


                      Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                      The number of jurisdictions at each activity level during week 36 and changes compared with the previous week are summarized in the table below and shown in the following maps.
                      Activity Level Number of Jurisdictions
                      Week 36
                      (Week ending
                      September 5, 2020)
                      Compared with Previous Week
                      Very High 1 +1
                      High 0 No change
                      Moderate 0 No change
                      Low 1 No change
                      Minimal 50 -1
                      Insufficient Data 2 No change
                      *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                      National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                      NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                      Nationwide during week 36, 1.8% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared with week 35, this week the percentage of visits for CLI and the percentage of visits for ILI decreased or remained stable (changes of ≤0.1%) nationally and in all 10 HHS regionsexternal icon.



                      Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                      Hospitalizations


                      The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                      A total of 54,425 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and September 5, 2020. The overall cumulative hospitalization rate was 166.9 per 100,000 population. Among the 0–4 year, 5–17 year, 18–49 year, 50–64 year, and ≥65 year age groups, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50–64 years and adults aged 18–49 years.

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                      Overall 166.9
                      0-4 years 16.8
                      5-17 years 9.7
                      18-49 years 113.8
                      18-29 years 72.5
                      30-39 years 113.4
                      40-49 years 167.5
                      50-64 years 249.8
                      65+ years 451.2
                      65-74 years 338.9
                      75-84 years 534.9
                      85+ years 814.6
                      Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). From the week ending August 1 (MMWR week 31) to the week ending August 29 (MMWR week 35), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates initially remained constant in the 5–17 year age group and increased during the week ending August 29 (MMWR week 35). Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                      Among the 54,425 laboratory-confirmed COVID-19-associated hospitalizations, 51,286 (94.2%) had information on race and ethnicity; collection of race and ethnicity was still pending for 3,139 (5.8%) hospitalizations. When examining overall age-adjusted rates by race/ethnicity, both Hispanic or Latino persons and non-Hispanic Black persons had age-adjusted hospitalization rates approximately 4.7 times that of non-Hispanic White persons. The rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.6 times the rate among non-Hispanic White persons.




                      When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 8.0 times higher among Hispanic or Latino persons aged 0–17 years; 8.6 times higher among Hispanic or Latino persons aged 18–49 years; 6.2 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.8 times higher among non-Hispanic Black persons aged ≥65 years.
                      Age Category Non-Hispanic
                      American Indian or Alaska Native
                      Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                      Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                      0—17 years 13.6 4.7 17.2 5.9 22.3 8.0 6.0 2.1 2.9 1
                      18—49 years 247.8 8.0 184.3 5.9 265.6 8.6 53.1 1.7 31.0 1
                      50—64 years 603.5 6.2 513.6 5.3 570.0 5.8 156.0 1.6 97.7 1
                      65+ years 685.5 2.5 1028.8 3.8 743.4 2.7 293.7 1.1 273.6 1
                      Overall rate4 (age-adjusted) 332.3 4.6 339.0 4.7 341.1 4.7 97.7 1.3 72.8 1
                      1 COVID-19-associated hospitalization rates by race/ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                      2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial/ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                      3 The highest rate ratio in each age category is presented in bold.
                      4 Overall rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, and 65+ years.

                      Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalizations as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                      1.3% 33.0% 23.1% 5.0% 31.5%
                      0.7% 17.9% 14.1% 8.9% 58.5%
                      1.9 1.8 1.6 0.6 0.5
                      1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.8%) are not represented in the table but are included as part of the denominator.
                      2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                      Among 10,824 hospitalized adults with information on underlying medical conditions, 90.3% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 344 hospitalized children with information on underlying conditions, 50.3% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were obesity, neurologic disease, and asthma.

                      resize iconView Larger


                      Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                      Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                      Mortality Surveillance


                      The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on September 10, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 36 is 6.3% and, while lower than the percentage during week 35 (9.5%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                      Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                      resize iconView Larger


                      *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                      View Data Table


                      Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                      More Information
                      View Page In:pdf icon 14 Pages, 1.5 MB
                      Last Updated Sept. 11, 2020
                      Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                      https://www.cdc.gov/coronavirus/2019.../09112020.html

                      Comment


                      • #26
                        1. CASES, DATA & SURVEILLANCE
                        COVIDView Summary ending on September 12, 2020


                        Updated Sept. 18, 2020
                        Print
                        Download Weekly Summary pdf icon[13 Pages, 1.4 MB]
                        Key Updates for Week 37, ending September 12, 2020


                        Nationally, indicators that track COVID-19 activity continued to decline or remain stable (change of ≤0.1%); however, two regions reported a slight increase in the percentage of specimens testing positive for SARS-CoV-2, the virus causing COVID-19, and four regions reported a slight increase in the percent of visits for influenza-like illness (ILI) to outpatient providers or emergency departments (EDs). Mortality attributed to COVID-19 declined but remains above the epidemic threshold.
                        Virus

                        Public Health, Commercial and Clinical Laboratories


                        Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 5.2% during week 36 to 4.8% during week 37. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed.
                        • Public health laboratories – decreased from 5.4% during week 36 to 4.5% during week 37
                        • Clinical laboratories – increased from 5.2% during week 36 to 5.4% during week 37
                        • Commercial laboratories – decreased from 5.2% during week 36 to 4.8% during week 37
                        Outpatient and Emergency Department Visits

                        Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                        Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                        • Nationally, ILI activity remains below baseline for the 22nd consecutive week and is at levels that are typical for this time of year.
                        • Nationally, the percentage of visits reported for ILI by ILINet participants remained stable (change of ≤0.1%) in week 37 compared with week 36. The percentage of visits for COVID-like illness (CLI) reported to NSSP decreased for the ninth consecutive week, from 2.0% during week 36 to 1.8% during week 37.
                        • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                        Severe Disease

                        Hospitalizations


                        Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 170.4 per 100,000, with the highest rates in people aged 65 years and older (460.7 per 100,000) and 50–64 years (255.1 per 100,000).
                        Mortality


                        Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 37 is 6.2%. This is currently lower than the percentage during week 36 (9.3%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                        All data are preliminary and may change as more reports are received.

                        A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                        Key Points
                        • Nationally, since mid-July, there has been an overall decreasing trend in the percentage of specimens testing positive for SARS-CoV-2 and a decreasing or stable (change of ≤0.1%) trend in the percentage of visits for ILI and CLI; however, there has been some regional variation.
                        • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 5.2% during week 36 to 4.8% during week 37.
                          • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly in Regions 2 (New Jersey/New York/Puerto Rico) and 8 (Mountain) and decreased or remained stable in the remaining eight regions.
                          • The highest percentage of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (South East, 7.5%), 6 (South Central, 8.3%), and 7 (Central, 8.9%), but the percentage is decreasing in all three regions.
                        • The percentage of outpatient or ED visits to ILINet providers for ILI is below baseline nationally and in all 10 regions of the country.
                          • Compared with week 36, the percentage of visits for ILI during week 37 remained stable (change of ≤0.1%) nationally and decreased or was stable in seven of 10 regions. Regions 2 (New Jersey/New York/Puerto Rico), 5 (Midwest), and 6 (South Central) reported a slight increase in the percentage of visits for ILI.
                        • The percentage of visits to EDs for CLI decreased nationally for the ninth consecutive week and, compared with the previous week, decreased or remained stable (change of ≤0.1%) in all 10 HHS regions. The percentage of visits to EDs for ILI was stable nationally and decreasing or stable in nine of the 10 regions. Region 7 (Central) reported a slight increase in the percentage of visits to EDs for ILI.
                        • The overall cumulative COVID-19-associated hospitalization rate was 170.4 per 100,000; rates were highest in people 65 years of age and older (460.7 per 100,000) followed by people 50–64 years (255.1 per 100,000).
                          • From the week ending August 1 (MMWR week 31) to the week ending September 12 (MMWR week 37), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                          • Hispanic or Latino persons, non-Hispanic American Indian or Alaska Native persons, and non-Hispanic Black persons all had age-adjusted hospitalization rates approximately 4.6 times that of non-Hispanic White persons.
                        • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 37 was 6.2%, lower than the percentage during week 36 (9.3%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                        • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                        U.S. Virologic Surveillance


                        The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                        1,831,880 48,727,297
                        234,583 5,818,198
                        129,586 5,488,128
                        1,467,711 37,420,971
                        88,565 (4.8%) 4,045,085 (8.3%)
                        10,634 (4.5%) 446,780 (7.7%)
                        6,993 (5.4%) 335,696 (6.1%)
                        70,938 (4.8%) 3,262,609 (8.7%)
                        * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                        Public Health Laboratories


                        resize iconView LargerView Data Table

                        Clinical Laboratories


                        resize iconView LargerView Data Table

                        Commercial Laboratories


                        resize iconView Larger


                        * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                        View Data Table


                        Additional virologic surveillance information: Surveillance Methods


                        Outpatient/Emergency Department Illness


                        Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                        ILINet


                        The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                        Nationwide during week 37, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and is typical for this time of year compared to previous influenza seasons. Compared with week 36, the percentage of visits for ILI during week 37 slightly increased overall and among the pediatric age groups (0-4 years and 5-24 years) and the 50-64 year olds.

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                        * Age-group specific percentages should not be compared with the national baseline.

                        On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.6% during week 37 and was below the region-specific baseline in all regions. Compared with week 36, the percentage increased in three of the ten regions: Regions 2 (New Jersey/New York/Puerto Rico), 5 (Midwest), and 6 (South Central).

                        Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                        Overall Percentage of Visits for ILI | Age Group ILI Data

                        ILI Activity Levels


                        Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                        The number of jurisdictions at each activity level during week 37 and changes compared with the previous week are summarized in the table below and shown in the following maps. The “high” level of activity in Iowa is due to visits for ILI associated with COVID-19 activity.
                        Activity Level Number of Jurisdictions
                        Week 37
                        (Week ending
                        September 12, 2020)
                        Compared with Previous Week
                        Very High 0 -1
                        High 1 +1
                        Moderate 1 +1
                        Low 0 -1
                        Minimal 49 -1
                        Insufficient Data 3 +1
                        *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                        National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                        NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                        Nationwide during week 37, 1.8% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared with week 36, this week the percentage of visits for CLI and the percentage of visits for ILI decreased or remained stable (changes of ≤0.1%) nationally and in 9 of 10 HHS regionsexternal icon. Region 7 (Central) saw a slight increase in ILI compared with week 36.



                        Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                        Hospitalizations


                        The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                        A total of 55,544 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and September 12, 2020. The overall cumulative hospitalization rate was 170.4 per 100,000 population. Among those aged 0–4 years, 5–17 years, 18–49 years, 50–64 years, and ≥65 years, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50–64 years and adults aged 18–49 years.

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                        Overall 170.4
                        0-4 years 17.3
                        5-17 years 9.8
                        18-49 years 116.0
                        18-29 years 73.9
                        30-39 years 115.6
                        40-49 years 170.6
                        50-64 years 255.1
                        65+ years 460.7
                        65-74 years 345.8
                        75-84 years 546.3
                        85+ years 833.1
                        Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). From the week ending August 1 (MMWR week 31) to the week ending September 12 (MMWR week 37), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                        Among the 55,544 laboratory-confirmed COVID-19-associated hospitalizations, 52,547 (94.6%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,997 (5.4%) cases. When examining overall age-adjusted rates by race and ethnicity, Hispanic or Latino persons, non-Hispanic American Indian or Alaska Native persons, and non-Hispanic Black persons all had age-adjusted hospitalization rates approximately 4.6 times that of non-Hispanic White persons.




                        When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 7.7 times higher among Hispanic or Latino persons aged 0–17 years; 8.5 times higher among Hispanic or Latino persons aged 18–49 years; 6.4 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.7 times higher among non-Hispanic Black persons aged ≥65 years.
                        Age Category Non-Hispanic
                        American Indian or Alaska Native
                        Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                        Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                        0—17 years 11.7 3.8 17.9 5.8 23.8 7.7 6.0 1.9 3.1 1
                        18—49 years 257.5 8.0 188.3 5.9 271.4 8.5 54.2 1.7 32.1 1
                        50—64 years 643.4 6.4 526.1 5.2 584.5 5.8 160.3 1.6 100.8 1
                        65+ years 710.8 2.5 1048.3 3.7 760.1 2.7 306.8 1.1 282.0 1
                        Overall rate4 (age-adjusted) 347.7 4.6 346.2 4.6 349.0 4.6 101.0 1.3 75.2 1
                        1 COVID-19-associated hospitalization rates by race and ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                        2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial and ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                        3 The highest rate ratio in each age category is presented in bold.
                        4 Overall rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0–17, 18–49, 50–64, and 65+ years.

                        Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalizations as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                        1.3% 32.9% 23.1% 5.1% 31.7%
                        0.7% 17.9% 14.1% 8.9% 58.5%
                        1.9 1.8 1.6 0.6 0.5
                        1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.6%) are not represented in the table but are included as part of the denominator.
                        2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                        Among 11,428 hospitalized adults with information on underlying medical conditions, 90.3% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 371 hospitalized children with information on underlying conditions, 49.1% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were obesity, neurologic disease, and asthma.

                        resize iconView Larger


                        Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                        Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                        Mortality Surveillance


                        The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on September 17, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 37 is 6.2% and, while lower than the percentage during week 36 (9.3%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                        Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                        resize iconView Larger


                        *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                        View Data Table


                        Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19
                        More Information
                        View Page In:pdf icon 13 Pages, 1.4 MB
                        Last Updated Sept. 18, 2020
                        Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                        https://www.cdc.gov/coronavirus/2019.../09182020.html


                        Comment


                        • #27
                          1. CASES, DATA & SURVEILLANCE
                          COVIDView Summary ending on September 19, 2020


                          Updated Sept. 25, 2020
                          Print
                          Download Weekly Summary pdf icon[13 pages, 1 MB]
                          Key Updates for Week 38, ending September 19, 2020


                          Nationally, indicators that track COVID-19 activity continued to decline or remain stable (change of ≤0.1%); however, three regions reported an increase in the percentage of specimens testing positive for SARS-CoV-2, the virus causing COVID-19, and one of those regions also reported an increase in the percentage of visits for influenza-like illness (ILI) and COVID-like illness (CLI) to emergency departments (EDs). Mortality attributed to COVID-19 declined but remains above the epidemic threshold.
                          Virus

                          Public Health, Commercial and Clinical Laboratories


                          Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 5.1% during week 37 to 4.8% during week 38. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed.
                          • Public health laboratories – increased from 4.6% during week 37 to 5.1% during week 38
                          • Clinical laboratories – decreased from 6.0% during week 37 to 5.4% during week 38
                          • Commercial laboratories – decreased from 5.0% during week 37 to 4.6% during week 38
                          Outpatient and Emergency Department Visits

                          Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                          Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                          • Nationally, ILI activity remains below baseline for the 23rd consecutive week and is at levels that are typical for this time of year.
                          • Nationally, the percentage of visits for ILI reported by ILINet participants and the percentage of visits for COVID-like illness (CLI) reported to NSSP remained stable (change of ≤0.1%) in week 38 compared with week 37.
                          • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                          Severe Disease

                          Hospitalizations


                          Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 174.8 per 100,000, with the highest rates in people aged 65 years and older (472.3 per 100,000) and 50–64 years (261.5 per 100,000).
                          Mortality


                          Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 38 is 6.6%. This is currently lower than the percentage during week 37 (9.8%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                          All data are preliminary and may change as more reports are received.

                          A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                          Key Points
                          • Nationally, since mid-July, there has been an overall decreasing trend in the percentage of specimens testing positive for SARS-CoV-2 and a decreasing or stable (change of ≤0.1%) trend in the percentage of visits for ILI and CLI; however, there has been some regional variation.
                          • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 5.1% during week 37 to 4.8% during week 38.
                            • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased in Regions 7 (Central), 8 (Mountain) and 10 (Pacific Northwest) and decreased or remained stable in the remaining seven regions.
                            • The highest percentage of specimens testing positive for SARS-CoV-2 were seen in Regions 6 (South Central, 8.3%) and 7 (Central, 9.0%).
                          • The percentage of outpatient or ED visits to ILINet providers for ILI is below baseline nationally and in all 10 regions of the country.
                            • Compared with week 37, the percentage of visits for ILI during week 38 remained stable nationally and decreased or was stable (change of ≤0.1%) in all 10 regions.
                          • Nationally, the percentage of visits to EDs for CLI and ILI remained stable (change of ≤0.1%) in week 38 compared with week 37. This is the tenth consecutive week of a declining or stable percentage of visits for CLI and ILI.
                            • Region 8 (Mountain) reported an increase in the percentage of visits for both CLI and ILI in week 38 compared to week 37. The remaining nine regions reported a stable (change of ≤0.1%) or decreasing percentage.
                          • The overall cumulative COVID-19-associated hospitalization rate was 174.8 per 100,000; rates were highest in people 65 years of age and older (472.3 per 100,000) followed by people 50–64 years (261.5 per 100,000).
                            • From the week ending August 1 (MMWR week 31) to the week ending September 19 (MMWR week 38), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                            • Age-adjusted hospitalization rates for Hispanic or Latino persons and non-Hispanic Black persons were both approximately 4.6 times that of non-Hispanic White persons. The age-adjusted hospitalization rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.5 times that of non-Hispanic White persons.
                          • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 38 was 6.6%, which was lower than the percentage during week 37 (9.8%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                          • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                          U.S. Virologic Surveillance


                          The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                          2,029,130 51,075,554
                          294,153 6,159,942
                          175,308 5,848,708
                          1,559,669 39,066,904
                          96,477 (4.8%) 4,163,115 (8.2%)
                          15,074 (5.1%) 464,343 (7.5%)
                          9,509 (5.4%) 357,369 (6.1%)
                          71,894 (4.6%) 3,341,403 (8.6%)
                          * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                          Public Health Laboratories


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                          Clinical Laboratories


                          resize iconView LargerView Data Table

                          Commercial Laboratories


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                          * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                          View Data Table


                          Additional virologic surveillance information: Surveillance Methods


                          Outpatient/Emergency Department Illness


                          Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                          ILINet


                          The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                          Nationwide during week 38, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and is typical for this time of year compared to previous influenza seasons. Compared with week 37, the percentage of visits for ILI during week 38 slightly increased overall and among those aged 0 to 4 years and 25 to 49 years.

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                          * Age-group specific percentages should not be compared with the national baseline.

                          On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.4% during week 38 and was below the region-specific baseline in all regions. Compared with week 37, the percentage during week 38 decreased slightly in regions 6 (South Central) and 7 (Central) and remained stable (change of ≤0.1%) in the remaining eight regions.

                          Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                          Overall Percentage of Visits for ILI | Age Group ILI Data

                          ILI Activity Levels


                          Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                          The number of jurisdictions at each activity level during week 38 and changes compared with the previous week are summarized in the table below and shown in the following maps.
                          Activity Level Number of Jurisdictions
                          Week 38
                          (Week ending
                          September 19, 2020)
                          Compared with Previous Week
                          Very High 0 No Change
                          High 0 -1
                          Moderate 1 No Change
                          Low 1 +1
                          Minimal 49 No Change
                          Insufficient Data 3 No Change
                          *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                          National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                          NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                          Nationwide during week 38, 1.8% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared with week 37, the percentage of visits for CLI and the percentage of visits for ILI this week decreased or remained stable (changes of ≤0.1%) nationally and in 9 of 10 HHS regionsexternal icon. Region 8 (Mountain) saw an increase in both CLI and ILI compared with week 37.



                          Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                          Hospitalizations


                          The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                          A total of 57,006 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and September 19, 2020. The overall cumulative hospitalization rate was 174.8 per 100,000 population. Among those aged 0–4 years, 5–17 years, 18–49 years, 50–64 years, and ≥65 years, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50–64 years and adults aged 18–49 years.

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                          Overall 174.8
                          0-4 years 17.9
                          5-17 years 10.3
                          18-49 years 119.2
                          18-29 years 76.6
                          30-39 years 119.1
                          40-49 years 174.4
                          50-64 years 261.5
                          65+ years 472.3
                          65-74 years 354.2
                          75-84 years 562.3
                          85+ years 850.1
                          Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). From the week ending August 1 (MMWR week 31) to the week ending September 19 (MMWR week 38), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                          Among the 57,006 laboratory-confirmed COVID-19-associated hospitalizations, 54,074 (94.9%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,932 (5.1%) cases. When examining overall age-adjusted rates by race and ethnicity, rates for Hispanic or Latino persons and non-Hispanic Black persons were both approximately 4.6 times the rate among non-Hispanic White persons. The age-adjusted hospitalization rate for non-Hispanic American Indian or Alaska Native persons was approximately 4.5 times that of non-Hispanic White persons.




                          When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 7.5 times higher among Hispanic or Latino persons aged 0–17 years; 8.4 times higher among Hispanic or Latino persons aged 18–49 years; 6.2 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.7 times higher among non-Hispanic Black persons aged ≥65 years.
                          Age Category Non-Hispanic
                          American Indian or Alaska Native
                          Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                          Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                          0—17 years 11.7 3.5 18.6 5.6 24.6 7.5 6.3 1.9 3.3 1
                          18—49 years 260.5 7.8 194.7 5.8 279.3 8.4 55.4 1.7 33.4 1
                          50—64 years 643.4 6.2 545.0 5.2 595.8 5.7 166.8 1.6 104.4 1
                          65+ years 715.0 2.5 1074.2 3.7 784.5 2.7 319.8 1.1 290.3 1
                          Overall rate4 (age-adjusted) 349.9 4.5 356.8 4.6 358.5 4.6 104.7 1.3 77.7 1
                          1 COVID-19-associated hospitalization rates by race and ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                          2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial and ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                          3 The highest rate ratio in each age category is presented in bold.
                          4 Overall rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0–17, 18–49, 50–64, and 65+ years.

                          Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalizations as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                          1.3% 33.0% 23.1% 5.1% 31.8%
                          0.7% 17.9% 14.1% 8.9% 58.5%
                          1.9 1.8 1.6 0.6 0.5
                          1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.4%) are not represented in the table but are included as part of the denominator.
                          2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                          Among 12,151 hospitalized adults with information on underlying medical conditions, 90.4% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 393 hospitalized children with information on underlying conditions, 49.9% had at least one reported underlying medical condition. The most commonly reported underlying medical conditions were obesity, neurologic disease, and asthma.

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                          Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                          Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                          Mortality Surveillance


                          The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on September 24, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 38 is 6.6% and, while lower than the percentage during week 37 (9.8%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                          Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

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                          *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                          View Data Table


                          Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19
                          More Information
                          View Page In:pdf icon 13 Pages, 1 MB
                          Last Updated Sept. 25, 2020
                          Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillancehttps://www.cdc.gov/coronavirus/2019.../09252020.html

                          Comment


                          • #28
                            1. CASES, DATA & SURVEILLANCE
                            COVIDView Summary ending on September 26, 2020


                            Updated Oct. 2, 2020
                            Print
                            Download Weekly Summary pdf icon[13 pages, 1 MB]
                            Key Updates for Week 39, ending September 26, 2020


                            Nationally, indicators that track COVID-19 activity continued to decline or remain stable (change of ≤0.1%); however, three regions reported an increase in the percentage of specimens testing positive for SARS-CoV-2, the virus causing COVID-19, and two of those regions also reported an increase in the percentage of visits for influenza-like illness (ILI) or COVID-like illness (CLI) to emergency departments (EDs) or outpatient providers. Mortality attributed to COVID-19 declined but remains above the epidemic threshold.
                            Virus

                            Public Health, Commercial and Clinical Laboratories


                            Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2 decreased from 5.0% during week 38 to 4.8% during week 39. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory are listed.
                            • Public health laboratories – decreased from 5.1% during week 38 to 4.9% during week 39
                            • Clinical laboratories – increased slightly from 6.2% during week 38 to 6.3% during week 39
                            • Commercial laboratories – decreased from 4.8% during week 38 to 4.6% during week 39
                            Outpatient and Emergency Department Visits

                            Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                            Two surveillance networks are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                            • Nationally, ILI activity remains below baseline for the 24th consecutive week and is at levels that are typical for this time of year.
                            • Nationally, the percentage of visits for ILI reported by ILINet participants and the percentage of visits for COVID-like illness (CLI) reported to NSSP remained stable (change of ≤0.1%) in week 39 compared with week 38.
                            • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit ED visits to severe illnesses, and increased social distancing, are likely affecting both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                            Severe Disease

                            Hospitalizations


                            Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate was 178.2 per 100,000, with the highest rates in people aged 65 years and older (481.5 per 100,000) and 50–64 years (266.3 per 100,000).
                            Mortality


                            Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 39 is 6.4%. This is currently lower than the percentage during week 38 (9.5%); however, the percentage remains above the epidemic threshold and will likely increase as more death certificates are processed.

                            All data are preliminary and may change as more reports are received.

                            A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                            Key Points
                            • Nationally, since mid-July, there has been an overall decreasing trend in the percentage of specimens testing positive for SARS-CoV-2 and a decreasing or stable (change of ≤0.1%) trend in the percentage of visits for ILI and CLI; however, there has been some regional variation.
                            • Using combined data from the three laboratory types, the national percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased from 5.0% during week 38 to 4.8% during week 39.
                              • Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased in Regions 7 (Central), 8 (Mountain), and 10 (Pacific Northwest) and decreased or remained stable in the remaining seven regions.
                              • The highest percentage of specimens testing positive for SARS-CoV-2 were seen in Regions 6 (South Central, 8.0%), 7 (Central, 9.1%), and 8 (Mountain, 7.3%). Compared to week 38, the percentage of specimens testing positive during week 39 is increasing in Regions 7 and 8 and decreasing in Region 6.
                            • The percentage of outpatient or ED visits to ILINet providers for ILI is below baseline nationally and in all 10 regions of the country.
                              • Compared with week 38, the percentage of visits for ILI during week 39 remained stable nationally and decreased or was stable (change of ≤0.1%) in nine of the 10 regions. Region 10 (Pacific Northwest) reported a slight increase.
                            • Nationally, the percentage of visits to EDs for CLI and ILI remained stable (change of ≤0.1%) in week 39 compared with week 38. This is the 11th consecutive week of a declining or stable percentage of visits for CLI and ILI.
                              • Regions 5 (Midwest) and 8 (Mountain) reported an increase in the percentage of visits for CLI in week 38 compared to week 37, and Region 10 (Pacific Northwest) reported an increase in the percentage of visits for ILI. The remaining regions reported a stable (change of ≤0.1%) or decreasing percentage.
                            • The overall cumulative COVID-19-associated hospitalization rate was 178.2 per 100,000; rates were highest in people 65 years of age and older (481.5 per 100,000) followed by people 50–64 years (266.3 per 100,000).
                              • From the week ending August 1 (MMWR week 31) to the week ending September 26 (MMWR week 39), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                              • The age-adjusted hospitalization rate for Hispanic or Latino persons was approximately 4.6 times that of non-Hispanic White persons. Age-adjusted hospitalization rates for both non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons were approximately 4.5 times that of non-Hispanic White persons.
                            • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 39 was 6.4%, which was lower than the percentage during week 38 (9.5%), but above the epidemic threshold. These percentages will likely increase as more death certificates are processed.
                            • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                            U.S. Virologic Surveillance


                            The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                            2,080,268 53,644,944
                            296,373 6,481,480
                            216,040 6,403,163
                            1,567,855 40,760,301
                            99,950 (4.8%) 4,292,225 (8.0%)
                            14,670 (4.9%) 480,199 (7.4%)
                            13,629 (6.3%) 390,489 (6.1%)
                            71,651 (4.6%) 3,421,537 (8.4%)
                            * Commercial and clinical laboratory data represent select laboratories and do not capture all tests performed in the United States.
                            Public Health Laboratories


                            resize iconView LargerView Data Table

                            Clinical Laboratories


                            resize iconView LargerView Data Table

                            Commercial Laboratories


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                            * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                            View Data Table


                            Additional virologic surveillance information: Surveillance Methods


                            Outpatient/Emergency Department Illness


                            Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together, these systems provide a more comprehensive picture of mild-to-moderate COVID-19 illness than either would individually. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, compliance with recommendations to limit ED visits to severe illnesses, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                            ILINet


                            The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments, and urgent care centers in all 50 states, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild-to-moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                            Nationwide during week 39, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is below the national baseline of 2.4% and is typical for this time of year compared to previous influenza seasons. Compared with week 38, the percentage of visits for ILI during week 39 remained increased among those aged 0 to 4 years and 5 to 24 years but remained stable overall and among the adult age groups.

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                            * Age-group specific percentages should not be compared with the national baseline.

                            On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.7% to 1.4% during week 39 and was below the region-specific baseline in all regions. Compared with week 38, the percentage during week 39 increased in Region 10 (Pacific Northwest) and decreased or remained stable (change of ≤0.1%) in the remaining nine regions.

                            Note: In response to the COVID-19 pandemic, new data sources are being incorporated into ILINet through the summer weeks, when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, enrollment of new sites began, leading to increases in the number of patient visits. While all regions remain below baseline levels for ILI, these system changes should be considered when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                            Overall Percentage of Visits for ILI | Age Group ILI Data

                            ILI Activity Levels


                            Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                            The number of jurisdictions at each activity level during week 39 and changes compared with the previous week are summarized in the table below and shown in the following maps.
                            Activity Level Number of Jurisdictions
                            Week 39
                            (Week ending
                            September 26, 2020)
                            Compared with Previous Week
                            Very High 0 No Change
                            High 0 No Change
                            Moderate 1 No Change
                            Low 0 -1
                            Minimal 49 No Change
                            Insufficient Data 4 +1
                            *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                            National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                            NSSP is a collaboration among CDC, federal partners, local, and state health departments and academic and private sector partners to collect, analyze, and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                            Nationwide during week 39, 1.9% of ED visits captured in NSSP were due to CLI and 0.7% were due to ILI. Compared with week 38, the percentage of visits for CLI and the percentage of visits for ILI this week decreased or remained stable (changes of ≤0.1%) nationally and in eight of 10 HHS regionsexternal icon. Regions 5 (Midwest) and 8 (Mountain) saw an increase in CLI while ILI percentages remained stable compared with week 38.



                            Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                            Hospitalizations


                            The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                            A total of 58,088 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and September 26, 2020. The overall cumulative hospitalization rate was 178.2 per 100,000 population. Among those aged 0–4 years, 5–17 years, 18–49 years, 50–64 years, and ≥65 years, the highest rate of hospitalization was among adults aged ≥65 years, followed by adults aged 50–64 years and adults aged 18–49 years.

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                            Overall 178.2
                            0-4 years 18.4
                            5-17 years 10.6
                            18-49 years 121.4
                            18-29 years 78.5
                            30-39 years 121.4
                            40-49 years 176.8
                            50-64 years 266.3
                            65+ years 481.5
                            65-74 years 361.5
                            75-84 years 572.6
                            85+ years 865.8
                            Weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). From the week ending August 1 (MMWR week 31) to the week ending September 26 (MMWR week 39), weekly hospitalization rates declined for all adult age groups. However, over this same time period, weekly rates remained steady for the pediatric age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

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                            Among the 58,088 laboratory-confirmed COVID-19-associated hospitalizations, 55,241 (95.1%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 2,847 (4.9%) cases. When examining overall age-adjusted rates by race and ethnicity, the rate for Hispanic or Latino persons was approximately 4.6 times the rate among non-Hispanic White persons. Age-adjusted hospitalization rates for both non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons were approximately 4.5 times that of non-Hispanic White persons.




                            When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 7.5 times higher among Hispanic or Latino persons aged 0–17 years; 8.2 times higher among Hispanic or Latino persons aged 18–49 years; 6.1 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.7 times higher among non-Hispanic Black persons aged ≥65 years.
                            Age Category Non-Hispanic
                            American Indian or Alaska Native
                            Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                            Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                            0—17 years 11.7 3.4 19.2 5.6 25.5 7.5 6.6 1.9 3.4 1
                            18—49 years 269.2 7.8 198.2 5.7 285.2 8.2 57.0 1.6 34.7 1
                            50—64 years 654.0 6.1 553.3 5.2 610.4 5.7 170.3 1.6 107.2 1
                            65+ years 719.2 2.4 1091.0 3.7 807.2 2.7 327.9 1.1 298.2 1
                            Overall rate4 (age-adjusted) 356.2 4.5 362.6 4.5 367.4 4.6 107.4 1.3 80.0 1
                            1 COVID-19-associated hospitalization rates by race and ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                            2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial and ethnic group and the crude hospitalization rate among non-Hispanic white persons in the same age category.
                            3 The highest rate ratio in each age category is presented in bold.
                            4 Overall rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0–17, 18–49, 50–64, and 65+ years.

                            Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalizations as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                            1.3% 32.8% 23.1% 5.1% 32.1%
                            0.7% 17.9% 14.1% 8.9% 58.5%
                            1.9 1.8 1.6 0.6 0.5
                            1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.3%) are not represented in the table but are included as part of the denominator.
                            2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                            For underlying medical conditions, data were restricted to cases reported during March 1–May 31, 2020, due to delays in reporting. During this time frame, sampling was conducted among hospitalized adults; therefore, weighted percentages are reported. Among 7,865 sampled adults hospitalized during March 1–May 31, 2020, 90.9% reported at least one underlying medical condition. The most commonly reported were hypertension, obesity, metabolic disease, and cardiovascular disease. No sampling was conducted among hospitalized children. Among 243 children hospitalized during March 1–May 31, 2020, 52.7% reported at least one underlying medical condition. The most commonly reported underlying medical conditions were obesity, asthma, and neurologic disease.

                            resize iconView Larger


                            Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                            Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                            Mortality Surveillance


                            The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on October 1, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 39 is 6.4% and, while lower than the percentage during week 38 (9.5%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                            Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                            resize iconView Larger


                            *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                            View Data Table


                            Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19
                            More Information
                            View Page In:pdf icon 13 Pages, 1 MB
                            Last Updated Oct. 2, 2020
                            Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                            https://www.cdc.gov/coronavirus/2019.../10022020.html


                            Comment


                            • #29
                              1. CASES, DATA & SURVEILLANCE
                              COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                              Updated Oct. 9, 2020
                              Print
                              Download Weekly Summary pdf icon[846 KB, 10 pages]
                              Key Updates for Week 40, ending October 3, 2020


                              Nationally, indicators that track COVID-19 activity continued to decline or remain stable (change of ≤0.1%). However, one region reported a slight increase in the percentage of specimens testing positive for SARS-CoV-2 and four regions reported slight increases in the percentage of visits for influenza-like illness (ILI). Mortality attributed to COVID-19 declined but remains above the epidemic threshold.


                              Download Chart Data excel icon[XLS – 2 KB]
                              Virus: Public Health, Commercial and Clinical Laboratories


                              Nationally, the percentage of respiratory specimens testing positive for SARS-CoV-2, the virus causing COVID-19, decreased from 5.2% during week 39 to 4.9% during week 40. Percent positivity increased slightly among those aged 5-17 years and those 65 years and older; percent positivity in the other age groups remained stable or declined. Regionally, the percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly in Region 4 (Southeast) and remained stable or decreased in the remaining nine regions.
                              Mild/Moderate Illness: Outpatient and Emergency Department Visits


                              Nationally, the overall percentage of visits to outpatient providers or emergency departments (EDs) for ILI or CLI remained stable (change or ≤0.1%) from week 39 to week 40; however, the percentage of visits for ILI to ILINet providers increased in those 50-64 years while remaining stable among the other age groups. Compared to week 39, the percentage of visits to EDs for ILI or CLI remained stable or declined in all ten regions. However, three regions reported slight increases in the percentage of visits for ILI to ILINet providers.
                              Severe Disease: Hospitalizations and Deaths


                              The weekly COVID-19-associated hospitalization rate reported through COVID-NET has remained steady among all age groups in recent weeks. Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 40 is 7.0% and, while declining, remains above the epidemic threshold. Hospitalization and mortality data for the most recent weeks may change as additional data are reported.

                              All data are preliminary and may change as more reports are received. A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                              Key Points
                              • Nationally, the percentage of deaths due to pneumonia, influenza, or COVID-19 (PIC) has continued to decline since early September; other COVID-19 activity indicators included in this report (the percentage of specimens testing positive for SARS-CoV-2, the percentage of visits to EDs or outpatient providers for ILI and CLI, and COVID-19-associated hospitalization rates) have remained stable during this same period. In contrast, there was a decreasing trend in all these COVID-19 indicators from mid-July through August.
                              • Peak COVID-19 activity and trends have varied regionally with three general patterns:
                                1. The Northeast (Region 1), New Jersey/New York/Puerto Rico (Region 2), the Mid-Atlantic (Region 3) and the Midwest (Region 5) regions, reported the highest levels of COVID-19 activity in April. Activity declined through June and July and remained stable until recent weeks when some indicators have shown slight increases.
                                2. The Central (Region 7), Mountain (Region 8) and Pacific Northwest (Region 10) regions also reported the highest levels of COVID-19 activity in April. After several weeks of decline, these regions reported increases in activity during the summer but relatively stable activity recently. The exception is the Pacific Northwest which reported some recent increases in activity.
                                3. The Southeast (Region 4), South Central (Region 6) and the South/West Coast (Region 9) regions experienced a different pattern of COVID-19 activity with the highest levels occurring in July. Activity has declined since the July peak and has been primarily stable for the past several weeks; however, during the most recent weeks, some indicators are showing a slight increase.
                              • The overall cumulative COVID-19-associated hospitalization rate through the week ending October 3, 2020 was 183.2 per 100,000 population.
                                • Following an initial decline of hospitalization rates between the weeks ending July 25 (MMWR week 30) and August 22 (MMWR week 34), weekly hospitalization rates have remained steady among all age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                                • The age-adjusted hospitalization rate for Hispanic or Latino persons was approximately 4.6 times that of non-Hispanic White persons. Age-adjusted hospitalization rates for both non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons were approximately 4.5 times that of non-Hispanic White persons.
                              • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                              U.S. Virologic Surveillance


                              Based on data reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States, 56,235,035 specimens have been tested for SARS-CoV-2 using a molecular assay since March 1, 2020. The percentage of specimens testing positive for SARS-CoV-2 each week, based on week of specimen collection, are summarized below.

                              Nationally, during week 40, 2,014,912 specimens were tested for SARS-CoV-2 for diagnostic purposes and 98,338 (4.9%) were positive. This is decreased compared with week 39, during which 5.2% of specimens tested were positive. The percentage of specimens testing positive increased slightly in those aged 5-17 years and those 65 years and older while remaining stable or decreasing in all other age groups.




                              *The different laboratory types came on board with testing during different weeks. This graph includes public health laboratory data beginning in week 10, clinical laboratory data beginning in week 11 and commercial laboratory data beginning in week 14.
                              View Data Table


                              Despite the overall national decline in percent positivity, the percentage of specimens testing positive increased in Region 4 (Southeast). This increase was reported among those 5-17 years, 50-64 years and 65 years and older. The highest percentage of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (Southeast, 6.7%), 6 (South Central, 7.7%), 7 (Central, 9.0%) and 8 (Mountain, 7.2%) and is decreasing in the latter three regions.

                              Additional virologic surveillance information: Surveillance Methods


                              Outpatient/Emergency Department Illness


                              Two syndromic surveillance systems, the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) and the National Syndromic Surveillance Project (NSSP), are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors activity in a slightly different set of providers/facilities. ILINet provides information about visits to outpatient providers or emergency departments for influenza-like illness (ILI; fever plus cough and/or sore throat) and NSSP provides information about visits to EDs for ILI and COVID-like illness (CLI; fever plus cough and/or shortness of breath or difficulty breathing). Some EDs contribute ILI data to both ILINet and NSSP. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine, and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.

                              Nationally, the overall percentage of visits to outpatient providers or EDs for ILI or CLI remained stable (change of ≤0.1%) from week 39 to week 40, with 2.0% and 0.9% of ED visits captured in NSSP being for CLI and ILI, respectively and 1.1% of visits reported through ILINet being for ILI. The percentage of ILI visits to ILINet providers remains below the national baseline (2.4% October 2019 through September 2020; 2.6% since October 2020) for the 24th consecutive week and is at levels that are typical for this time of year.

                              resize iconView LargerView Data Table


                              Compared with week 39, the percentage of ILI visits to ILINet providers increased in those 50-64 years while remaining stable (change of ≤0.1%) among other age groups.

                              resize iconView LargerView Data Table


                              On a regional levelexternal icon, the percentage of visits to EDs for ILI or CLI remained stable (change of ≤0.1%) from week 39 to week 40 in all ten regions. The percentage of visits for ILI to ILINet providers increased slightly from week 39 to week 40 in four regions (Regions 2 [New Jersey/New York/Puerto Rico], 6 [South Central], 9 [South/West Coast] and 10 [Pacific Northwest]) but remained below the region-specific baseline in all 10 regions. When compared to the percentage of visits to EDs or outpatient providers two weeks ago, an additional five regions (Regions 1 [New England], 3 [Mid-Atlantic], 4 [Southeast], 7 [Central] and 8 [Mountain]) reported an increase in the percentage of visits for CLI or ILI during week 40.
                              ILI Activity Levels


                              Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City and for each core-based statistical area (CBSA) where at least one provider is located. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                              The number of jurisdictions at each activity level during week 40 and the previous week are summarized in the table below.
                              Activity Level Number of Jurisdictions Number of CBSAs
                              Week 40
                              (Week ending
                              Oct. 3, 2020)
                              Week 39
                              (Week ending
                              September 26, 2020)
                              Week 40
                              (Week ending
                              Oct. 3, 2020)
                              Week 39
                              (Week ending
                              September 26, 2020)
                              Very High 0 0 0 0
                              High 0 1 1 2
                              Moderate 0 1 4 3
                              Low 1 0 14 20
                              Minimal 52 49 569 523
                              Insufficient Data 1 3 341 381
                              *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.

                              Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods

                              Hospitalizations


                              The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                              A total of 59,728 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and October 3, 2020. The overall cumulative hospitalization rate was 183.2 per 100,000 population.

                              Overall weekly hospitalization rates among all ages first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). Following an initial decline in hospitalization rates between the weeks ending July 25 (MMWR week 30) and August 22 (MMWR week 34), weekly hospitalization rates have remained steady for all age groups. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

                              resize iconView Larger
                              Among the 59,728 laboratory-confirmed COVID-19-associated hospitalizations, 56,327 (94.3%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 3,401 (5.7%) cases. When examining overall age-adjusted rates by race and ethnicity, the rate for Hispanic or Latino persons was approximately 4.6 times the rate among non-Hispanic White persons. Rates for both non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons were approximately 4.5 times the rate among non-Hispanic White persons.



                              When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 7.3 times higher among Hispanic or Latino persons aged 0–17 years; 8.2 times higher among Hispanic or Latino persons aged 18–49 years; 6.1 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.6 times higher among non-Hispanic Black persons aged ≥65 years.

                              Age Category Non-Hispanic
                              American Indian or Alaska Native
                              Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                              Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                              0—17 years 11.7 3.3 19.4 5.4 26.1 7.3 7.0 1.9 3.6 1
                              18—49 years 276.1 7.8 200.9 5.6 290.6 8.2 58.8 1.7 35.6 1
                              50—64 years 677.9 6.1 561.0 5.1 623.9 5.6 175.0 1.6 110.6 1
                              65+ years 740.2 2.4 1104.9 3.6 826.3 2.7 338.1 1.1 305.7 1
                              Overall rate4 (age-adjusted) 366.8 4.5 367.4 4.5 375.4 4.6 110.6 1.3 82.2 1
                              1 COVID-19-associated hospitalization rates by race and ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                              2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial and ethnic group and the crude hospitalization rate among non-Hispanic White persons in the same age category.
                              3 The highest rate ratio in each age category is presented in bold.
                              4 Overall rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0–17, 18–49, 50–64, and 65+ years.

                              Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalizations as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                              1.3% 32.6% 23.1% 5.2% 32.3%
                              0.7% 17.9% 14.1% 8.9% 58.5%
                              1.9 1.8 1.6 0.6 0.6
                              1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.1%) are not represented in the table but are included as part of the denominator.
                              2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                              For underlying medical conditions, data were restricted to cases reported during March 1–May 31, 2020, due to delays in reporting. During this time frame, sampling was conducted among hospitalized adults; therefore, weighted percentages are reported. No sampling was conducted among hospitalized children. Among 7,897 sampled adults hospitalized during March 1–May 31 with information on underlying medical conditions, 91.0% reported at least one underlying medical condition. The most reported underlying medical conditions were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 247 children hospitalized during March 1–May 31 with information on underlying conditions, 53.0% reported at least one underlying medical condition. The most reported underlying medical conditions were obesity, asthma, and neurologic disease.

                              Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                              Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                              Mortality Surveillance


                              The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on October 8, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 40 is 7.0% and, while lower than the percentage during week 39 (9.7%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                              Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                              resize iconView Larger


                              *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. It is possible that a death certificate includes both influenza and COVID as a cause of death therefore, the number of influenza and COVID coded deaths may not be mutually exclusive.
                              View Data Table


                              Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19
                              More Information
                              View Page In:pdf icon 846 KB, 10 pages
                              Last Updated Oct. 9, 2020
                              Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                              https://www.cdc.gov/coronavirus/2019...ata/covidview/

                              Comment


                              • #30
                                1. CASES, DATA & SURVEILLANCE
                                COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                                Updated Oct. 16, 2020


                                Download Weekly Summary pdf icon[907 KB, 10 pages]

                                Key Updates for Week 41, ending October 10, 2020


                                Nationally, the percentage of specimens testing positive for SARS-CoV-2 and the percentage of visits to emergency departments (ED) or outpatient providers for COVID-like illness (CLI) and influenza-like illness (ILI) have increased slightly in recent weeks. COVID-19 related hospitalizations and mortality attributed to COVID-19 remained stable or declined but this may change as more data are received.


                                Download Chart Data excel icon[XLS – 2 KB]
                                Virus: Public Health, Commercial and Clinical Laboratories


                                Nationally, the overall percentage of respiratory specimens testing positive for SARS-CoV-2, the virus causing COVID-19, increased from 5.3% during week 40 to 5.4% during week 41. Percent positivity decreased slightly among those 18-49 years but increased among the other age groups. Regionally, the percentages of respiratory specimens testing positive for SARS-CoV-2 increased in Regions 5 (Midwest), 6 (South Central), 7 (Central) and 10 (Pacific Northwest) and decreased in the remaining six regions.
                                Mild/Moderate Illness: Outpatient and Emergency Department Visits


                                Nationally, the overall percentage of visits to outpatient providers or emergency departments (EDs) for ILI or CLI has been increasing slowly since mid-September. In ILINet, this increase can be seen among all age groups. The percentages of visits to EDs for ILI or CLI have increased in all ten regions in recent weeks. Seven regions have reported increases in the percentages of visits for ILI to ILINet providers in recent weeks; the percentages have remained stable in the remaining three regions.
                                Severe Disease: Hospitalizations and Deaths


                                Nationally, weekly COVID-19-associated hospitalization rates reported through COVID-NET have remained steady for all age groups in recent weeks; however, rates have increased in 7 of 14 COVID-NET sites during this time period. Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 41 was 7.2% and, while declining, remains above the epidemic threshold. Hospitalization and mortality data for the most recent weeks may change as additional data are reported.

                                All data are preliminary and may change as more reports are received. A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                                Key Points
                                • Nationally, the percentage of deaths due to pneumonia, influenza, or COVID-19 (PIC) have continued to decline since early September; other COVID-19 activity indicators included in this report (the percentage of specimens testing positive for SARS-CoV-2, the percentages of visits to EDs or outpatient providers for ILI and CLI, and COVID-19-associated hospitalization rates) have increased or remained stable in recent weeks.
                                • At least one indicator used to monitor COVID-19 activity is increasing in all ten HHS regions and many regions are reporting increases in multiple indicators.
                                  • The percentages of specimens testing positive for SARS-CoV-2 increased in four regions.
                                  • The percentages of visits for ILI, CLI or both increased in all ten regions.
                                  • For some indicators and regions, the increases have been small from week to week but have continued over several weeks while other indicators have increased more sharply in some regions.
                                • The overall cumulative COVID-19-associated hospitalization rate through the week ending October 10, 2020 was 188.2 per 100,000 population.
                                  • Following an initial decline in hospitalization rates between the weeks ending July 25 (MMWR week 30) and August 22 (MMWR week 34), weekly hospitalization rates for all sites combined have remained steady for all age groups. However, since the week ending September 19 (MMWR Week 38), overall weekly hospitalization rates have increased in 7 of 14 COVID-NET sites. Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.
                                  • The age-adjusted hospitalization rate for Hispanic or Latino persons was approximately 4.5 times that of non-Hispanic White persons. Age-adjusted hospitalization rates for both non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons were approximately 4.4 times those of non-Hispanic White persons.
                                • All surveillance systems aim to provide the most complete data available. Estimates from previous weeks are subject to change as data are updated with the most complete data available.

                                U.S. Virologic Surveillance


                                Based on data reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States, 61,120,152 specimens have been tested for SARS-CoV-2 using a molecular assay since March 1, 2020. The percentages of specimens testing positive for SARS-CoV-2 each week, based on week of specimen collection, are summarized below.

                                Nationally, during week 41, 2,632,222 specimens were tested for SARS-CoV-2 for diagnostic purposes and 141,317 (5.4%) were positive. This is slightly increased compared with week 40, during which 5.3% of specimens tested were positive. The percentages of specimens testing positive increased slightly in those 0–4 years, 5–17 years, 50-64 years and 65 years and older while remaining stable in those 18–49 years.




                                *The different laboratory types came on board with testing during different weeks. This graph includes public health laboratory data beginning in week 10, clinical laboratory data beginning in week 11 and commercial laboratory data beginning in week 14.
                                View Data Table


                                The national increase in percent positivity was driven by increases in Regions 5 (Midwest), 6 (South Central), 7 (Central) and 10 (Pacific Northwest). The increase was reported among all age groups in Regions 6, 7, and 10 and among those 5 years of age and older in Region 5. The highest percentages of specimens testing positive for SARS-CoV-2 were seen in Regions 4 (Southeast, 6.5%), 6 (South Central, 8.0%), 7 (Central, 10.1%) and 8 (Mountain, 7.0%).

                                Additional virologic surveillance information: Surveillance Methods


                                Outpatient/Emergency Department Illness


                                Two syndromic surveillance systems, the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) and the National Syndromic Surveillance Project (NSSP), are being used to monitor trends in outpatient and emergency department (ED) visits that may be associated with COVID-19 illness. Each system monitors activity in a slightly different set of providers/facilities. ILINet provides information about visits to outpatient providers or emergency departments for influenza-like illness (ILI; fever plus cough and/or sore throat) and NSSP provides information about visits to EDs for ILI and COVID-like illness (CLI; fever plus cough and/or shortness of breath or difficulty breathing). Some EDs contribute ILI data to both ILINet and NSSP. Both systems are currently being affected by changes in health care seeking behavior, including increased use of telemedicine and increased social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.

                                Nationally, the overall percentage of visits to outpatient providers or EDs for ILI or CLI has been increasing since mid-September, with 2.5% and 1.1% of ED visits captured in NSSP being for CLI and ILI, respectively, and 1.2% of visits reported through ILINet being for ILI. The percentage of ILI visits to ILINet providers remains below the national baseline (2.4% October 2019 through September 2020; 2.6% since October 2020) for the 25th consecutive week and is at levels that are typical for this time of year.

                                resize iconView LargerView Data Table


                                The increase in percentage of ILI visits to ILINet providers in recent weeks has been reported among all age groups.

                                resize iconView LargerView Data Table


                                On a regional levelexternal icon, the percentages of visits to EDs for ILI or CLI have been increasing in recent weeks in all ten regions. The largest increases during week 41 compared with week 40 were for CLI in Regions 5 (Midwest, 0.4%) and 8 (Mountain, 0.6%). The percentage of visits for ILI to ILINet providers have been increasing in recent weeks in seven regions (Regions 1 [New England], 2 [New Jersey/New York/Puerto Rico], 3 [Mid-Atlantic], 4 [Southeast], 7 [Central], 8 [Mountain], and 9 [South/West Coast] and stable in Regions 5 (Midwest), 6 (South Central) and 10 (Pacific Northwest). The percentage remained below the region-specific baseline in all 10 regions.
                                ILI Activity Levels


                                Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the U.S. Virgin Islands, the District of Columbia, and New York City and for each core-based statistical area (CBSA) where at least one provider is located. The mean reported percentage of visits due to ILI for the current week is compared with the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at, or above the mean.

                                The number of jurisdictions at each activity level during week 41 and the previous week are summarized in the table below.
                                Activity Level Number of Jurisdictions Number of CBSAs
                                Week 41
                                (Week ending
                                Oct. 10, 2020)
                                Week 40
                                (Week ending
                                Oct. 3, 2020)
                                Week 41
                                (Week ending
                                Oct. 10, 2020)
                                Week 40 (Week ending
                                Oct. 3, 2020)
                                Very High 0 0 0 0
                                High 0 0 3 2
                                Moderate 2 0 5 4
                                Low 0 1 30 16
                                Minimal 50 52 534 577
                                Insufficient Data 2 1 357 330
                                *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.

                                Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods

                                Hospitalizations


                                The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                                A total of 61,364 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and October 10, 2020. The overall cumulative hospitalization rate was 188.2 per 100,000 population.

                                Overall weekly hospitalization rates among all ages combined first peaked during the week ending April 18 (MMWR week 16), followed by a second peak during the week ending July 18 (MMWR week 29). Following an initial decline in hospitalization rates between the weeks ending July 25 (MMWR week 30) and August 22 (MMWR week 34), weekly hospitalization rates among all sites combined remained steady for each age group. However, since the week ending September 19 (MMWR Week 38), overall weekly hospitalization rates have increased in 7 of 14 COVID-NET sites (Colorado, Michigan, Minnesota, New Mexico, Oregon, Tennessee and Utah). Data for the most recent weeks may change as additional admissions occurring during those weeks are reported.

                                resize iconView Larger
                                Among the 61,364 laboratory-confirmed COVID-19-associated hospitalizations, 58,134 (94.7%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 3,230 (5.3%) cases. When examining overall age-adjusted rates by race and ethnicity, the rate for Hispanic or Latino persons was approximately 4.5 times the rate among non-Hispanic White persons. Rates for both non-Hispanic American Indian or Alaska Native persons and non-Hispanic Black persons were approximately 4.4 times the rate among non-Hispanic White persons.



                                When examining age-stratified crude hospitalization rates by race and ethnicity, compared with non-Hispanic White persons in the same age group, crude hospitalization rates were 7.1 times higher among Hispanic or Latino persons aged 0–17 years; 8.0 times higher among Hispanic or Latino persons aged 18–49 years; 6.0 times higher among non-Hispanic American Indian or Alaska Native persons aged 50–64 years; and 3.5 times higher among non-Hispanic Black persons aged ≥65 years.
                                Age Category Non-Hispanic
                                American Indian or Alaska Native
                                Non-Hispanic Black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic White
                                Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3 Rate1 Rate Ratio2,3
                                0—17 years 11.7 3.1 19.9 5.2 27.1 7.1 8.1 2.1 3.8 1
                                18—49 years 284.8 7.6 205.8 5.5 299.0 8.0 60.7 1.6 37.4 1
                                50—64 years 688.6 6.0 575.5 5.0 643.1 5.6 177.9 1.5 115.3 1
                                65+ years 769.7 2.4 1130.7 3.5 850.3 2.7 348.2 1.1 319.5 1
                                Overall rate4 (age-adjusted) 376.9 4.4 376.3 4.4 386.6 4.5 113.8 1.3 85.9 1
                                1 COVID-19-associated hospitalization rates by race and ethnicity are calculated using COVID-NET hospitalizations with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator.
                                2 For each age category, rate ratios are the ratios between crude hospitalization rates within each racial and ethnic group and the crude hospitalization rate among non-Hispanic White persons in the same age category.
                                3 The highest rate ratio in each age category is presented in bold.
                                4 Overall rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0–17, 18–49, 50–64, and 65+ years.

                                Non-Hispanic Black persons and non-Hispanic White persons represented the highest proportions of hospitalizations reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios were highest among non-Hispanic American Indian or Alaska Native persons, followed by non-Hispanic Black persons and Hispanic or Latino persons.
                                1.3% 32.4% 23.1% 5.2% 32.7%
                                0.7% 17.9% 14.1% 8.9% 58.5%
                                1.9 1.8 1.6 0.6 0.6
                                1 Persons of multiple races (0.3%) or unknown race and ethnicity (5.0%) are not represented in the table but are included as part of the denominator.
                                2 Prevalence ratio is calculated as the ratio of the proportion of COVID-NET hospitalizations over the proportion of population in COVID-NET catchment area.

                                For underlying medical conditions, data were restricted to cases reported during March 1–May 31, 2020, due to delays in reporting. During this time frame, sampling was conducted among hospitalized adults; therefore, weighted percentages are reported. No sampling was conducted among hospitalized children. Among 7,989 sampled adults hospitalized during March 1–May 31 with information on underlying medical conditions, 90.8% reported at least one underlying medical condition. The most reported underlying medical conditions were hypertension, obesity, metabolic disease, and cardiovascular disease. Among 248 children hospitalized during March 1–May 31 with information on underlying conditions, 50.8% reported at least one underlying medical condition. The most reported underlying medical conditions were obesity, asthma, and neurologic disease.

                                Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes and discharge diagnoses, stratified by age, sex and race and ethnicity, are available.

                                Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                                Mortality Surveillance


                                The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on October 15, 2020, the percentage of deaths attributed to pneumonia, influenza, or COVID-19 (PIC) for week 41 was 7.2% and, while lower than the percentage during week 40 (9.7%), remains above the epidemic threshold. Percentages for recent weeks will likely increase as more death certificates are processed.

                                Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. The percentage of deaths due to PIC is higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

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                                *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. It is possible that a death certificate includes both influenza and COVID as a cause of death therefore, the number of influenza and COVID coded deaths may not be mutually exclusive.
                                View Data Table


                                Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19
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                                Last Updated Oct. 16, 2020
                                Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCases, Data & Surveillance
                                https://www.cdc.gov/coronavirus/2019...iew/index.html

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