# COVID-19, Influenza, and RSV Wastewater Monitoring in the U.S. | Week of September 23, 2024

#### amena

- September 25, 2024
- 4:22 pm

### Summary: Week of 9/23/24

[Biobot’s national wastewater network](https://biobot.io/biobot-network/) showed high but declining concentrations of SARS-CoV-2, low concentrations of influenza A and RSV that are starting to increase, and a continued uptick of national influenza B concentrations in week 38. National hospitalization rates for COVID-19 remain elevated, but have continued to decline, currently at 2.8 per 100,000 persons in week 37. National hospitalizations rates for influenza and RSV remain very low — both have less than 0.1 hospitalizations per 100,000 persons through week 37.

**The Bottom Line:** COVID-19 activity remains elevated across most of the country while influenza A and RSV are still at low levels. Our recommendations to remain healthy are the same as they were in the winter: if you feel unwell, minimize contact with others, consider wearing a mask in crowded areas, and stay current with vaccinations and boosters.

### National Outlook

#### **COVID-19**

Nationally, SARS-CoV-2 concentrations are elevated but decreasing.

#### **Influenza**

Nationally, influenza A concentrations remained very low in week 38 but are starting to increase, mostly driven by increases in the midwest. Influenza B concentrations have increased over the past month, but remain low.

#### **RSV**

Nationally, RSV concentrations remained low in week 38 but have slightly increased in recent weeks.

## Regional

#### **The South**

**COVID-19:** SARS-CoV-2 wastewater concentrations in the South have peaked and are decreasing, though they remain quite elevated.

**Influenza:** Influenza A concentrations are low in the South, while influenza B concentrations are elevated. Thankfully, influenza hospitalization rates in the South remain very low.

**RSV:** RSV wastewater concentrations remain low in the South.

#### **The Midwest**

**COVID-19:** SARS-CoV-2 wastewater concentrations have peaked in the Midwest and are decreasing, though they are still quite high.

**Influenza:** Influenza A and B concentrations have recently increased in the Midwest, but are still at low levels.

**RSV:** RSV wastewater concentrations low in the Midwest, but are starting to show some hints of increasing activity.

#### **The Northeast**

**COVID-19:** SARS-Cov-2 concentrations have continued to increase in the Northeast and are still quite elevated. This trend is also reflected in hospitalizations — rates in both Connecticut and New York increased through week 37.

**Influenza:** Influenza A concentrations remain low in the Northeast, while influenza B concentrations have recently increased. Thankfully, influenza hospitalization rates remain very low in the Northeast.

**RSV:** RSV wastewater concentrations remain very low in the Northeast.

#### **The West**

**COVID-19:** SARS-CoV-2 concentrations are elevated but declining in the West.

**Influenza:** Influenza A and B concentrations remain very low in the West.

**RSV:** RSV wastewater concentrations remain very low in the West.

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Footnotes:
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We continue to monitor the evolving H5N1 influenza virus situation. As we do, a quick reminder that Biobot’s influenza A assay detects the H5N1 influenza subtype, which is an influenza A virus, but does not distinguish between the different subtypes of influenza A (e.g. H5N1 vs H1N1). Thankfully, we still have not seen large, widespread increases in influenza A concentrations. We will share any important updates via Twitter and in the risk reports.

Wastewater data from Biobot Analytics for RSV, influenza, and SARS-CoV-2 are through September 21, 2024 (MMWR week 38). Clinical data for RSV, influenza, and COVID-19 are from the Centers for Disease Control and Prevention. Updates to clinical data are through September 14, 2024 (MMWR week 37).
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