Covid, Flu, RSV hotspots report, January 13th, 2025.
Arizona, New Hampshire, Ohio, Minnesota, and Delaware have increased activity. Plus, more improvements to our data dashboard.
Mid-January is upon us and the “Big 3” respiratory pathogens—Covid, Flu, and RSV—are behaving as expected, with increasing rates of illness and hospitalizations in most places in the United States.
Continuing to track the “Big 3” respiratory viruses.
While Covid-19 was by far the most dangerous pathogen of the three when it first appeared in 2020, it’s difficult to say that on either a systemic or individual level now. That’s especially true given the various numbers of vaccinations and infections any given person has had over the last few years. Immune history matters.
Consider a standard-risk 60-year-old man who has had Covid-19 once before and received 4-6 doses of a Covid-19 vaccine. RSV could actually hit him harder if he hasn’t been infected with it in many years (especially since he is not eligible for the new RSV vaccine). The permutations here are endless, and the extent to which other viruses cause milder long-term complications and risks compared to Covid-19 in 2025 is an unknown. So, increasingly, I’m thinking about respiratory virus risk in terms of the “Big 3” pathogens combined. That’s why the Inside Medicine dashboard has now been reconfigured (and rebranded as the Inside Medicine Respiratory Virus Dashboard). As you explore the data, you’ll see that in many places, the number of hospitalizations caused by Covid, Flu, and RSV are often in the same ballpark. So, deciding when to up my mask wearing and hand hygiene, I’m not just looking at Covid levels, but at the overall additive picture of the Big 3.
Below you’ll find a heat map with the most recent data for the Big 3 combined, followed by four tables (alphabetical by state), one for the Big 3, followed by Covid, Flu, and RSV tables. If you want to know how these compare to historical values in your state, you can do so on the dashboard as well. One note: data for all 50 states on the Big 3 only goes back a few months because the federal government only recently required this reporting for Flu and RSV. However, for 14 states that participated in the CDC’s RESP-NET, we can look back several years. So, we’ve got those data for you (the tab on the right side of the dashboard).
Hotspots, for the week ending January 4, 2025 (as of January 13th).
As you can see, Arizona continues to be a trouble spot, due mostly to Flu, but Covid as well. New Hampshire is also looking rough, with elevated levels of all three viruses. Ohio and Minnesota are also seeing increased activity. Delaware’s overall levels are also notable, with RSV leading the charge there.
To see if you live in an area that might be considered a hotspot for any of these respiratory viruses, read on, or peruse the dashboard.
Dashboard improvements.
Lastly, Inside Medicine data guru Benjy Renton and I are continuously looking for ways to make the dashboard more useful and user-friendly for you. To that end we’ve added some new features and upgrades:
We added graphs and maps for the “Big 3” respiratory viruses. We think we’re the first to do this.
A new, more user-friendly layout that reflects current reader priorities. We moved the “Big 3” up to the top, and hospital and ICU capacity data lower (these numbers are important during massive surges like early Omicron, and we want to keep track of them even though they are not our “main” concerns at this moment).
We added a new slide bar (upper right, below the State dropdown menu) so you can limit the graphs to certain timeframes (5 years, 3 years, 1 year, 1 month). Note: this was a response to a reader comment. Thanks!
We continue to post the RESP-NET data for the Big 3, because that datasource has demographic information (national level), and data going back to 2018 for the participating states. (RESP-NET data tab on the right).
We also continue to post county-level Covid-19 wastewater data (COVID counties tab on the right).
Here’s how it looks (and a link to the data).
Screenshot of our new dashboard by Benjy Renton.
Let us know what you think. We welcome your suggestions and your support!
As always, big thanks to Benjy Renton for wrangling the data and maintaining and improving the dashboard!
Hi Dr. Faust, I’m a recent subscriber but big fan of your Substack. I first came across your work on The House of Pod. I would love it if you could do an article on the most up to date estimate of the risk of long COVID per infection. This is something I deeply struggle with as a 26 year old who is trying to manage both staying healthy and living my life (work, intimate relationships, friends). Despite being fairly cautious and masking much more than the average person, I’ve now had 4 infections, though all with extremely mild symptoms, even borderline asymptomatic, and no apparent long term issues. The last three (all in 2024) came from exposures from family, colleagues, and my SO. I’ve also had 8 total COVID vaccines.
Overall, I’m finding it very difficult to figure out who I can trust in regards to the risk of long COVID. On one hand, you have absolute COVID minimizers who dismiss it as just a cold, but on the other hand, you have the ZeroCovid community who say that we all have long COVID and we just don’t know it, that COVID is HIV, and that we’re all going to get cancer/heart attacks/strokes and drop dead if we get infected. While some of these people are doctors or scientist (some in relevant fields and some not), many are not, but they simplify, attempt to interpret, and amplify studies on the internet. I know I don’t have the qualifications of read and interpret these studies, so I tend to lean into the fear that they project, for better or for worse. Even highly qualified people such as Dr. Al-Aly tend to put the estimate at less than 10% of infections result in long covid. It’s also frustrating seeing many people my age continue on with their lives as though covid doesn’t exist.
I think there are many others out there who are similarly confused by the magnitude of information that is out there, while also trying to navigate the complexities of life. I would really appreciate it if you could share your thoughts.
All the best, and thank you so much for the work you do!
Hi Jeremy,
In your RSV example above why would the 60 y.o. not be eligible for the RSV vaccine? I thought anyone 60+ was eligible.
P.S. I LOVED your AI frustration post last week. Particularly the image with the "taller" nurse. ;)