Overall, indicators used to monitor COVID-19 activity remain lower than peaks seen in March and April; however, increases are being seen in the percentage of specimens testing positive for SARS-CoV2 and percentage of visits for ILI or CLI in multiple parts of the country, in some cases for consecutive weeks.

The percentage of outpatient and emergency department visits for ILI are below baseline nationally and in all regions of the country. Most regions have remained stable, compared to last week; however, a few regions experienced an increase in the percentage visits of for CLI and/or ILI 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 healthcare-seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits severe illnesses and increased practice of social distancing.

The overall cumulative COVID-19 associated hospitalization rate is 98.4 per 100,000, with the highest
rates in people 65 years of age and older (297.6 per 100,000) followed by people 50-64 years (148.6
per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic

Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5 times that of non-Hispanic White persons, while non-Hispanic Black persons and Hispanic or Latino persons each have a rate approximately 4.5 times that of nonHispanic 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 are within ranges of cumulative influenza hospitalization rates observed at comparable time points* during recent influenza seasons.

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 9.5% during week 24 to 6.9% during week 25.

This is the ninth week during which a declining percentage of deaths due to PIC has been recorded; however, the percentage remains above the epidemic threshold. The percentage may change as additional death certificates for deaths during recent weeks are processed.

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