Centers for Disease Control and Prevention researchers report national estimates of 43.6 million COVID-19-associated illnesses and 101,300 deaths in the US during October 2022 to September 2023, plus 33.0 million illnesses and 100,800 deaths during October 2023 to September 2024. People 65 years and older accounted for the majority of hospitalizations and deaths.

COVID-19 has continued to affect the US health care system through outpatient visits, hospitalizations, and deaths long after the public health emergency declaration ended in May 2023. SARS-CoV-2 circulation has added pressure during winter respiratory illness seasons while other respiratory viruses continue to circulate.

Current estimates feed decisions on resource allocation and public health policy, but they cannot react to what they cannot see. Case reporting to the US Centers for Disease Control and Prevention ended with the end of the COVID-19 public health emergency, removing a national stream of case-based data used earlier in the pandemic.

Mortality tracking often relies on death certificates listing COVID-19 as an underlying or contributing cause of death. Relaxed reporting requirements, new variants, and reduced testing complicate estimates of disease burden. Even symptomatic people often do not seek care or testing, creating gaps in attributable illness and death.

In the study, “Estimated Burden of COVID-19 Illnesses, Medical Visits, Hospitalizations, and Deaths in the US From October 2022 to September 2024,” published in JAMA Internal Medicine, researchers applied hierarchical Bayesian modeling and probabilistic mathematical multiplier models to estimate COVID-19-associated illnesses, outpatient visits, hospitalizations, and deaths in the US from October 2022 to September 2024.

COVID-19 Hospitalization Surveillance Network (COVID-NET) data came from 89 counties and jurisdictional equivalents in 12 states, covering approximately 10% of the US population. Data included 94,363 participants for October 2022 to September 2023 and 72,176 participants for October 2023 to September 2024.

Concentration of severe outcomes

During the 2022–2023 period, there were an estimated 43.6 million COVID-19-associated illnesses, 10.0 million outpatient visits, 1.1 million hospitalizations, and 101,300 deaths.

During the 2023–2024 period, there were an estimated 33.0 million COVID-19-associated illnesses, 7.7 million outpatient visits, 879,100 hospitalizations, and 100,800 deaths.

Adults aged 65 years and older made up 17.7% of the total US population during 2023–2024 and accounted for 47.9% of COVID-19-associated illnesses. 65 and older accounted for 64.3% of COVID-19-associated outpatient visits, 67.6% of associated hospitalizations, and 81.2% of deaths.

Prevention and treatment gaps

Vaccination and early antiviral treatment may prevent severe COVID-19 consequences. Estimates in 2024 indicate 18% of US adults aged 18 years and older and 30% of nursing home residents received a recent COVID-19 vaccine. Outpatient antiviral treatment in 2024 reached fewer than one-half of adults aged 65 years and older.

Assumptions can begin to shape personal choices as well as national policy when a surveillance network stops reporting and there is a real danger that people will assume the risk is gone. COVID-19 hasn’t gone away, and vaccines are still actively preventing severe illness and death.

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