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COVID levels in waste water edge up post-Thanksgiving

Experts are unsure about what’s in store for winter.

Commuters in South Station stand in front of the train schedule board for holiday travels.David L. Ryan/Globe Staff

COVID levels have started their annual post-Thanksgiving uptick, but rates of hospitalizations and deaths remain far below where they were at this time last year.

“Things are actually in pretty good shape,” said Matthew Fox, a professor of epidemiology and global health at the Boston University School of Public Health.

Fox said built-up immunity from past infections and vaccinations could help blunt a winter surge of the virus.

The seven-day average of COVID levels in waste water in Eastern Massachusetts was more than 20 percent lower on Nov. 28 than on the same day last year, according to data analyzed by Biobot Analytics and posted to the website of the Massachusetts Water Resources Authority.

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Hospitalizations for COVID are about one-third of last year’s levels and deaths are about 50 percent lower, said Dr. Jacob Lemieux, an infectious disease specialist at Massachusetts General Hospital.

“Last year, we saw a big increase right after Thanksgiving,” said Dr. Cassandra Pierre, associate hospital epidemiologist and medical director of public health programs at Boston Medical Center. “We do see small increases over the past few weeks, but they are slow and steady.”

The lower levels may be partly due to relatively mild weather so far this fall, said Fox, which means that people have continued to spend time outdoors. But as temperatures drop and people travel and gather indoors for the holidays, cases will climb.

Lemieux said it’s too early to know how large of an increase the winter will bring.

Last year, waste water levels, which are a proxy for COVID transmission, spiked starting the first week of December and remained high until around mid-February. Increases are driven by a mix of factors including people’s behavior, population immunity levels and, sometimes, troublesome new variants.

Experts are now watching an offshoot of Omicron that is gaining ground. The variant, BA.2.86, accounts for between 5 percent and 15 percent of all cases nationwide, according to data from the Centers for Disease Control and Prevention. Last week, the World Health Organization upgraded it to a “variant of interest.” However, the CDC said earlier this week that it did not appear to be driving increases in infections or hospitalizations in the US.

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“I don’t think it’s going to change things in a major way,” Lemieux said.

Still, the public should take precautions against COVID and other respiratory viruses. Check with your doctor to see which vaccines you’re eligible for, as there are updated shots for all the major respiratory viruses this year, including RSV, influenza and COVID. And those who are older or who have underlying health conditions should consider masking, especially in crowded indoor venues, Pierre said.

A group of Massachusetts doctors and activists recently urged the state to reinstate universal masking in health care settings this winter.

Should you develop cold symptoms, take a home COVID test, and, if it’s negative, repeat the test after 48 hours, Pierre said. If it’s positive, ask your doctor about treatment options.

Those over 50 who have underlying conditions are eligible for the antiviral pill Paxlovid, which remains underprescribed, she said.

“I don’t think the picture is one where we need an extreme level of concern,” Lemieux said. “But individual risk may vary and [COVID] will still be a force this holiday season.”

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Anna Kuchment can be reached at anna.kuchment@globe.com. Follow her @akuchment.