ALBANY COUNTY — For the fourth week in a row Albany County is designated as having a “medium” level of hospitalizations from COVID-19 — and this week, it has been joined by most of the other counties in New York state, according to the Centers for Disease Control and Prevention.

At the same time, a new sublineage of the Omicron variant, JN.1, has rapidly become dominant in the state; JN.1 has been detected in Albany County’s wastewater.

The numbers charted by the state’s health department show that by mid-December nearly 42 percent of COVID-19 cases were caused by JN.1, a rapid increase from early October when no JN.1 cases were reported in the state.

The World Health Organization, on Dec. 18, named JN.1 as a “variant of interest.”

That is a step below a “variant of concern” such as Delta and Omicron.

Previously, the WHO announced, JN.1 was tracked as part of BA.2.86, the parent lineage that is also classified as a variant of interest. However, in recent weeks, JN.1 continues to be reported in multiple countries, and its prevalence has been rapidly increasing globally and now represents the vast majority of BA.2.86 descendent lineages.

The WHO also said that “immunity generated by XBB.1.5 booster vaccination is expected to remain cross-reactive to this variant, against symptomatic and severe disease” and “currently there are no reports of elevated disease severity associated with this variant.”

Some experts have estimated that vaccinating Americans of all ages could reduce the number of hospitalizations and deaths by 20 percent.

It is unclear whether the current spike in COVID cases both in Albany County and across the state and nation is related to the new sublineage or is instead because of increased gatherings and travel during the holiday season.

Hospital admissions have been rising statewide although they are still low compared to the surges in 2020, 2021, and 2022.

A “low” level means fewer than 10 hospital admissions per 100,000 of population while “medium” is between 10.0 and 19.9, and “high” means there were more than 20 hospital admissions per 100,000 of population.

Albany County, through Dec. 23, shows hospitalizations for confirmed cases of COVID-19 totaled 85, an increase of nearly 27 percent from the week prior.

New COVID-19 hospitalizations for the past week per 100,000 of population for Albany County total 17.

Only 12 of New York’s 62 counties are designated as having a “low” rate of COVID hospitalizations.

Nationwide, the CDC reports, about 7 percent of counties have a “high” rate of hospitalization; 31 percent, like most New York counties, have a “medium” rate; and 62 percent have a “low” rate of hospitalization.

The CDC also tracks deaths from COVID-19 in each state.

New York state, as of Dec. 28, had 3.7 percent of its deaths for the past week caused by COVID-19, which is up 12 percent from the week prior.

New York is one of eight states with a rate between 2.0 and 3.9 percent of deaths caused by COVID-19.

Only nine states have a higher rate: seven are between 4.0 and 5.9 percent while two states are still higher. Massachusetts had 6.1 percent of its deaths caused by COVID-19 and Maine, the highest nationwide, had 6.3 percent.

Wastewater surveillance

Some virologists believe JN.1 prefers a receptor that is more common in the gut so that, rather than being infected, as was typical with COVID, through the nose and mouth, it can infect the stomach.

With the ending of mandatory reporting of positive COVID-19 tests, it is hard to track the spread of the virus. However, testing wastewater for fragments of the virus can predict infection rates.

The Biobot Network of Wastewater Treatment Plants shows a marked increase this fall in the concentration of virus present in wastewater samples across the nation with the steepest increase in the Northeast, including in New York state.

A statewide network in New York is being used to identify fragments of the virus in wastewater. In Albany County, four treatment facilities participate:

— The North Plant sewershed that serves Cohoes, Guilderland, the town of Colonie, the village of Colonie, Green Island, Watervliet, and the North End of the city of Albany;

— The South Plant sewershed that serves the majority of the city of Albany;

— The Town of Bethlehem Plant that serves the majority of the town of Bethlehem; and

— The Town of Guilderland Plant serves the majority of the town of Guilderland.

According to the state’s health department all four of those plants have a “high” level of COVID detection, between 75 and 100 percent for December readings. Albany’s North and South plants were recorded on Dec. 18 while Guilderland was recorded on Dec. 27 and Bethlehem on Dec. 28.

Out of the 206 sewersheds statewide, 63 are in the “high” percentile range of 75 to 100 percent.

According to the most recent report on Albany County’s wastewater surveillance, covering the two-week period from Nov. 28 to Dec. 14, the trends show an increase from the North Plant, the South Plant, and the Town of Guilderland Plant while showing a decrease for the Town of Bethlehem Plant.

JN.1 is listed among the sublineages detected in Albany County’s wastewater.

The level of the virus RNA “can tell us roughly how many cases can be expected in a population,” the report says. 

For Albany’s North Plant, South Plant, and the town of Guilderland, the detection level suggests a daily case incidence of more than 50 cases per 100,000 people, the report says.

For the most recent sample from the town of Bethlehem’s plant, the detection level suggests daily case incidence of 10 to 50 cases per 100,000, the report says.