You’d think we’d be done with this by now. But here we are in January 2026, and the wastewater data is telling a story many of us would rather ignore. If you feel like everyone you know has a "scratchy throat" or a "nasty cold" that lingers for ten days, you aren't imagining things. The virus is moving again.
Honestly, the map looks a bit like a bruised plum right now. While some parts of the country are seeing a breather, other spots are officially in the "Very High" viral activity zone. It’s not just about case counts anymore—since basically nobody reports home tests to the state—but about what we're finding in the sewers and who’s showing up at the ER.
The Worst States For Covid Right Now (The January 2026 List)
If you're looking for the current hotspots, look toward the center of the country. According to the latest CDC wastewater surveillance for the week ending January 10, 2026, the Midwest is currently the epicenter of the surge.
Here are the states currently hitting "Very High" or "High" levels of viral activity:
- Ohio and Illinois: These two are leading the pack with "Very High" levels across nearly all reporting sites. If you’re in Chicago or Columbus, the concentration of SARS-CoV-2 in the water is significantly higher than it was just a month ago.
- Michigan and Indiana: Also sitting in the "Very High" tier. Health officials in Michigan have noted that while hospitalizations haven't hit 2021 levels, the sheer volume of infections is causing some serious staffing shortages in essential services.
- Kansas and Missouri: These states have seen a massive vertical spike in the last two weeks. Missouri, in particular, has seen a 41% increase in viral load in certain metro areas.
- The Northeast Exception: While much of the East Coast is "Moderate," Connecticut and Massachusetts are currently bucking that trend with "Very High" activity levels.
It’s a weird mix. You have Florida and Georgia currently sitting at "Low" or "Moderate" levels, while the Rust Belt is getting absolutely hammered.
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What’s Driving the Surge? Meet the "Nimbus" Family
We aren't dealing with the old-school Omicron anymore. The dominant strains right now are part of the XFG sub-lineage, specifically XFG.14.1 and the newer NB.1.8.1 (which some online trackers have nicknamed the "Nimbus" group).
Why does this matter to you? Because these variants are incredibly good at "immune escape."
Basically, even if you had Covid last summer, your antibodies might look at this new version and not recognize it until it’s already set up shop in your respiratory tract. Dr. Rupp from Nebraska Medicine recently pointed out that the "original" Omicron is long gone; what we have now is a hyper-evolved descendant that spreads faster but, thankfully, doesn't seem to be significantly more lethal for the average person.
The symptoms have shifted slightly too. We're seeing way more reports of:
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- Severe, sharp sore throats (feels like swallowing glass).
- Intense fatigue that lasts 3–5 days before the respiratory stuff even starts.
- Lingering congestion that sticks around for two weeks.
Why the Midwest is Getting Hit So Hard
It isn't just bad luck. Weather plays a massive role. In January, people in Ohio and Illinois are trapped indoors. The air is dry, the windows are shut, and ventilation is usually terrible.
Plus, there’s the "Holiday Hangover" effect. We just came off two weeks of family gatherings and travel. When you combine those indoor parties with a variant like NB.1.8.1, you get a recipe for the exact spike we’re seeing in the worst states for covid right now.
The CDC’s current $R_t$ estimates (that's the number that tells us if the epidemic is growing or shrinking) show that in states like Delaware, Maryland, and Washington, the probability of growth is over 90%. So even if a state isn't "Very High" yet, it's likely on its way there.
The Problem With Our Data
We have to be real about the limitations here. The CDC admits that precision is lower than it used to be. Why? Because many states have scaled back their genomic sequencing. We’re often looking at data that is 7 to 10 days old by the time it hits the public dashboard.
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If you live in a state like North Dakota or Oregon, the wastewater data is currently "No Data" or has very limited coverage. This doesn't mean Covid isn't there; it just means we aren't looking for it as aggressively.
Actionable Steps: What Should You Actually Do?
If you find yourself in one of these high-activity zones, you don't need to panic, but you should probably stop "winging it."
- Upgrade the Mask: That cloth mask from 2020 is basically a chin accessory at this point. If you’re heading into a crowded grocery store in Illinois or Ohio, grab a high-quality respirator (N95 or KF94).
- Ventilate or Purify: If you’re having people over, run a HEPA filter. It sounds like overkill, but it significantly cuts down the viral load in the air.
- Test Early, Test Often: These new variants can take a few days to show up on a rapid test. If you have symptoms but test negative on day one, test again on day three. Many people are testing "false negative" during the most contagious first 48 hours.
- Watch the ER Trends: Keep an eye on local hospital capacity. If "Emergency Department visits for COVID-like illness" are spiking in your specific county, that's your cue to dial back the high-risk social activities for a week or two.
The "worst states" list changes every few weeks as the waves move across the country. Right now, the Midwest is the focus, but as the XFG sub-lineage continues to migrate, we’ll likely see the West Coast and South start their climb as the weather shifts or new travel patterns emerge.
Stay aware of your local wastewater levels through the CDC’s NWSS dashboard to get the most "real-time" view of what’s actually in your community before it shows up in the official case counts.