Like past waves, this variant is hitting some parts of the nation harder than others. So far, the worst-hit states are New York and New Jersey—which haven’t led the nation in cases since spring of 2020, when the New York City metropolitan area became the first North American region to get overwhelmed by COVID-19.

Over the past seven days, New Jersey has seen 1,106 positive cases per 100,000 people. The Garden State is followed by New York (842 per 100,000 rate), Rhode Island (800), Florida (775), and Delaware (740). Keep in mind, any region with a rate above 100 per 100,000 people is considered by the CDC to be a “high transmission” area. As of Monday, the nationwide rate is 436 per 100,000 people.

A deeper look at the numbers shows why New York and New Jersey lead the nation. The biggest spike in cases is concentrated around the New York City metro area. In fact, the positive case rate in New York City is a staggering 1,717 per 100,000 residents over the past seven days. Still, while the hospitalization rate is rising in New York and New Jersey, they’re seeing a COVID-19 death rate that’s lower than those in states like Ohio, Pennsylvania, and Arizona. Indeed, over the past seven days Ohio has seen the most COVID-19 related deaths, at 692. That’s more than double New York’s death total (283) during the same period.

The states with the fewest cases are Montana (85 cases per 100,000 residents), Alaska (88), Idaho (98), Mississippi (102), and South Carolina (108). That said, the CDC still considers Mississippi and South Carolina above the “high transmission” threshold, while the other three are one tier down in the “substantial transmission” range.

While many COVID-19 tests don’t tell people what strain they’ve tested positive for, it’s likely they’re coming down with Omicron. Indeed, last week the CDC estimated that more than half of recent positive cases in the nation are from the Omicron variant. As a result of exploding cases and new research, the CDC has revised some of its guidelines in recent weeks (see below).

What should you do if you test positive for COVID-19?

On Monday, the CDC advised Americans who test positive for COVID-19 (and are also asymptomatic) that they can cut their quarantine down from 10 days—which the agency has recommended for much of the pandemic—to just five days. If they do so, the CDC says they should continue to wear a mask for their first five days out of quarantine.

“The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1–2 days prior to onset of symptoms and the 2–3 days after,” wrote the CDC in a statement on Monday.

What are the symptoms of the Omicron variant?

The CDC says, “The Omicron variant likely will spread more easily than the original SARS-CoV-2 virus.” But the agency admits it can’t say for certain. In addition, the CDC says it doesn’t know how Omicron symptoms differ from those of previous variants.

“We don’t yet know how easily it spreads, the severity of illness it causes, or how well available vaccines and medications work against it,” writes the CDC.

So what should Americans be on the lookout for? Here’s the list of symptoms the CDC found for previous strains: cough; fever or chills; diarrhea; nausea or vomiting; congestion; new loss of taste or smell; muscle or body aches; and shortness of breath or difficulty breathing.