Multiple signs in the United States are pointing to an increase in COVID-19 activity as the fall season approaches. These indicators include a rise in hospitalizations, an uptick in deaths, the detection of the virus in wastewater samples, and positive lab results across the country.
Dr. Jodie Guest, a professor of epidemiology at Emory University’s Rollins School of Public Health in Atlanta, emphasized that all these factors signal an escalation in COVID-19 transmission within communities.
Hospitalizations have been on the rise since reaching an all-time low in late June. As of the week ending August 26, over 17,400 individuals were hospitalized with COVID-19, reflecting a nearly 16% increase compared to the previous week, as reported by the Centers for Disease Control and Prevention (CDC). Notably, current hospitalization data may underestimate the true figures as testing protocols have evolved. Initially, every admitted patient was tested for COVID-19, regardless of symptoms, but now, testing is primarily reserved for symptomatic individuals.
Dr. Peter Chin-Hong, a professor of medicine at the University of California, San Francisco, cited an increase in COVID-19 hospitalizations at his hospital system compared to earlier in the summer. Nevertheless, he highlighted that the current numbers do not reach the levels seen during the previous winter surge.
Emergency room visits with a COVID-19 diagnosis have also surged since early July. The week ending August 19 witnessed 2.3% of ER visits attributed to COVID-19, a notable increase from the 0.5% recorded during the week ending July 1, according to the CDC.
Wastewater samples have become another valuable tool for tracking COVID-19. Marlene Wolfe, an assistant professor of environmental health at Emory University and program director for WastewaterSCAN, reported an increase in SARS-CoV-2 levels in wastewater, aligning with a rise in community cases.
Furthermore, deaths from COVID-19 have seen a slight increase. The week ending August 19 reported 636 deaths, following a summer period during which weekly totals remained mostly below 600, occasionally dipping below 500.
Additionally, increased community transmission has become evident in people’s personal networks, with more individuals experiencing COVID-19 symptoms or testing positive for the virus. Shortages of COVID-19 tests in retail stores like Walgreens and CVS have also become noticeable due to increased transmission.
Regarding variants, experts believe that the current rise in cases and hospitalizations is likely attributed to XBB subvariants rather than the BA.2.86 variant. Subvariants such as EG.5 and FL.1.5.1 are contributing to the surge in cases.
While the BA.2.86 variant initially appeared concerning due to its numerous mutations compared to the XBB.1.5 subvariant targeted by vaccines, recent research indicates that individuals previously infected with an XBB subvariant within the past six months have demonstrated effective immunity against BA.2.86. This suggests that upcoming booster shots should provide protection against this variant, even if it becomes dominant.
Despite these developments, health experts continue to emphasize established measures to protect against COVID-19, including wearing masks, staying home when symptomatic, getting tested when exposed or experiencing symptoms, and staying up-to-date with vaccinations. In crowded settings, masking remains crucial for self-protection and the protection of others. Experts also recommend having a plan for therapies like Paxlovid or remdesivir if testing positive, particularly for older individuals or those with compromised immune systems.
The CDC highlights the importance of improving indoor ventilation by opening windows, using fans, and employing air filters to reduce infection risk. Furthermore, new COVID-19 boosters targeting the XBB variants are expected to receive approval from the FDA and CDC in the coming weeks, and experts encourage individuals to receive these boosters as soon as they become available.