The United States will soon face its third autumn and winter with the coronavirus, and a new surge in cases may be on its way as colder weather forces people to spend more time indoors. However, updated boosters may offer people new protection and reduce the risk of severe disease and death.

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What the pandemic is currently like in the US

Currently, new Covid-19 cases, which were largely driven by the highly transmissible omicron subvariant BA.5, are trending downward from a summer peak. As of Aug. 22, CDC data shows that there were 577,330 positive cases reported that week, down from 858,282 cases a month prior on July 25.

Similarly, Covid-19 hospitalizations are also seeing a decline after a modest peak earlier in the summer. As of Aug. 28, there were 36,920 hospitalized Covid-19 patients across all age groups in the United States, compared to 44,433 hospitalized patients a month prior on July 31.

Deaths from Covid-19 have also fallen since their peaks during the omicron surge last winter and are now near all-time lows. However, health officials say that the number of Covid-19 deaths is still high and has not declined much in recent months. As of Aug. 22, 2,714 Covid-19 patients died every week—or around 400 people every day.

"Despite that lower mortality, we're still seeing numbers that are far too high," said Paul Simon, chief science officer at the Los Angeles Department of Public Health. "This shouldn't be viewed as normal."

In mid-May, the United States marked 1 million deaths from Covid-19, and since then, roughly 41,000 more people have died from the disease. Overall, individuals who are unvaccinated remain at higher risk of death than those who are vaccinated and boosted. 

In addition, most Covid-19 deaths continue to be concentrated among older Americans, particularly those over the age of 85. Although most older Americans are vaccinated, their immune systems are generally weaker and they are more likely to have chronic conditions, which put them at greater risk of severe disease and death from Covid-19.

"This is a pretty sad reality," said Sean Leng, a professor at Johns Hopkins University School of Medicine. "Older individuals still shoulder the majority of deaths."

How the US can protect itself from Covid-19 going forward

To reduce the risk of Covid-19 this fall, the "first step is to ensure that everyone — but particularly the most vulnerable — has their immunity topped up," Vox writes. On Wednesday, FDA authorized updated Covid-19 boosters from Pfizer-BioNTech and Moderna ahead of a new booster campaign.

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However, even with new boosters becoming available, they will only be effective if people are willing to get them. Currently, only 51.6% of all adults have received an initial booster dose, and only a third of those eligible for a second booster have received the additional dose.

"The mantra I always have is, 'Vaccination saves lives, not the vaccines,'" Leng said. "You can produce all the vaccines you want and put them onto shelves and not into people's arms, and it won't do much good."

In addition, Simon notes that the United States' booster strategy needs to go beyond just vaccinating those who are at the highest risk and include family members, health workers, and other people they will encounter. "Just as important is creating what I call a cocoon around seniors to protect them, making sure that everybody around them is also fully vaccinated," he said.

Aside from boosters, people will likely need to be proactive about precautionary measures, such as wearing masks and testing themselves regularly, to reduce transmission of the coronavirus—particularly as mask mandates and distancing guidelines become less common. Slowing the spread of the virus will reduce the likelihood it will mutate into new variants.

Overall, "Americans may have to live with Covid-19, but they don't have to die from it," Vox writes. (Parker/Joseph, STAT, 9/1; Irfan, Vox, 8/31)