COVID-19 cases, hospitalizations are slowly rising again

According to the New York Times, COVID-19 infections have been rising over the last few weeks, with wastewater analyses suggesting that the highest increases have been in the Northeast and South, then the West and Midwest.

Currently, COVID-19 test positivity rates are 7.6%, a level that was last seen in the summer of 2021, just before the delta variant spread across the country, and November 2021.

"We have had a summer wave of COVID for the last few summers and so it's not surprising to see an increase in COVID right now," said Jill Rosenthal, director of public health policy at the Center for American Progress.

COVID-19 hospitalizations are also on the rise. According to CDC data, nationwide COVID-19 hospitalizations were up 12% the week of July 22, the latest week of available data. Some areas of the country are seeing even higher increases.

Currently, there are 17 counties across the United States classified as having "medium" levels of COVID-19 hospitalizations. Two counties in Texas, Navarro County and Freestone County, are also classified as having "high" levels of COVID-19 hospitalization. 

According to Eric Sztejman, a pulmonologist at Virtua Health, the current increase in COVID-19 cases and hospitalizations may be partly due to more people staying inside from the heat this summer.

"When it gets really hot, people go indoors, when it gets really cold, people go indoors, and when you're inside the ventilation is different, people are closer together. So I think that's part of it," said David Wohl, an infectious disease physician.

However, even with increased transmission over the last few weeks, many health experts say it's unlikely that the current rise will become a major COVID-19 wave.

"There seems to be some level of stability in the balance between immunity and what the virus is doing," said Jay Varma, an epidemiologist at Weill Cornell Medical College. "The virus does not appear to be evolving to become either more transmissible or more lethal at this point" — although that could change in the future.

What will COVID-19 look like this fall and winter?

According to many health experts, COVID-19's true impact on patients and the healthcare system will likely not be seen until the fall and winter when respiratory viruses are more likely to spread.

"This fall is something that us epidemiologists are watching with much curiosity," said Katelyn Jetelina, a public health expert and author of the newsletter "Your Local Epidemiologist." "I think a lot of us are cautiously optimistic that we may start getting a new normal respiratory season."

However, some experts are concerned about how COVID-19 will interact with respiratory syncytial virus (RSV), influenza, and other pathogens in the colder months. Last year, many hospitals struggled to care for patients under a "tripledemic" of COVID-19, RSV, and the flu.

"Even before Covid, it was very difficult for health care systems to keep up with the surge of patients," said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. "If this is, in fact, what we can expect year over year going forward, I think we're going to have to adjust the health care system to accommodate that increased load."

Currently, drugmakers are working on an updated COVID-19 vaccine for the fall. The updated vaccine is expected to target the omicron variant XBB.1.5, which was the dominant variant this spring. However, research suggests that even in a best-case scenario where people of all ages get vaccinated, COVID-19 is projected to cause 484,000 hospitalizations and 45,000 deaths — a toll similar to a bad influenza season.

"Based on these projections, Covid is likely to remain in the leading causes of death in the United States for the foreseeable future," said Justin Lessler, an epidemiologist at the UNC Gillings School of Global Public Health.

Going forward, COVID-19 cases are unlikely to reach the highs seen earlier in the pandemic, but some health experts recommend people considering wearing masks again when cases rise, testing when they experience symptoms, and being careful around others who may be at a high risk of severe illness, such as older individuals and those with weakened immune systems.

"Whether we're completely out of the pandemic and settled into our seasonal routine, I am going to pencil in the yes," Rivers said. "But I'm also prepared to be surprised, because this virus has surprised me before." (Mandavilli, New York Times, 8/2; Martichoux, The Hill, 8/2; Goldstein, New York Times, 8/3; Stahl, CBS News, 8/3)

As case counts increase across the country rise as a result of COVID-19, hospitals and health systems already strained by staffing shortages must be ready to confront the challenges at stake. Access the collection of our best resources and insights for creating capacity, supporting staff, communicating with patients, and more.