COVID-19 cases and hospitalizations rise

It's not completely clear exactly how many people are contracting COVID-19 at any point because of a lack of testing and the fact that so many infections are mild enough that people don't test, STAT reports.

However, recent CDC wastewater numbers say that viral activity is "high" in July, and that 26 states are seeing either "high" or "very high" levels of the coronavirus. Similarly, WastewaterSCAN, which is a private initiative that tracks municipal wastewater data, found there's been a 54% increase in copies of viral RNA per gram of wastewater solids between June 30 and July 12.

CDC also found that the District of Columbia and 26 states are seeing "substantial increases" in COVID-19 ED visits. Nationwide, the average share of ED patients with COVID-19 currently stands at the highest it's been since February and has increased 115% since June.

According to Aaron Glatt, chair and professor of medicine at Mount Sinai South Nassau, hospitalizations act as a surrogate for what's happening in a community. Over the past month or so, COVID-19 admissions at Mount Sinai have increased from only two or three patients to 10 to 15.

"I think people have to understand that we're probably going to be dealing with Covid for many, many, many years to come. There will be waxing and waning of infections, summer or winter," Glatt said.

Overall, ED visits and hospitalization trends remain at what CDC considers to be "low" levels in many states, significantly below levels seen earlier in the pandemic.

"We are seeing patterns that are consistent with what we have observed over the last couple of years in the summer, where we have seen upticks in activity that have occurred around this time of year that are not quite as large as what we see during the winter peaks," said Aron Hall, deputy director for science in CDC's Coronavirus and Other Respiratory Viruses Division.

Hall added that previous trends suggest that COVID-19 cases will peak soon, if they haven't already.

"It's hard to predict the future. And if COVID has taught is anything, it's that things can always change. But based on previous trends, where we have seen sort of a summer wave that has peaked around July or August, is what we might expect for this year," he said.

While cases and hospitalizations are increasing, COVID-19 deaths are currently at their lowest point since the virus first emerged, according to CDC.

Why COVID-19 cases are surging in the summer

Unlike other respiratory diseases like influenza and respiratory syncytial virus, COVID-19 has shown patterns of surging in the summer for a number of reasons.

The virus is exceptionally adept at spreading, especially with the emergence of new KP variants, called FLiRT, as well as LB. 1, which accounted for 85% of new cases as of early July. These variants have mutations that make it easier for the virus to spread than previous variants. However, Hall noted there is "still no indication of increased severity of illness" associated with any of the new variants.

When surges occur, new variants are key, according to Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"Each of the peaks occur relative to the arrival of a new variant," he said. While waning immunity from the most recent round of vaccines also plays a role, "it really is all about when the variants come."

Other experts note that factors such as increased travel, large gatherings like weddings and conferences, and the heat driving people indoors also play a role.

"When we're outdoors, it's difficult for covid to transmit, but it's been so oppressively hot, particularly in the Southwest United States, and people are just spending a lot more time indoors," said Andrew Pekosz, a professor of microbiology who specializes in respiratory viruses at the Johns Hopkins Bloomberg School of Public Health.

"Covid is not gone. Covid is going to be around, probably forever, and we are going to typically see two to three waves a year," said Ashish Jha, dean of the Brown University School of Public Health and former White House coronavirus coordinator.

"It raises a question of how worried should we be," Jha added. "It sounds scary, but it's not, for most people." (Cooney et. al., STAT, 7/18; Nirappil/Ortega, Washington Post, 7/18; Tin, CBS News, 7/12; Edwards/Bendix, NBC News, 7/18)

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