COVID-19 surges across the US

According to CDC data, the test positivity rate for COVID-19 was 18% for the week ending Aug. 17, one of the highest positivity rates recorded since January 2022. Wastewater surveillance also shows that 32 states have reported "very high" levels of wastewater viral activity.

Currently, the KP.3.1.1 variant makes up almost 37% of all COVID-19 cases, followed by the related KP.3 variant at 17%. These variants are also known as FLirT based on their mutations, and are the fastest growing omicron subvariants circulating across the United States.

As of Aug. 16, CDC estimates that COVID-19 infections are growing or likely growing in 27 states. COVID-19 cases are also either stable or uncertain in 17 states and declining or likely declining in four states. 

"Covid is still very transmissible, very new, and people congregate inside in air-conditioned rooms during the summer," said John Moore, a virologist and professor at Cornell University's Weill Cornell Medical College.

With COVID-19 cases rising across the country, HHS has also announced that it plans to reopen its free at-home COVID test delivery program starting in late September. Since 2021, the program has distributed 1.8 billion tests to U.S. households and community-based access points, such as food banks, libraries, and long-term care facilities.

FDA approves new COVID-19 vaccines

Last Thursday, FDA approved new COVID-19 vaccines from Pfizer-BioNTech and Moderna. The new vaccines are designed to target the KP.2 variant, which is a descendent of the JN.1 variant. Currently, KP variants make up almost 70% of all COVID-19 cases in the country.

"We strongly encourage those who are eligible to consider receiving an updated COVID-19 vaccine to provide better protection against currently circulating variants," said Peter Marks, director of the FDA's Center for Biologics Evaluation and Research. "Vaccination continues to be the cornerstone of COVID-19 prevention."

CDC Director Mandy Cohen also recommended that every individual ages six months and older get a new COVID-19 vaccine. Eligible children and adults should get vaccinated in September or October if possible, and co-administration of the COVID-19 and flu vaccines should be encouraged.

However, vaccine uptake has declined significantly in recent years. Compared to around 80% of people who received the first dose of the COVID-19 vaccine, only around 20% of adults received the latest vaccine last fall. The uptake among older adults, who are at a greater risk of severe disease, was only 40%.

A lack of public health funding for vaccination campaigns has limited uptake, the New York Times reports.

"Health departments got extra money during the pandemic to send teams to people who were so disabled they had to stay at home," said William Schaffner, an infectious disease specialist at Vanderbilt University. "That money's gone."

According to Demetre Daskalakis, director of CDC's National Center for Immunization and Respiratory Diseases, the agency has $62 million in unspent vaccine contract funding that would be sent to state health departments to purchase new vaccines for people not covered by insurance.

However, Kelly Moore, CEO of Immunize.org, said the funding "may not go very far" if the vaccine costs CDC $86 a dose like it did last year. People who pay out of pocket for the vaccine at pharmacies will also face higher prices, with CVS planning to sell the new COVID-19 vaccine for $201.99.

"Price can be a barrier, access can be a barrier" to vaccination, said David Scales, an assistant professor of medicine at Weill Cornell Medical College.

Unless there is an access program to vaccinate uninsured adults, "[we'll] see disparities in health outcomes and disproportionate outbreaks in the working poor, who can ill afford to take off work," Kelly Moore said.

"We don't have the community push or diffusion of vaccines the way we once did," said Zeke McKinney, a physician in Minneapolis, who organized vaccinations at a local barbershop until funding ran out. "It's mostly up to everyone on their own to figure it out." (CDC COVID Data Tracker, accessed 8/26; AHA News, 8/20; Loehrke, USA Today, 8/20; CDC Current Epidemic Growth Status for States, accessed 8/26; Reed, Axios, 8/22; Constantino, CNBC, 8/22; Kahn, MedPage Today, 8/23; Mueller/Weiland, New York Times, 8/22; Allen et al., KFF Health News, 8/26; Associated Press/STAT, 8/22; Cohen, Science, 8/21)