COVID Is Revving Up For Another Round

The number of deaths from COVID-19 is way down from its peak and pandemic-related restrictions and mandates have virtually disappeared, but there are hints we are in for a late summer surge in infections.

Most of us know people, first- or second-hand who have been infected recently. The brother-in-law of a friend of mine attended a baby shower suffering from what he thought were summer allergies … and gave COVID to almost every other attendee. In addition, two distinguished academic physicians known for dispensing advice on COVID recently had serious outcomes from their own bouts with the infection. 

In early July, Dr. Bob Wachter, the chairman of the Department of Medicine at the University of California, San Francisco, tweeted about his COVID experience. He had awakened with brain fog and a fever and sweating and took a hot shower, which dropped his blood pressure and caused him to lose consciousness. He later tweeted: “I work (sic) up in a bloody pool on my bathroom floor. There was a dent in the lid of a trashcan, likely where my head had hit. I remembered nothing. As I managed to get up, it was clear that my face was going to need stitches, and more than a couple.”

He had a black eye, a couple of lacerations that required stitches, a subdural hematoma, and a fractured vertebra.

Professor Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, contracted COVID in March, apparently while “hosting a few (tested) guests for dinner and attending a small, uncrowded music show (wearing an N-95 mask).” He was one of three people infected at the event.

Within several weeks, Dr. Osterholm experienced the onset of long COVID: “By week[s] three and four, the fatigue really set in worse than during the illness itself. And I started having memory loss. If you’d asked me, ‘What’s a Champagne and orange juice drink?’ I couldn’t have thought of the word mimosa.”

These accounts are anecdotes, of course, and as the saying goes, in medicine the plural of anecdote is not data. But there are actual data, as well.

The U.S. recorded a 10% increase in new COVID-19 hospital admissions for the week that ended July 15 compared with the previous seven-day period. They are rising fastest in the South, Great Plains and Rocky Mountain states. Emergency department visits have also begun to increase:

The increases in hospitalizations and test positivity are consistent with upticks in SARS-CoV-2 concentrations in wastewater nationwide, which are most pronounced in the South and West. 

Reading the tea leaves, Dr. Brendan Jackson, the CDC’s COVID-19 incident manager, told National Public Radio, “This could be the start of a late summer wave.” Or, as University of Texas epidemiologist, Katelyn Jetelina put it last week, “here we are yet again.”

There’s more, however. The SARS-CoV-2 virus continues to evolve, and there are some new mutants that could be more immune-evasive than its predecessors. 

I agree that we’re in for some sort of surge, especially with schools soon to reopen. So, where, exactly, does that leave us?

For one thing, it should not leave us underestimating the importance of avoiding COVID infection in the first place.  Although the COVID mortality rate is under 1 percent, the incidence of long COVID – the persistence of symptoms, many of them serious, or the appearance of new ones following apparent recovery – is much higher.

According to the most recent CDC data, just over 15% of U.S. adults ever had long COVID, and 5.8% (about 15 million) currently have it. But as pediatric health researcher Dr. Karen Bonuck wrote recently: “For a condition that’s fallen off the radar for those untouched by it, the percentages of U.S. adults reporting any (4.9%) and significant (1.5%) activity limitations is astonishing.” 

Researchers at Imperial College London minced no words in putting long COVID worldwide into perspective: “The oncoming burden of long COVID faced by patients, health-care providers, governments and economies is so large as to be unfathomable.”

People at high risk for COVID complications, such as older people and those with comorbidities, should ensure that they’re taking protective measures. They include being up to date on COVID vaccines (including the new round expected to be available in September or October), wearing a mask in moderate- or high-risk situations, testing if they feel sick, and getting the appropriate medicines quickly if they test positive.

Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. He was the founding director of the FDA’s Office of Biotechnology.