Back so soon? The unpredictable return of COVID-19
Not too long ago, metro Atlanta’s last surviving Viral Solutions testing site for COVID-19, in Brookhaven, was seriously considering closing down. But on a recent sunny Friday, it was still open, a slow yet steady trickle of patients driving up. A teacher. A radio journalist. A stay-at-home mom. A retired couple. A prison worker. An uptick in visits has put closure plans on hold.
For the moment.
Across Georgia and beyond, COVID is seeing a comeback. But no one is sure how bad it will be.
COVID hospital admissions are increasing week after week — up 16% in Georgia’s latest available data — though the number remains low compared to earlier surges. The number of overall COVID cases is impossible to know, because of the rise of home testing and new problems getting test kits.
Once again, essential public workers are testing positive and staying home. Two hundred of Fulton County Schools’ 10,000-plus staff came down with the virus, just since Aug. 1. At Morris Brown College, a surge in cases has prompted a mask mandate, for at least the next two weeks. Hospitals from Phoebe Putney in Southwest Georgia to Wellstar facilities in metro Atlanta report going from virtually no COVID patients in critical care units to suddenly having one or two.
Updated booster shots are estimated to be at least a month away, and relentless mutations of the virus haven’t stopped. The U.S. has scaled back its response to COVID. The government no longer provides free vaccines and treatments to all patients, and free tests are not as widely available. Some local pharmacies have sold out or are low on COVID tests. And many Georgians are finding that the COVID tests they’ve been saving are expired. (Your expired COVID tests might still be good. Go here to find out.)
Again, people will have to make decisions about how to respond to a pandemic that many wish would just go away. When COVID is there but not a national crisis, how often do we get vaccinated against it? Do we keep masks in a drawer to choose when and where we wear them? What supplies do health care providers keep on hand now, to guard against a possible disastrous surge?
If those actions are handled right at moments like this, life will just go on as it has for the past several months, said Dr. Felipe Lobelo, director of epidemiology, public health and preparedness at Kaiser Permanente Georgia.
“We know COVID is never going to go away,” said Lobelo. “And we need to some extent to keep one eye open all night to make sure that things don’t get out of control. ... But what does that translate to in the day-to-day of most Georgians? I don’t think it changes much.”
Dr. Sanjay Gupta, a neurosurgeon who practices in metro Atlanta and is the chief medical correspondent at CNN, cautioned against making assumptions that this and future increases will quickly peter out, or that they can’t be severe. An entire surgical team in his orbit was out sick with COVID this week.
The current uptick might just be a result of people congregating inside because of the heat, he said, and going back to school.
“But I think without a doubt, the numbers are going to continue to go up,” Gupta said. “I think it’s just a question of how much at this point.”
‘It’s never going away’
Ishmael Muhammad, 42, was one of those at Viral Solutions that day. He woke up with a terrible headache and extreme fatigue, which felt distressingly familiar to a COVID illness he’d had two years ago. He said he wasn’t surprised to find himself in this situation.
“COVID, it’s never going away,” said Muhammad.
Muhammad has a baby at home he’s concerned about getting sick. If he tests positive, he will need to miss at least five days of work.
“It would be very disruptive,” he said.
A refresher: How COVID-19 tests work
When should you test? If you have symptoms, test immediately. If you do not have symptoms but have been exposed to someone with COVID-19, wait at least 5 full days after your exposure before taking a test.
As explained by the Food and Drug Administration, there are two types of tests:
- PCR tests are the “gold standard” test done by a laboratory and are more likely to detect the virus than antigen or rapid tests. PCR test samples are usually be taken by a healthcare provider and sent to a lab. Results may take up to 3 days.
- Antigen tests are rapid tests that can be done at home and produce results in 15-30 minutes.
- Positive antigen results are very accurate and reliable. However antigen tests are less likely to detect the virus than PCR tests —especially early in an infection or in people who do not have symptoms. For that reason, the FDA recommends people who get negative results with an at-home test use multiple tests over a certain time period, such as 2-3 days.
- If your at-home antigen tests gives a positive result, it means you most likely have the virus and should follow the Centers for Disease Control and Prevention (CDC) guidance to stay home, isolate from others, and seek follow-up care with a health care provider.
- If your test gives a negative result, test again 48 hours after the first negative test, for a total of at least two tests. If you get a negative result on the second test and you are still concerned that you could have COVID, take a third test 48 hours later or consider getting a PCR lab test from a health provider.
Current testing data submitted by hospitals would indicate few of those tested along with Muhammad that day will become seriously ill or in need of hospitalization from COVID.
But that doesn’t mean there’s no cause for concern.
Charles Person managed to get through three years of the pandemic without an infection — until this summer.
Person is a Vietnam vet who was active in the civil rights movement as a freedom rider, surviving the firebombing of his bus by a white mob. He chose a career in the Marine Corps.
He doesn’t go out much, but he had to visit a local hospital this summer, and when he went in the emergency room, he recalls all three workers who greeted him and took his vitals were unmasked.
A week later, he tested positive for the virus and things got serious. His oxygen levels plummeted and eventually he was put on a ventilator to help him breathe. He survived and is slowly recovering, now in rehab.
”I wouldn’t wish this on anyone,” said Person, who was vaccinated against COVID. “It makes you feel helpless. You say you’ve got through things before. But it says, ‘No – I’ve got you. I’ve got you.’”
Hospitalizations on the rise
In the most recent week of data available, the U.S. has seen a 22% rise in COVID hospitalizations, according to the Centers for Disease Control and Prevention. Georgia has reported a 16% rise, on top of a 30% rise the week before that. The numbers have been ticking upward for seven weeks in Georgia and five in the U.S. But hospitalizations still remain at low numbers compared to last winter’s surge in omicron cases, and to what they were the past three summers.
The total number of new COVID hospitalizations in Georgia reached 461 for the week ending Aug. 12, the most recent week available. In the same week last year, there were 1,558 new hospitalizations in Georgia.
What experts in Georgia and the U.S. see now is a far cry from a surge like those earlier in the pandemic that upended every aspect of our daily lives and overwhelmed hospitals.
Because of vaccines and prior infections, people have protection from severe disease. Treatments like the antiviral drug Paxlovid can reduce the risk of hospitalization and death. Doctors say we are at the point where nearly every COVID death is preventable.
Even people who are considered high-risk due to age or pre-existing conditions are less likely than in previous surges to be hospitalized or die from the virus if they are current on their vaccines and seek treatment for a COVID infection, experts say.
“The upswing of the curve is alarming. But it is not matched by the intensity of the illness,” said Dr. Mir Husain, an infectious disease specialist with Wellstar Health System.
Booster vaccines are still available for those who are due for one and a new version targeting the latest variant should be available soon. In a statement Wednesday, the CDC said if the new vaccine formula is authorized by the FDA and recommended by the CDC, updated boosters could be available as early as mid-September.
Taking such protective measures remains important. Immunity wanes over time. Anyone infected can suffer from long COVID, with sometimes debilitating symptoms that linger for weeks, months, or even longer. The risk of new disease, disability and death remains elevated in some patients as long as two years after catching COVID, according to a large study published Monday in the journal Nature Medicine.
At the quiet Viral Solutions site in Brookhaven where a white tent is surrounded by pine trees, no one who was interviewed seemed surprised to find themselves there, needing to be tested. They’ve heard the reports about cases rising and started hearing about a smattering of people they knew getting COVID. Little by little, it got closer to them: co-workers, classmates, friends or family. What happened next felt almost inevitable.
Lilli Lanndero of Stone Mountain pulled up with her children and a family friend, a teen girl with symptoms of COVID. So far, Lanndero said her family of four has managed to avoid COVID. She’s hoping to keep it that way.
She said her children, ages 8 and 13, both have asthma and keep masks with them in their backpacks. If they notice sick classmates, or they themselves get sick, they put on their masks. They are back in school and eager to resume their pre-pandemic lives. They remain watchful. People infected with the coronavirus can spread it to others two or three days before symptoms start. When the number of cases rises sharply, Lanndero and her family take more precautions and wear masks more regularly.
“I’m in the middle,” said Lanndero about how she’s feeling about the state of COVID today. “I know there’s still COVID and it’s still a concern, but not like it used to be.”
Gupta hopes that’s true.
“I think maybe we’re just in the early phases of this virus still — even three years in — the lifecycle overall of the virus and how it’s going to affect humanity,” Gupta said. As much as the coronavirus may seem old hat, he said, “We’re still very much in the early days.”
AJC Staff Writer Martha Dalton and database reporter Stephanie Lamm contributed to this article.
Boost now or wait?
With COVID cases on the upswing, many are asking when they should get their next booster. Experts say most people should wait for the updated vaccine, expected to arrive to pharmacies and doctors in mid-September.
Those at high risk of infection or those who haven’t had a booster or infection for several months should ask their doctor’s advice. Plans for travel or a family gathering may also play into a decision to get boosted now rather than waiting.
But for the majority of people, public health experts say it makes sense to wait for a vaccine that will better target the variants now circulating.
The updated vaccine formula is also expected to at least provide some protection against one of the latest variants, EG.5.
Federal health officials are shifting to an annual model for COVID shots for all age groups, similar to flu shots. Proponents say an annual shot could simplify the process of staying vaccinated and protected against severe COVID.
In the meantime, if you are concerned about catching COVID, you can take elevated precautions such as wearing an N95 or KN95 mask or avoiding crowds until the new updated vaccine is available.
If you have COVID symptoms, stay home for a few days. If you test positive, stay home for at least 5 days from the date your symptoms began. Read more here about what steps to take if you test positive.
Testing
The Georgia Department of Public Health is still providing free COVID tests at locations throughout the state listed here. But hours are limited.
Home test kits are harder to come by now, but they’re still important.
Home test kits also have expiration dates, and many of the free tests distributed in the pandemic have now expired. However, some of those expiration dates have been extended. You can check your test kit’s current expiration date here.
Seeking treatment for COVID
Antiviral medications can help your immune system fight of the coronavirus infection by stopping the virus from multiplying in your body, with a goal of preventing you from becoming more seriously ill. There is a narrow window, typically five days from when you begin feeling ill, to begin this treatment so speak with your healthcare provider as soon as possible if you test positive for COVID.
About the Authors
Ariel Hart is a reporter on health care issues. She works on the AJC’s health team and has reported on subjects including the Voting Rights Act and transportation.
