Do we need to worry about COVID again?

A small rise in hospitalizations points to the need to get prepared for the fall virus season, doctors say
A COVID-19 test kit vending machine at the Regional Transportation Commission's Bonneville Transit Center, on Thursday June 9, 2022, in Las Vegas. The Southern Nevada Health District and its partners installed the vending machine. (Bizuayehu Tesfaye/Las Vegas Review-Journal/TNS)

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A COVID-19 test kit vending machine at the Regional Transportation Commission's Bonneville Transit Center, on Thursday June 9, 2022, in Las Vegas. The Southern Nevada Health District and its partners installed the vending machine. (Bizuayehu Tesfaye/Las Vegas Review-Journal/TNS)

This summer has been filled with blistering hot days, vacations, mingling with friends – and very little COVID-19.

But a late-summer uptick of coronavirus cases is now underway in Georgia and across the country. Hospitalizations in Georgia rose 8.4% during the week ending July 22, according to the most recent data from the Centers for Disease Control and Prevention. Nationally, for the same week, there was a 12% rise in COVID hospitalizations over the previous week.

Overall, the numbers remain very low — far lower than were seen in the past three summers. Georgia had 233 COVID patients hospitalized during the week ending July 22. A year ago the number hospitalized was 1,668.

Since May 2023, weekly COVID deaths also have been the lowest they have been since the start of the pandemic. According to provisional data from the Centers for Disease Control and Prevention, there were 11 deaths in Georgia for the week ending July 15 in which COVID was an underlying or contributing cause of death.

“Over the six months or so, we have seen a steady decline in our health system and across the state in the number of people hospitalized, and that’s been very encouraging,” said Dr. John E. Delzell, Jr., vice president of medical education for Northeast Georgia Health System. “But we’ve never gotten to zero in the health system. ... And we’ve seen a little uptick. Nothing really (major) we are just watching it right now.”

But the virus today is not the same as it was. Now, with vaccines, natural immunity and more treatments, which include the widespread use of the antiviral drug Paxlovid, doctors say we are at the point where nearly every death is preventable. At least 96% of adults in the U.S. have either been infected by COVID, providing natural immunity, or have been vaccinated. Many fall into both categories.

Even people who are high-risk are unlikely to be hospitalized or die from the virus if they are current on their vaccines and seek treatment for a COVID infection, experts say.

But COVID remains a threat, especially for those who are older and immunocompromised. Immunity wanes over time. Anyone infected can suffer from long COVID, with sometimes debilitating symptoms that linger for weeks, months or even longer.

And as fall approaches, other respiratory illnesses that nearly disappear during the summer months will resurface: the flu and respiratory syncytial virus or RSV, a highly contagious respiratory virus.

Doctors and public health authorities are encouraging Americans to get annual vaccine shots to help prevent a repeat of another “tripledemic” of respiratory illnesses that overwhelmed hospitals in Georgia and across the country last year.

Many are familiar with the annual flu shot. The same goes for the COVID booster vaccine, which is getting another update for this fall to better target the circulating variants. But for the first time this fall, the U.S. will have access to vaccines for the highly contagious and seasonal RSV, a respiratory virus that can cause serious illness, especially in infants and older adults. There are new shots now available for adults over 60, along with a new monoclonal antibody injection for babies and a third vaccine is under consideration for women during pregnancy.

The FDA voted to update the COVID vaccine to target the XBB variants, a branch of the omicron family tree now dominant. In a Johns Hopkins podcast, virologist Andrew Pekosz said the XBB-based vaccine for the fall will no longer be a “bivalent booster,” designed to fight two different variants of the coronavirus; this will be a “monovalent” vaccine aimed at just one version of the virus. Even as new variants emerge, the vaccine is expected to continue to be effective.

A bag of empty vials of the Pfizer-BioNTech COVID-19 vaccine in 2021. (Elizabeth Robertson/TNS)

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Pekosz said it’s not yet clear what the CDC guidance and recommendations will be around how the latest COVID vaccine should be used. Most likely, he said, it will be what we’ve seen before: recommended for people over the age of 60 for whom it’s been longer than four to six months since their last COVID vaccine.

“When I as a virologist look at the data, if you haven’t received a COVID vaccine in six months or a year, this is a good vaccine to take because it’s very different from the variants that you’ve been immunized against before,” Pekosz, a professor in Molecular Microbiology and Immunology said in the podcast.

Doctors and public health officials are monitoring cases, he said, “to get a sense of what’s happening in the U.S. So we have a sense of what’s going on, but it certainly isn’t nearly as in-depth or as rapid as it was a year ago.”

This is tracking what’s happening here in Georgia. At the Northeast Georgia Health System, which includes four hospitals and three long-term care facilities, the number of COVID patients fell to about 5 in June, an all-time low since the start of the pandemic. On Wednesday, the system had a total of 14.

Delzell said COVID patients are “generally a lot less sick,” than patients earlier in the pandemic. They are far less likely to end up in the intensive care unit.

Last year, the flu began spreading unusually early in October and peaked quickly. RSV also spiked earlier than usual as COVID continued to spread. Together the viruses swamped emergency rooms and pediatric units, forcing hospitals to rearrange staffing and resources to handle the surge of sick patients.

In this file photo, Meredith Legree of Lakeville, Minnesota, holds her frightened son Andrew, 3, as respiratory therapist Sirena Ortega holds a mask to his face for a nebulizer treatment to help decrease inflammation in his airway and allow him to breathe easier as they waited for the results of his RSV test at Children’s Hospital of St. Paul. (Minneapolis Star Tribune/TNS)

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Dr. Christina Rostad, a physician at Children’s Healthcare of Atlanta, said while all viruses have been at a summer low this year, “We can likely expect an uptick in infections as the school year resumes and we enter the fall and winter months.” She noted they’ve started seeing the numbers climb upward at Children’s Healthcare of Atlanta.

But exactly what will happen is impossible to predict.

“I think most of us in virology have given up predicting what the flu and virus season is going to be anymore,” said Dr. Colleen Kraft, professor of infectious diseases and pathology at Emory University School of Medicine.

Credit: Robert Morgan NGHS

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Credit: Robert Morgan NGHS

Kraft went on to say an earlier bump in COVID could mean there will be fewer cases during the fall when other respiratory viruses become active.

She and other doctors in Georgia expressed confidence in the state’s ability to have an adequate public health response to combat COVID, pointing to vaccines and treatments. “It’s just getting individuals to actually participate in that,” she said.

Staying up to date on vaccines and getting prompt treatment if sick with COVID is critical, but doctors said other measures are also important in staying healthy.

Delzell talked about the importance of having a primary care doctor to oversee all aspects of an individual’s health. Other steps include the importance of eating healthy and getting a good night’s sleep to help support the immune system and help fight infections more effectively.

“You know one of the things that changed since the pandemic is people would power through being sick,” he said. “I think we’ve learned that there is some value to the rest of the community to make sure if you have influenza or COVID or RSV that you stay home and don’t spread it.”

Report for American reporter Donovan Thomas contributed to this article.