surge

We reported last month on yet another COVID surge beginning, driven by yet another new, highly transmissible variant. When I checked in on the state of affairs this week, I found two different narratives.

With the demise of widespread public testing, it has become more difficult to track the progress of the disease. One means to do so now is to monitor hospital admissions for COVID. The New York Times provides this service, and it shows a continued uptrend in cases, at least through September 8:

Source: The New York Times

The chart above is for the whole country. It turns out that these cases are highly localized in certain hot spots, especially along the Atlantic seaboard (Delaware through South Carolina), plus the region of St. Joseph, Missouri:

Source: The New York Times

Wastewater Analysis Suggests a Plateau

An alternate means of monitoring the progress of COVID is to do ongoing testing of municipal wastewater. The virus is “shed” (to put it delicately) in sewage, and can be detected there some days before a person reports any symptoms. Most recent wastewater analyses indicate that incidence of the disease is plateauing for now, according to an NBC News article by Erika Edwards:

Biobot Analytics, a company that tracks wastewa ter samples at 257 sites nationwide, said that the current average Covid levels across the United States are approximately 5% lower than they were last week.

“All fingers crossed,” Cristin Young, a Biobot epidemiologist said, “this wave is plateauing and may be declining.”

While data from the Centers for Disease Control and Prevention show a rise in Covid-related hospitalizations and deaths, wastewater may indicate what’s to come.

After a mid- to late-summer rise, the CDC’s Covid wastewater surveillance now shows declines in mid-Atlantic states, such as Virginia and Maryland.

The findings are backed up from surveillance in North Carolina, said Jessica Schlueter, an associate professor in the department of bioinformatics and genomics at the University of North Carolina Charlotte. Her lab is responsible for testing 12 sites across the state.

The increase in Covid wastewater samples during the last six months “seems to be peaking and starting to taper off,” she said. …Wastewater collection sites in the Midwest and the Northeast, however, show a steady uptick in Covid spread.

Hospitalizations and deaths are lagging indicators, whereas wastewater analysis provides something of a leading indicator. Putting it all together, it may be that what we are seeing now is the usual late summer COVID increase, which may come down in the next two months, to be followed by another winter surge. Do get your latest booster shots.

The spread of highly-contagious and sometimes fatal Covid-19, and the responses to it (lockdowns and then trillions of dollars of federal giveaway money to mitigate the effects of the lockdowns and now huge interest rate hikes to counter the inflation caused by that giveaway money) have been arguably the most economically momentous events of this decade so far. Thus, it behooves us to keep an ongoing eye on this beast, since it seems to keep coming back in waves.

We all know that Covid is spread by little “aerosol” droplets coming out the infected people’s mouths and noses. Those aerosols are mainly generated by speaking and singing. So being in a room full of talking or singing people (e.g., a happy convention or bar, or a hymn-singing church) can be a super-spreader situation.

I have reasons to try to avoid respiratory diseases, and so I attended church on-line or outdoors for most of the past three years. The Covid numbers finally got low enough this spring that I started attending inside, and even going unmasked the past two months.

Alas, Covid cases and hospitalizations are back on the rise, it seems due to the new Eris or EG.5 subvariant. Like the infamous omicron variant of a year ago, it is very transmissible and resistant to existing vaccines, but is not as deadly as the original strain. Much of the population has some immunity due to vaccines and/or prior exposure. Also, antivirals like Paxlovid are widely available to help mitigate symptoms. Still, a case of Covid often makes for an uncomfortable and disruptive week or two, and can still be fatal or debilitating.

So, I have done a quick amateur scan of the internet, trying to get a fix on what to expect. One thing that stands out is that actual case numbers are far higher than officially reported, for a couple of reasons. One is that the rigorous, systematic reporting of cases has fallen off, since Covid was deemed no longer an emergency. Also, with the end of free test kits and the generally more lax public attitude (we just want to be done with this), there is far less testing done than in 2022. (In communities with systematic testing, it turns out that the best way to track Covid is by analyzing wastewater).

Will the Latest Vaccines Save Us?

The vaccine story seems somewhat mixed. The latest booster vaccine, to be available around October, will target the XBB.1.5 subvariant, which is what was mainly circulating earlier this year. However, it is expected that since EB.5 is closely related to XBB.1.5 (both of these are of the general omicron family), the booster will confer some immunity to EB.5. That is the good news.

The bad news is that the public’s uptake of boosters in general is well under 50%, so we may expect EB.5 or whatever the next subvariant is to continue to circulate, and probably surge during the colder months when respiratory diseases tend to spread. Also, vaccines do not really stop you from getting Covid, they mainly act to mitigate the symptoms by helping your body’s defenses to react faster.

Starting next week, I will resume wearing an effective KN-95 or my preferred KF-94 mask at church and other venues where a lot of people are talking or singing.