COVID-19 Still Rising In the US — What You Can Do To Protect Yourself and Others: Update for August 24, 2024

COVID in US wastewater — the most accurate measure we have of the number of COVID infections — rose again this past week, reaching the highest rate in seven months. While the flattening rate of growth suggests we’re near a peak in this lengthy surge, infection risks will remain substantial. COVID doesn’t hospitalize and kill as many as it did a couple of years ago, but rates of Long COVID are not declining in the US as equal numbers of people acquire Long COVID as recover from it. However, some help is on the way in the form of updated vaccines and a new free COVID test program for US households.

This week’s update:

COVID Rises Again in the US, Particularly in the Northeast and Midwest

COVID has been rising in US wastewater since early May. This summer surge has become one of the worst midyear surges of the pandemic. Currently, the CDC reports wastewater viral activity level is very high nationally. Fortunately, the rate of increase is declining, which implies we may be at or near peak, but do not expect a rapid decline or lull in infections in the coming months.

COVID in wastewater remains highest in the West and South, but both regions seem to be past their peak. Meanwhile, although the Northeast and Midwest have lagged considerably in this surge, COVID infections continue to increase in these regions.

Virtually every US state has high or very high COVID viral activity levels at this time. States such as Alabama, Arkansas, Louisiana, Washington, Wyoming, and New Hampshire are near the highest level of COVID in two years. Just four states are at moderate levels: Michigan, West Virginia, New Jersey, and Vermont. Even within these four states, COVID levels vary widely; according to the WastewaterSCAN dashboard, Warren and Traverse City, MI are among the sewersheds with the highest levels of COVID in wastewater in the nation.

CDC’s COVID-19 Current Wastewater Viral Activity Levels Map

As noted last week, data suggests we are near a peak in our summer surge. Both the National Wastewater Surveillance System and WastewaterSCAN dashboard report COVID is levelling off. And the positive rate of testing has stopped rising, according to the CDC and Walgreens.

Although we may be near the highest point of this surge, we should not expect a rapid decline or low trough in late summer and fall. Many factors are encouraging high levels of infections: Children are back in school (with some schools already closing in Texas, Tennessee, Virginia, and elsewhere due to outbreaks), enormous political rallies are drawing cheering and maskless crowds, and other events continue to encourage frequent reinfections. The Pandemic Mitigation Collaborative model forecasts the rate of COVID will only go down from 1,260,000 daily infections today to 1,212,000 in the next thirty days.

Interestingly, the number of Americans who see COVID as a small risk is diminishing slowly, while the number who see it as a major risk is rising gradually. However, “52% strongly or somewhat agree that the pandemic is over” and despite growing concern, only 13% of Americans report wearing a mask in public settings all or some of the time.

The Number of Americans Reporting Long COVID Symptoms is Remaining Steady

Because many think the pandemic is over, recurring and significant surges are causing the number of Americans with Long COVID to remain unchanged rather than decline (as would be expected if the pandemic were, in fact, over). There are no definitive treatments for Long COVID, but many with Long COVID experience a slow recovery in their symptoms. Based on the new Census Bureau Data, we know as many Americans are acquiring Long COVID as are recovering from it.

The Household Pulse Survey regularly collects data from Americans about their Long COVID symptoms. The latest wave of data, collected between June 25 and July 22 of this year, tells us that one of every 18 American adults reported currently experiencing Long COVID symptoms. Fewer Americans say they have Long COVID symptoms than did so in spring, following our terrible holiday surge, but the latest rate of Long COVID is the same as was reported last fall.

Most experiencing current Long COVID symptoms report they cause some activity limitations. One of every 22 adult Americans has some Long COVID activity limitations. And 1.4% of all American adults say they face significant activity limitations.

Meanwhile, the flow of studies reporting COVID causes lasting damage to bodies continues unabated. Studies published in the past week have found COVID:

• Damages cardiomyocytes mitochondria,
• Causes autonomic and neurological abnormalities that persist after more than a year,
• Is associated with elevated levels of depression, serious mental illness, addiction, self-harm, and suicide during weeks 1 through 4 (which persisted longer in hospitalized patients),
• Causes reduced mitochondrial respiration and content in skeletal muscle biopsies,
• Is associated with CT (computed tomography) abnormalities 12 and 18 months post infection, and
• Causes increased symptoms in 6-to-11-year-olds (4x palpitations with exercise, 11x nausea/vomiting, 7x trouble w/ memory/focusing) and 12-to-17-year-olds (18x change of smell/taste, 5x tired after walking, 3x back/neck pain).

It should be apparent that COVID is not just a mild acute illness. With many people getting one or more COVID infections annually, the threat of accumulated and repeated injury to hearts, brains, and other organs is (or should be) a concern.

You Can Protect Yourself and Significantly Reduce COVID Risks

While eliminating COVID reinfection risks is difficult or impossible for many due to employment or school attendance, that doesn’t mean we can’t reduce those risks. Anything we do to decrease reinfections can protect our health, minimizes risks to others around us, and helps reduce the rate of COVID mutation. Here’s what you can do:

• Get vaccinated. The big news this week is that the FDA has approved this year’s vaccines. Vaccination doesn’t guarantee you won’t get COVID, as the protection against infection is partial and fades over the course of months. But, being vaccinated does reduce infection risk, as well as decrease the likelihood of serious outcomes. Sadly, fewer than a quarter of eligible Americans got last year's updated vaccine, and that means most Americans now have little immunity from vaccines. If this low rate of vaccine uptake continues, we can expect continued and rapid COVID evolution, repeated surges, and more cases of Long COVID in 2025.
• Get free COVID tests. The other good news this week is that the US government is reimplementing the free test program. Every US household will soon be able to order four free tests. Testing when you are ill is an important step to confirm infection, stay home, and protect others in your household from illness. (We should all embrace the idea of staying home when we’re sick with anything rather than expose others to anything, be it flu, RSV, a cold or COVID, shouldn’t we?)
• Wear a mask. You know you should, but you likely don’t do it. Masks are proven to be effective in reducing infection risks. Furthermore, masks can reduce the amount of exposure, even in situations when you become infected, which helps to reduce the threat of severe outcomes. In a terrific new article about those still masking, one person shared the perfect wisdom: There is “no good reason not to wear a mask.”
• Avoid crowds. Crowded events — particularly those with singing, cheering, screaming, and loud talking — are high-risk situations during surges. While COVID risks remain high or very high (as they are likely to for the next five months), avoiding concerts, conferences, political rallies, crowded bars, and religious services can substantially lower your likelihood of contracting the disease. And, if you cannot or will not avoid these high-risk scenarios, then wearing a mask at events can help to keep you safe.
• Do not engage in consecutive social activities. Whether you take any of the prior suggestions, the one thing I wish people would have learned from the pandemic is this: Our actions can have a considerable impact on others. With COVID risks high and an estimated 2.6% of the US population infectious right now, think of others as you plan your social calendar. Do not attend a crowded political rally one day and then see your elderly parents the next. Don’t go to a concert, then gather with friends within a day or two. If you engage in higher-risk activities, allow yourself a couple of days to ensure you’re healthy before exposing others. Your choices are not just your own — don’t make your decision to ignore COVID someone else’s chronic Long COVID suffering.

Please be safe, friends.