If you are around many people who have COVID-19, you are not alone.
Federal data shows coronavirus levels in California wastewater have soared to levels not seen in the summer since 2022, pointing to the widespread and worsening spread of the coronavirus.
“We’re seeing…a clear surge,” said Dr. Elizabeth Hudson, regional chief of infectious diseases at Kaiser Permanente Southern California.
The surge is evident in doctors’ offices and clinics where people seek outpatient care, Hudson said. But thankfully, not many people are currently hospitalized with COVID-19.
“Wastewater discharges are still rising. So we’re definitely going to see more and more cases,” Hudson said.
She urged people to get tested for COVID-19 if they develop respiratory symptoms.
“If you live in Los Angeles right now and have cough and cold symptoms, you really should think they are COVID-19 until proven otherwise,” she said.
This latest surge is driven in large part by the FLiRT variants, a group of highly transmissible sibling strains that outlasted last winter’s dominant strain, JN.1.
One FLiRT strain in particular, called KP.3.1.1, “has really taken off,” says Hudson. The Centers for Disease Control and Prevention estimates that the strain accounted for 17.7% of coronavirus samples nationwide in the two weeks ending July 20, up from 6.8% during the same period last year.
At this rate of growth, that pressure is likely to become increasingly dominant in the coming weeks, Hudson said. “So, unfortunately, I think we’re going to see more cases.”
The U.S. Centers for Disease Control and Prevention said Friday that coronavirus levels in California’s sewage were considered “very high” for the third week in a row. Thirty-seven states and the District of Columbia, where nearly three-quarters of Americans live, have “high” or “very high” levels of the coronavirus in wastewater.
According to the latest data, coronavirus levels in California wastewater were 93% of their 2022 summer peak in the seven days ending July 20.
There are signs that this summer’s COVID-19 wave may have some staying power. Coronavirus levels in California wastewater have remained at “high” or “very high” levels for seven weeks in a row, with no sign of peaking. A wave in the summer of 2022 lasted more than 16 weeks, with virus levels at “high” or “very high” levels, and a wave last summer lasted eight weeks.
Experts say the spread of FLiRT variants could prolong this summer’s surge because they exhibit a special ability to escape immunity.
“It does appear that we are rolling out more and more variants at a faster pace, which is probably to be expected,” Hudson said. “This virus is still very, very new to humans, and this virus wants to survive, and the way it survives is by evading immunity” — circumventing people’s defenses by evolving in a way that keeps the chain of infection going.
Additionally, “things are pretty much back to normal,” with many people abandoning once-cautious pandemic behaviors, Hudson said.
Even at the Paris Olympics, COVID-19 is now treated like any other respiratory illness. The treatment plan for infected athletes — if they feel well enough to train — is for them to wear masks, quarantine when not training and avoid certain public areas like gyms.
Districts across California are reporting elevated levels of coronavirus in sewage. The Bay Area, San Jose and Palo Alto have generally seen higher coronavirus levels since late May. Fresno County health officials said last week that coronavirus levels are high throughout the San Joaquin Valley.
The rate of positive COVID-19 tests in California has now surpassed last summer’s peak. In the seven days ending July 22, 13.8% of coronavirus tests came back positive. This exceeds last summer’s peak of 13.1%.
Interestingly, there have been numerous reports of people contracting COVID-19 at events such as weddings, work meetings and flights, with symptoms severe enough to leave them miserable for days. Although there is no indication that the latest subvariant causes more severe disease overall, some people are surprised by the more severe symptoms this time compared to previous rounds of COVID-19.
People who are older or immunocompromised remain at highest risk.
Hundreds of COVID-19 deaths are still being reported across the country each week. Among those who have died recently from COVID-19 complications and pneumonia was 80-year-old journalist Dan Collins, co-author of “The Grand Illusion: The Untold Story of Rudy Giuliani and 9/11” Author.
His wife, New York Times columnist Gail Collins, wrote that she and her husband both contracted COVID-19. “I felt like I had a bad cold, but one night Dan woke up completely unable to breathe. We went to the nearest hospital intensive care unit, but he never recovered,” she wrote.
Overall, COVID-19 deaths and hospitalizations appear to be lower than last summer.
In Los Angeles County, the nation’s most populous county, there were an average of 286 COVID-19 positive patients in hospitals during the week ending July 20. A quarter of the summer peak.
At UCSF, COVID-19 hospitalizations appear to have stabilized, but “there are a lot of people with COVID-19 outside the hospital. Almost everyone has the disease: You know, there have been outbreaks at music parties and people’s dinner parties.” This disease,” said Dr. Peter Chin-Hong, an infectious disease expert there.
Chin-Hong said there could be several reasons behind the first signs of stabilization in hospitalizations. Generally speaking, the population has higher immunity to COVID-19. In addition, the introduction and widespread use of COVID-19 antiviral drugs such as Paxlovid may prevent high-risk groups from being hospitalized.
But with COVID-19 infections increasing or threatening to increase in 35 states as well as the nation’s capital, Chin-Hong suggested that high-risk groups who were not up to date with the COVID-19 vaccine should get it now rather than wait until the newer fall version becomes available.
According to CDC guidelines, everyone 6 months and older should get the updated COVID-19 vaccine starting in September. People 65 and older should receive their second vaccine dose four months after their first update. However, many older adults have not received even a single updated dose.
Immunocompromised people should have received one or two doses of the updated vaccine since September and may receive additional vaccines two months after the last recommended dose.
“There is no sign that the epidemic is declining,” Chin-Hong said of the COVID-19 wave. “For those who are older or immunocompromised, it would still be a good idea to get vaccinated now. Because so far, I thought COVID-19 was going to level off and go down, but that doesn’t seem to be the case – probably because of the rest of the country.” The region has caught up with states like California.
The CDC estimates that only one state, Hawaii, is likely to experience a decline in COVID-19 outbreaks.
Los Angeles County’s COVID-19 indicators continue to rise across multiple metrics. Los Angeles County reported an average of 413 cases per day in the week ending July 21, up from 359 the week before. Officially reported cases are thought to be undercounts because they don’t take into account the fact that fewer people are being tested at home or overall, but the numbers are still helpful in understanding transmission trends.
In the 10 days ending July 13, coronavirus levels in Los Angeles County wastewater were 40% of last winter’s peak.
In the week ending July 21, 3.4% of emergency department visits in Los Angeles County were related to the coronavirus. This was up from 2.8% the previous week.
Hudson encourages people to repeatedly test for symptoms of COVID-19, even as late as the fifth day after illness onset. Someone who feels unwell may test negative on the first or second day of symptoms but may later test positive.
It’s important to know if you have COVID-19 “because if you think you don’t have COVID-19, you may go back to your normal activities — you may go to work — without wearing a mask. Unfortunately, this will continue A very easy way to spread COVID-19,” said Hudson.
The CDC urges people to stay home and away from others if they are sick. People can resume normal activities without the use of medications like Tylenol or Advil 24 hours after their symptoms improve and their fever is gone. But the CDC also recommends five extra days of taking extra precautions to avoid infecting others, such as wearing a mask and keeping your distance from others.
The Los Angeles County Department of Public Health recommends that symptomatic infected people get a negative test result before leaving isolation. The agency also recommends that infected people — regardless of whether they have symptoms — wear a mask when they are around others for 10 days after they start feeling sick, or if asymptomatic, when they first test positive. However, they can remove their masks sooner if they have two consecutive negative tests at least one day apart.
Los Angeles County also recommends that infected people avoid contact with high-risk groups for 10 days after developing symptoms or first testing positive.
If patients get sick again after recovering, they may experience a rebound of COVID-19 and need to quarantine.
For people who want to avoid getting COVID-19, wearing a mask in indoor public spaces can reduce the risk of infection. This strategy works especially well when traveling, such as on an airplane. Travel is “a very common way that we see people being exposed to the virus,” Hudson said.
Doctors say it’s still wise to take precautions to avoid contracting COVID-19, including avoiding contact with sick people. Each new infection carries the risk of long-term COVID-19 infection, in which someone develops lasting and sometimes severe symptoms that can last for months or years after being infected.
The risk of long-term COVID-19 infection has declined since the pandemic began, in part due to the advent of vaccines. But the risks of holding on to COVID-19 for the long term remain high.
“There are still people who have long COVID,” said Hudson. “And long COVID is something we all want to avoid.”
