INDIANAPOLIS — COVID-19 cases and hospitalizations were already on a steady rise from some of the lowest levels since 2020 throughout the last weeks of summertime, an uptick now prompting health officials throughout major U.S. cities to monitor new variants circulating throughout the country.
Let's be clear: we are not in the midst of a desperate surge or hurtling back toward a point where our hospital systems are under strain. But researchers and health departments are keeping a close eye on multiple strains and readying themselves, lest one of the strains now under monitor causes problems.
We spoke with experts at Indiana University, gathered insight from national health organizations and have the latest numbers you need to know now about the slight rise in COVID-19 cases.
What variants should I know about?
The U.S. isn’t the only country experiencing a rise in COVID-19 cases, although data from the Center for Disease Control and Prevention showed they had increased 18.8% between Aug. 13 and Aug. 19. In the last 28 days, the World Health Organization reported more than 1.4 million new cases of COVID worldwide, with over 1,800 deaths.
There are a few different strands that now make up most of the cases throughout the U.S.
EG.5, sometimes called Eris, is currently the dominant strain nationwide and accounts for about 21.5% of cases for the last two weeks as of Sept. 2, according to the CDC.
A risk assessment for EG.5 released by WHO on Aug. 6 said while the variant may spread globally and contribute to a surge in case incidence, there is no evidence of an increase in disease severity directly associated with EG.5.
FL.1.5.1, or Fornax, is the second-largest strain and, according to the CDC, accounts for 14.5% of infections as of Sept. 2. It too is descended from the omicron variant, which spurred an influx of cases between late 2021 and early 2022.
At the beginning of August, Fornax was the fifth most dominant strain. By late August, it accounted for 13.3% of cases. EG.5 and FL.1.5.1 are both descended from omicron.
The CDC is also tracking the presence of the BA.2.86, a mutated omicron variant that's sometimes called Pirola, in the United States. according to the department’s latest update.
“Over the last few weeks, a new variant called BA.2.86 has been detected in a small number of samples from infected people and waste – sewer – water in several countries, including the United States,” the CDC reported in a statement.
There were 24 cases of the variant as of Aug. 30 worldwide. BA.2.86 initially prompted concern because cases popped up across four continents, in what used to a be a surefire sign that variants were poised to spread rapidly prior to vaccines. Cases were found in Denmark, Sweden, South Africa, Portugal, Canada and the United Kingdom.
In the U.S. wastewater samples from Ohio and New York contained traces of the BA.2.86 variant.
Officials so far believe it is too early to tell what impact BA.2.86 will have on public health.
CDC researchers do not believe current increases in cases and hospitalizations in the United States are being driven by BA.2.86, but rather FL.1.5.1 and EG.5.
In terms of genetic makeup, the Fornax and Eris variants are similar to the Omicron XBB variants, while the Pirola variant is more similar to Omicron BA.2 variant.
"There's just so much virus out there, it's not really about these massive surges or peaks anymore because of that variant soup," said Graham McKeen, who is the director of public and environmental health at IU. "It's more about this kind of constant and rising sea level of viral spread. And it's just kind of concerning. It's really just viruses doing what viruses do in getting more fit and adapting."
Still, the rise in recent hospitalizations is coming from one of the lowest rates since 2020 and are far from the surge of cases we’ve seen at different points throughout the pandemic. The highest rate of new hospital admissions in 2023 so far for the U.S. came during the week of Dec. 31, 2022, which saw 44,473 new hospitalizations.
Compare that to the most recent rate of new hospitalizations from COVID-19 in the U.S. the week of Aug. 27, which was 17,418.
How can I protect myself?
As temperatures cool and we head into fall, epidemiologists caution we could experience another so-called "tripledemic" from the blend of COVID-19, flu and RSV. Getting properly vaccinated against all three is necessary for mitigating your risk of getting one.
The first new COVID-19 vaccines and boosters for the fall season will be available in September. Moderna, Pfizer and Novavax said they will all have their vaccines ready for adults and children.
These new boosters vary from their predecessors in a few ways. They are the first round of vaccines that contain a single component to target a certain strain of COVID-19: the XBB.1.5 variant.
"This is a historical first. We have three vaccines available for the first time this fall to protect against three of the biggest respiratory illnesses," said Dr. Thomas Divinsky, who is a professor in the Department of Epidemiology at the Richard M. Fairbanks School of Public Health at IU, in a statement.
Divinsky expects all three of these viruses will be back this fall.
"All three represent a serious risk of hospitalization, be admitted to the ICU or even dying, especially among those with a compromised, immature or weakened immune system. Hospitalizations for COVID-19 are already starting to increase in the U.S.," Divinsky said.
Epidemiologist Marco Ajelli, an associate professor at IU, said he'd like to see a shift in terminology related to boosters, in that we should be thinking of them more as shots. Unlike boosters we get as kids, which cover us over the course of several years, flu shots, like the COVID-19 vaccines, should be a yearly occurrence.
"We should think of it more as a flu shot," Ajelli said.
Over the summer, the U.S. Food and Drug Administration approved two RSV vaccines for people over 60 and a preventative monoclonal antibody for infants and toddlers. Those should be available in the fall and will provide protection into the New Year.
What are the symptoms?
Eris EG.5: Cough, shortness of breath, fatigue
Pirola BA.2.86: Sore throat, cough, headaches, runny or blocked nose
Fornax: FL.1.5.1: Cough, chillness, shortness of breath
I want to test at home. Can I use old or expired COVID-19 tests?
The FDA states expiration dates for at-home COVID-19 diagnostic tests may have extended past the date displayed on outer packaging. You can check the expiration date column on the “List of Authorized At-Home OTC COVID-19 Diagnostic Tests” to see if the date for your test was extended.
Expired tests could reveal inaccurate or invalid results.
Epidemiologists caution the basics of what we all learned from the first days of the coronavirus pandemic should hold true amid brief surges for the sake of public health.
"Staying home when you're sick, getting tested, following quarantine isolation guidance. And, you know: wearing a mask," McKeen said.