Visual Representation for COVID-19 Virus | Credits: Getty Images

COVID-19 Surge Hits US States as New Subvariants Spread

United States: California might be bracing for a premature commencement of the summer COVID-19 wave, as viral loads in sewage systems are escalating in some regions alongside an uptick in the statewide positivity rate.

This trend coincides with the ascendance of the latest cluster of coronavirus subvariants, colloquially termed FLiRT, which has seen considerable proliferation nationally, according to reports by the Los Angeles Times. 

The FLiRT subvariants — designated KP.2, KP.3, and KP.1.1 — have surpassed the predominant winter strain, JN.1. Over the two-week interval concluding last Saturday, they accounted for an estimated 50.4% of nationwide coronavirus cases, a significant increase from 20% the previous month.

Contrary to the reduction in COVID-19 prevalence observed earlier this spring, state health authorities now estimate that the virus’s spread is either stabilizing or gradually rising.

“COVID-19 concentrations in wastewater have indicated increases in several Californian regions since early May. Test positivity for COVID-19 has been on a slow rise since May,” stated the state Department of Public Health to The Times on Friday.

During the seven-day period ending on Monday, approximately 3.8% of COVID-19 tests returned positive; in late April, the positivity rate was 1.9%. (Last summer’s peak positivity rate was 12.8%, recorded at the end of August.)

Healthcare providers in hospitals across Southern California and the San Francisco Bay Area are also noting a rise in coronavirus transmission.

“We’re definitely witnessing a minor increase. This is attributable to the so-called FLiRT variants,” commented Dr. Elizabeth Hudson, regional chief of infectious disease at Kaiser Permanente Southern California.

The uptick is predominantly observed in outpatient cases at Kaiser, as per the Los Angeles Times. 

“New variants inherently possess the capability to evade immunity from prior infections. If it’s been some time since an individual’s last vaccination, they will naturally have reduced protection compared to those recently vaccinated,” Hudson explained.

In San Francisco, infectious disease specialists are observing more patients hospitalized with COVID-induced pneumonia.

“I’ve encountered more severe cases in the hospital than anticipated,” noted Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco. Though the numbers remain small, “it’s certainly noticeable.”

After analyzing the wastewater data, Chin-Hong observed, “We see an increase, and it’s happening sooner than last year.” He remarked that last year’s rise began in late June, while this year, it’s occurring in late May, albeit from a lower baseline.

Additionally, anecdotal evidence suggests increased discussions about COVID in the Bay Area, with reports of cases in school classrooms surfacing.

“It’s not a significant number yet, but it’s the beginning of summer, which aligns with our expectations,” Chin-Hong said.

The Los Angeles County Department of Public Health has also reported a slight rise in cases recently.

From May 10 to 15, the latest data available, there were an average of 82 to 92 COVID-19 cases per day, up from earlier in the spring. Previously, between March 25 and May 9, there were 60 to 80 new cases daily. These figures primarily reflect tests conducted at medical facilities and exclude home tests and unreported infections.

“It’s too early to determine if this small increase will lead to a sustained uptick. The current case counts are low, making trend assessment challenging,” stated the LA County Department of Public Health, as mentioned by the LA Times. 

Representation for COVID-19 test sample | Credits: Shutterstock

COVID-19 levels in LA County wastewater remain relatively stable at 9% of last winter’s peak, though the data have a significant reporting lag, with the most recent being for the period ending May 11.

Statewide, viral loads in sewage are rising, particularly in Santa Clara County, home to Silicon Valley. Recently, coronavirus levels in Palo Alto’s sewershed reached the “high” threshold.

With summer travel beginning in earnest over Memorial Day weekend, doctors recommend staying up to date with vaccinations, especially for those at higher risk of severe complications from COVID-19.

In California, only 36% of seniors aged 65 and older have received the updated COVID-19 vaccine available since September. The CDC advises everyone aged six months and older to receive one dose of the updated vaccine, with a second dose recommended for those 65 and older if at least four months have passed since their last shot.

It is particularly crucial for older individuals to get at least one updated dose. Dr. Chin-Hong noted that all recently hospitalized patients with severe COVID had not received the updated vaccine since September and were either older or immunocompromised.

“We are still seeing hospitalizations, and CDC data from February showed that over 95% of those hospitalized had not received the updated 2023-2024 vaccine,” stated the LA County Department of Public Health. CDC data indicate that the updated vaccine offers a 54% increase in protection against COVID-19 illness compared to those unvaccinated.

Older individuals considering a second updated COVID-19 vaccine should weigh factors such as travel plans or jobs involving frequent interactions. There’s ample time to get vaccinated now and again in the fall with the new formulation.

“Getting your booster now provides protection through the anticipated summer wave,” Hudson advised.

Though many no longer see COVID as a hospital concern, “for some, it remains significant,” Chin-Hong emphasized. “Those hospitalized were extremely ill and required prolonged care,” the reports by the LA Times claimed. 

Nationally, since October, over 43,000 people have died from COVID, with more than 3,400 fatalities in California, according to the CDC. In comparison, flu has likely caused around 25,000 deaths nationwide over the same period.

Nancy Rose, who contracted COVID-19 in 2021 and suffers from long-haul symptoms like brain fog and memory issues, cooks for her mother, Amy Russell, at their home in Port Jefferson, N.Y., on January 25, 2022. Rose, 67, noted that many symptoms improved post-vaccination, though she still experiences fatigue and memory loss.

Hospitalized patients with COVID face a higher risk of death compared to those with the flu, particularly among older adults, according to the LA County Department of Public Health.

“In the hospital, various complications can arise, such as hospital-acquired infections. Hence, preventing hospitalization is crucial,” Chin-Hong explained.

California recently marked a significant COVID milestone with zero deaths on April 2, a feat not achieved since the pandemic’s onset. Los Angeles County also recorded a new low with an average of 0.14 deaths per day over the week ending April 2.

“It is a scientific triumph that we have reached a point with zero COVID deaths on some days,” Hudson said, attributing the success to vaccines, anti-COVID medications, and improved patient treatment techniques.

However, “COVID is more than a flu or cold,” Hudson noted. “It can have long-term effects for some individuals, making long COVID a distinct concern.”

Paxlovid, an antiviral drug from Pfizer, is used against COVID-19.

Evidence suggests that the more one contracts COVID, the higher the likelihood of developing long COVID, Hudson noted. Individuals in their 30s and 40s appear more prone to long COVID.

Some patients have been permanently disabled by COVID, but “most recover after 12 to 18 months,” Hudson said. “But that’s a long time to feel unwell.”

Despite discussions about lower prevalence now, each COVID infection carries the risk of developing long COVID.

Some patients experience breathing difficulties, while others develop postural orthostatic tachycardia syndrome (POTS), causing heart rate spikes and dizziness.

“Long COVID can disrupt the autonomic nervous system in ways we don’t fully understand,” Hudson explained. “But it significantly impacts lives,” according to the reports by the LA Times. 

Doctors recommend the following to prepare for a potential COVID surge:

• Avoid sick individuals who might misidentify COVID symptoms as a common cold.

• Test if symptomatic, with daily rapid COVID tests for three to five days following the onset of symptoms to confirm infection.

• Have a plan for obtaining Paxlovid if ill; this antiviral reduces severe COVID-19 risks.

• Masks, though less common, remain effective, especially in crowded settings with symptomatic individuals.

By adopting these precautions, individuals can better navigate the anticipated increase in COVID cases.

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