Interpreting the COVID-19 Summer Surge

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The Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases (NFID) both weigh in on the evolving summer COVID-19 season, and strategies for prevention.

CDC logo; Image credit: CDC

CDC and NFID offer some insights on dealing with the summer increase of COVID-19 cases and strategies to prevent transmission.

Image credit: CDC

The CDC is reporting there has been an increase of 18% in emergency department (ED) visits related to COVID-19 infection in the agency’s most recent week of reporting through June 29, 2024. Along with ED visits, there has been a subsequent increase of 13% in hospitalizations in the most recent week of reporting (June 9 to June 15).1

Interestingly, geography has played a role in these trends, as the western United States has seen the largest increases. Test positivity rates were highest among the Department of Health and Human Services (HHS) region 9, which consists of Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau (rates of 15% to 19.9%); and region 10, which consists of Alaska, Idaho, Oregon, and Washington (rates of 10.0% to 14.9%).

“In June 2024, we saw increases in COVID-19 test positivity and a slight increase in emergency department visits, suggesting increases in COVID-19 activity across several western states, and increases in rates of COVID-19–associated hospitalizations in May and June 2024 among adults 65 [years and older] at some sites,” a CDC spokesperson told Contagion.

If there has been a silver lining to this news, it is in the mortality data, as rates of death are down 25% in the most recent week’s reporting.1

Why the Summer Surge?

Summertime is a season to see family and friends and spend time in close proximity to each other. Although people may associate this time of year with being outdoors, there is often also a “summer hibernation” element to the season where people want to stay indoors, near the air conditioning. However, this can lend itself to breathing in air that has people in close quarters, and, depending on the indoor air quality and the size of the location, it makes people vulnerable to respiratory viruses.

"There are many contributing causes including the traditional large group activities and air travel in a situation where very few are implementing precautions to prevent infection," Robert H. Hopkins, Jr, MD, medical director of the NFID, told Contagion. “In addition, unfortunately, far too few people are up to date on COVID-19 vaccination.”

“COVID-19 activity tends to fluctuate with the seasons, meaning it has some seasonal patterns. Data from four years of COVID-19 cases, hospitalizations, and deaths show that COVID-19 has winter peaks (most recently in late December 2023 and early January 2024), but also summer peaks (most recently in July and August of 2023). There is no distinct COVID-19 season like there is for influenza and respiratory syncytial virus (RSV),” the CDC spokesperson said.

Circulating Variants

According to the CDC’s COVID-19 tracker, which tracks data such as the types of variants and incidence rates in the United States, the most dominant strain of SARS-CoV-2 is the KP3 variant, accounting for 36.9% of cases in the US. The second biggest strain is the KP2 variant, which accounts for 24.4% of cases. These numbers reflect the 2-week period ending on July 6, 2024.1 These 2 strains account for approximately 60% of all cases in the country and are a part of the Flirt strains a newer family of variants, named after their mutations.

These newer “FLiRT” variants have been so named based on the technical names for their mutations, one of which includes the letters “F” and “L,” and another of which includes the letters “R” and “T.”2

What You Need to Know

There has been an increase in COVID-19 test positivity and emergency department visits, indicating higher COVID-19 activity across several western states.

COVID-19 activity fluctuates with the seasons, showing peaks in winter and summer. The most recent summer peak was in July and August 2023.

The most dominant strain is the KP3 variant (36.9% of cases), followed by the KP2 variant (24.4% of cases). These belong to the "FLiRT" family of variants.

How Data is Collected

According to CDC, it is important to note that as of May 1, 2024, hospitals were no longer required to report COVID-19 hospital admissions, hospital capacity, or hospital occupancy data to Health and Human Services, through CDC’s National Healthcare Safety Network (NHSN). Thus the data going forward could be limited, especially as medical institutions are not obligated to report data.2

However, the CDC says it still encourages ongoing, voluntary reporting of hospitalization data.2

With this in mind, statistics on incidence rates, hospitalizations and deaths may not be complete.

Are the COVID-19 Vaccines Still Efficacious?

Within the last couple of weeks, the CDC’s Advisory Committee on Immunization Practices (ACIP) met to discuss updating this fall’s vaccine.

As the pharmaceutical companies are updating their vaccines, are the current crop of immunizations still offering protection? Hopkins makes an important distinction between those who should consider a vaccine now and those who may consider waiting until the fall and the launch of the newer COVID-19 vaccines.

“Currently available COVID-19 vaccines do help protect against severe disease from the latest variants. Updated COVID-19 vaccines will be available by early fall,” Hopkins said. “It’s important that those who are at increased risk and have not yet received an updated vaccine (including adults age 65 and older and people who are immune compromised) get vaccinated now. In the fall, when updated COVID-19 vaccines are available, everyone ages 6 months and older should plan to get vaccinated.”

Additional Prevention Measures


Along with getting up to date with vaccination, NFID’s Hopkins recommends several other strategies to prevent transmission. To help prevent the spread of disease, here are some other measures he recommends:

  • Wash your hands with soap and water for at least 20 seconds
  • Avoid touching your eyes, nose, and mouth
  • Clean and disinfect objects and surfaces
  • Avoid close contact with people who are sick and stay home if you are sick
  • Consider wearing a high-quality face mask, particularly if you are at high risk for severe disease
  • Take steps for cleaner air, such as opening windows or going outdoors


With these aforementioned prevention measures and up-to-date vaccination, most people can avoid the surge of COVID-19, and continue to enjoy their summer uninterrupted.


References
1. COVID Data Tracker.CDC. Accessed July 12, 2024.
https://covid.cdc.gov/covid-data-tracker/#variant-proportions
2. Parkinson J. A Member of Newer Family of ‘FLiRT’ COVID-19 Variants is Dominant Strain In United States. Contagion. May 6, 2024. Accessed July 12, 2024.
https://www.contagionlive.com/view/a-member-of-newer-family-of-flirt-covid-19-variants-is-dominant-strain-in-united-states
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