The past two pandemic summers saw a spike in COVID-19 cases, hospitalizations and death, but this season may be different.
While health experts expect cases to rise, they don’t think there will be a wave as devastating as the previous two summers or the recent omicron surge.
Unlike the previous summers, most of the U.S. population now has some immunity against the coronavirus from vaccines, boosters and previous infections. People also have access to antivirals that can prevent hospitalizations in the unvaccinated.
Research however shows that immunity wanes and new variants could evade what protection remains.
“I know we all want to be done with COVID, but I don’t think it’s done with us,” said Dr. Jessica Justman, associate professor of medicine in epidemiology and senior technical director of ICAP at Columbia University’s Mailman School of Public Health.
What to expect this summer
Coronavirus trends in the spring give experts clues about what to expect this summer. Cases plummeted after the omicron surge in the winter, then plateaued and began to rise again in the spring.
A USA TODAY analysis of Johns Hopkins data shows the pace of cases doubled in April compared to the month prior to about 54,000 per day. But the average pace of deaths fell to 327 per day, about half of where it was at the end of March.
The month ended with 17,288 COVID-19 patients in the hospital, not far above March’s ending of 16,032.
While the unpredictable coronavirus makes it difficult to pinpoint what the summer will look like, experts have a few theories.
The worst case scenario is the emergence of a potent new variant that isn’t dulled by current vaccines and previous infections, causing a large wave of cases, hospitalizations and deaths.
“A full surge over the summer is going to be really dependent on a variant fully emerging. That tends to be the biggest trigger that will send us into a surge,” said Dr. Keri Althoff, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “Those transmissible variants are good at finding pockets of unvaccinated people and those people are more at risk of hospitalization and death.”
The best case scenario is a sustained level of low transmission and no new variants.
Julie Swann, a professor and public health researcher at North Carolina State University, expects the situation this summer to land in the middle: a small wave throughout the country with a slight uptick in hospitalizations and deaths.
Areas likely to be most affected by this swell are ones not heavily impacted by the omicron variant where people haven’t mounted recent immunity protection.
“I expect this next wave to be much smaller than the one we had in January,” she said. “In the U.S., there are communities that have had less exposure to this virus and so (they will) likely have a large impact from the virus in the next few weeks and months.”
What to expect long term: Is COVID-19 endemic, yet?
Barring a new devastating variant, most health experts agree the country may finally be out of the acute pandemic phase.
But it’s still far from an endemic phase, when COVID-19 is expected to become like the seasonal flu, bringing a week or two of misery but low risk of severe disease or death.
“We’re in the middle,” Justman said. “I hope that we are moving towards endemic but I can’t say that we’re endemic because I don’t feel like things are predictable, yet.”
For a virus to be considered endemic, Althoff said, scientists must determine an acceptable level of COVID-19 transmission. That hasn’t happened.
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“We don’t have an agreed upon baseline level of COVID that occurs in communities for years and decades and life-longs to come,” she said. “We have to figure out what that level is and agree (on it) as a reasonable level of disease.”
A virus also can be considered endemic when it follows a predictable pattern, Justman said.
For example, health officials can predict each year when the flu season will start and end, what strains may appear and how many cases may occur. But SARS-CoV-2 has no discernible seasonable pattern so far..
“We would all agree that we’re not in a place where we can predict how many cases there will be and what the locations of those case numbers will be,” Justman said. “We don’t know what’s coming.”
An endemic virus also doesn’t cause disruption to people’s lives, Althoff said, but that’s still not the case with COVID.
When a person tests positive, they have to isolate from other family members, quarantine, wear a mask and avoid travel. Sometimes a person is pulled out of school or works from home, and must notify close contacts.
“Is the virus still disrupting our lives? Absolutely it is,” Althoff said.
Although the virus hasn’t entered an endemic phase, health experts are hopeful the country is on its way. The first step is to prevent severe illness so that a surge in cases doesn’t lead to more hospitalizations and deaths, Justman said.
The best way to do this is for Americans to stay up to date with their vaccines and practice mitigation measures to keep vulnerable loved ones safe.
“I’m hopeful that we’re approaching the point where we can disconnect the surge in cases from a surge in hospitalizations,” she said. “That’s where we want to go.”
Contributing: Karen Weintraub and Mike Stucka, USA TODAY. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.