A summer COVID surge is building across parts of the United States, as federal and state surveillance data show rising transmission and renewed viral activity during the warm-weather months.

The Centers for Disease Control and Prevention said in its Aug. 14 respiratory illness update that COVID-19 activity remained low in many regions but was increasing in the West and South. National laboratory data also show a steady rise in test positivity, adding to evidence that another seasonal wave is underway even as severe disease remains well below the levels recorded during earlier stages of the pandemic.

The Centers for Disease Control and Prevention said in its Aug. 14 respiratory illness update that COVID-19 activity remained low in many regions but was increasing in the West and South. National laboratory data also show a steady rise in test positivity: the share of tests positive for SARS-CoV-2 increased from about 1% in late June to 3.7% for the week ending Aug. 8.

Wastewater surveillance, which can detect rising transmission even when people do not seek testing or medical care, is also showing increased viral activity in parts of the country. CDC wastewater data are updated weekly and are increasingly important for tracking COVID-19 because widespread clinical testing and case reporting have declined from earlier stages of the pandemic.

The increase is particularly visible in California, where state and regional data indicate that COVID-19 transmission has climbed sharply during the summer. In parts of the Bay Area, wastewater concentrations rose substantially from June into July, while California health officials have reported increasing test positivity and hospital admissions, although hospitalizations remain comparatively low.

The pattern has prompted public health experts to increasingly describe summer as a recurring COVID season rather than an unusual exception. Unlike influenza and respiratory syncytial virus, or RSV, which generally produce their largest waves during colder months, SARS-CoV-2 has repeatedly generated significant transmission during warm weather.

Experts say several factors can contribute to summer spread, including travel, indoor gatherings during periods of extreme heat, waning immunity from prior vaccination or infection and the continual evolution of new variants.

The CDC’s latest national summary nevertheless offers an important qualification: overall acute respiratory illness requiring medical care remains very low. Emergency department visits associated with COVID-19 have risen from earlier summer levels but remain far below the peaks seen during the pandemic’s most severe waves.

That distinction matters. A summer surge in infections does not necessarily mean the country is returning to the levels of severe disease seen in 2020 or 2021. Population immunity from vaccination and previous infection has changed the impact of the virus, while antiviral treatments can reduce the risk of hospitalization and death among people who are at higher risk.

Rising transmission still poses risks for vulnerable communities

The consequences of another COVID wave are not distributed evenly. Older adults, people with weakened immune systems and those with certain underlying medical conditions remain at greater risk for severe disease. CDC guidance identifies age 65 and older as the strongest demographic risk factor for severe COVID-19, with risk increasing with age.

For people at higher risk who develop mild or moderate COVID-19, the CDC recommends that clinicians consider antiviral treatment quickly. Treatments must generally begin within five to seven days after symptoms start, making timely testing, diagnosis and access to medical care especially important.

That narrow treatment window also has health-equity implications. Earlier CDC research documented racial and ethnic disparities in access to outpatient COVID treatments, including substantially lower use of Paxlovid among Black and Hispanic patients compared with White and non-Hispanic patients during portions of 2022. Researchers pointed to factors including unequal access to treatment facilities, transportation, insurance, health care relationships and timely testing.

Although those studies reflect earlier phases of the pandemic, they underscore why equitable access to testing, vaccination and treatment remains important as COVID settles into a longer-term pattern of recurring waves.

Vaccination coverage also remains a concern. The CDC said in its Aug. 14 update that national vaccination coverage for COVID-19, influenza and RSV remained low among both adults and children. The agency continues to describe vaccination as an important tool for reducing serious illness, hospitalization and death from COVID-19.

Meanwhile, scientists continue to monitor the virus for changes that could alter transmission or severity. The World Health Organization has been tracking emerging Omicron descendants, including PQ.16.1.1, which it designated as a variant under monitoring. WHO’s July risk assessment found no evidence that the lineage causes more severe disease than other circulating variants and assessed its additional global public health risk as low.

For individuals, the renewed summer activity means COVID-19 remains worth considering when respiratory symptoms develop. Testing can be especially important for people at higher risk because treatment works best when started early. People who are sick can also reduce the likelihood of spreading infection by staying home when possible, improving ventilation and considering a well-fitting mask around others.

Five years after the emergency phase of the pandemic, COVID-19 is no longer producing the same nationwide disruption it once did. But the latest rise in transmission is another reminder that the virus has not disappeared. As summer waves become a recurring feature of the country’s respiratory disease landscape, surveillance, timely treatment and equitable access to prevention will remain central to limiting severe illness in the communities most at risk.

For readers looking to follow COVID-19 developments beyond national surveillance reports, FYH.News also directs audiences to Auntie Rona Watch, a National Minority Quality Forum resource focused on COVID-19 information, community awareness and the continuing impact of the virus. Resources that make public health information accessible can be particularly important as testing and reporting become less visible while periodic waves of infection continue.

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