If you have the sniffles or a cough, don’t assume you have a summer cold. Instead, take a COVID-19 test.
“If it’s not clear already by people to the left and right of you getting COVID, we are in a surge,” says UNC Health infectious diseases specialist David Wohl, MD. “We’ve had a mid-to-late-summer surge every year of the pandemic, but this one is steep and happened quickly. It’s definitely bigger than last summer. There is a lot of COVID out there right now.”
Summer surges are likely due to an increase in people traveling on vacation, and the extreme heat of summer also drives people inside, where they are in close quarters and more likely to spread a virus. Dr. Wohl says that the current “KP” variants also have evolved to be easier to transmit.
According to the Centers for Disease Control and Prevention, viral activity in wastewater at a national level is “high”; nearly half of states, including North Carolina, are at “very high” levels of COVID-19 in wastewater, with Dr. Wohl saying the surge showed up “almost overnight.”
While a summer surge is nothing new, Dr. Wohl says the severity of this particular one is concerning, and it may mean there won’t be as much of a lull between typical summer and winter spikes.
“I’m cautiously pessimistic,” he says. “I think we’ll see a lot of cases over the next few weeks and then a bigger surge in winter. This is still with us, so we’ll have to be resilient and deal the best we can.”
Dr. Wohl explains what you need to know about COVID-19 now.
1. For most people, symptoms are mild and not resulting in hospitalization.
While the current COVID-19 numbers are concerning, Dr. Wohl says there is some good news.
“The rate of severe disease is relatively low, due to built-up immunity,” he says. “And while the virus is more transmittable, there aren’t more or worse symptoms due to the newer variants. It’s the same old COVID-19 illness we are used to.”
Symptoms of COVID-19 include fever, chills, cough, difficulty breathing, fatigue, sore throat, congestion, headache, nausea or vomiting, and diarrhea.
Dr. Wohl says that the current variants of COVID-19 descended from the initial omicron variant; when omicron emerged, it was a major shift from the dominant delta variant and not recognized as well by our immune systems. Over time, immunity has built up through exposure to the virus and vaccination, lowering the risk of serious illness or hospitalization.
However, older adults and people with underlying medical conditions still remain at higher risk for becoming very sick from the virus as their immune systems may not respond as well.
If you have COVID-19, even if your case is mild, you should take steps to minimize the spread of disease to others. According to current CDC guidance, you can return to normal activities when your symptoms improve and you are fever-free for 24 hours without using fever-reducing medication.
For the next five days, you should take precautions such as wearing a mask, physical distancing and repeat testing.
“My rule of thumb is that you should feel better, have no fever and have a negative home test” to return to work or school or be around other people, Dr. Wohl says. “A negative home test means it’s very unlikely there is a sufficient level of virus in the nose to pass the infection to others.”
2. You should still take a COVID-19 test and consider Paxlovid.
Because people often test at home or not at all, testing no longer can be relied upon to indicate how many cases of COVID-19 there are on a community level—the wastewater data does that. But testing can still provide you with important information.
“You should test to know what you have so you can stay away from other people, but also so you can get a therapeutic like Paxlovid,” Dr. Wohl says.
Paxlovid remains the standard treatment for COVID-19; in addition to possibly reducing the duration of your symptoms, Dr. Wohl says there is good evidence that Paxlovid can reduce your risk of developing long COVID-19.
“We don’t need to treat COVID like a scarlet letter, compared to the flu or RSV, but it’s still a dangerous virus,” he says. “We don’t really see ‘long flu’ or ‘long RSV,’ but long COVID is real, so COVID still requires special consideration.”
Dr. Wohl recommends testing if you have any symptoms of COVID-19 and to stock up on tests for the rest of the year.
“Check the expiration dates on your tests, and look online to see if there’s been an extension on expiration for the brand,” Dr. Wohl says. “If the test is more than a year old, I’m doubtful of the accuracy of a negative result.”
There are now at-home kits that can test for both the flu and COVID-19. Dr. Wohl says these are great options that will help you get the right treatment for your symptoms during flu season.
3. Look for new vaccines in the fall and consider masking in the meantime.
Dr. Wohl expects new COVID-19 vaccines to be available in the first weeks of September.
“These vaccines will be tailored to the KP variants, the dominant variants now,” he says. “It will be current, so I’m excited for this vaccination.”
Dr. Wohl anticipates the recommendation will be for everyone to get this vaccine, with the expectation being that it will be an annual shot. If you’re at higher risk for negative outcomes from COVID-19, your doctor may recommend you get the vaccine every six months.
Hesitant about another shot because you had COVID-19 after vaccination?
“At some point, the vaccine’s ability to prevent acute infection wears off, but the protection against severe disease extends beyond that,” Dr. Wohl says. “It’s hard to quantify prevention, because we don’t know how many people who get the vaccine didn’t get sick, but if you don’t get COVID, you can’t get long COVID, which remains really scary.”
Dr. Wohl says that in the coming years, there may be better vaccines and medications for COVID-19, including nasal vaccines, which would provide an enhanced level of protection because they target the main points of transmission. In the meantime, he’s relying on an existing method of protection—a mask.
“With the numbers back up, I’m back to masking because I’m uneasy about being inside right now,” he says. “People are making individual decisions that reflect their tolerance for catching the virus, so masking is not going away. We have to go on with our lives and make those accommodations.”
Concerned about COVID-19 symptoms? Talk to your doctor. Need a doctor? Find one near you.