California's COVID-19 surge is stronger and longer-lasting than expected, surprising experts

California's summer surge in coronavirus cases has proven particularly strong and durable, surprising experts with its tenacity as it enters its third month.

Dr. Elizabeth Hudson, regional director of infectious diseases for Kaiser Permanente Southern California, said the strength of this summer's COVID surge likely has a lot to do with ever-more-transmissible variants that continue to emerge as the coronavirus evolves. The number of relevant variants is alarming. Collectively, they are called FLiRT. — have emerged in recent months. In particular, KP.3.1.1 has been gaining momentum at an alarming pace and has become the most common strain across the country.

“KP.3.1.1 appears to be the most contagious,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco, “and people think this virus is going to continue to circulate not just in the U.S. but around the world.”

Levels of coronavirus in California's wastewater have surpassed each of the past two summer peaks, according to data estimates released Friday by the Centers for Disease Control and Prevention for the week ending July 27. Levels of coronavirus in wastewater have remained “high” or “very high” for eight consecutive weeks.

“This storm surge has been pretty strong and lasted a long time, a little longer than I would have thought it would be, and it's definitely a lot different than last summer,” Hudson said.

California is one of 43 states, along with the District of Columbia, with “high” or “very high” levels of coronavirus in wastewater.

While hospitalization numbers overall remain at just a fraction of previous levels, Summer COVID case surgeHospitalizations and emergency department visits are on the rise, and doctors' offices are seeing a surge in the number of infected patients.

“This is not a harmless wave.” I have written “We're in a big wave right now. We haven't hit a plateau yet,” Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, said in a blog post published Saturday.

Los Angeles County averaged 389 positive coronavirus hospitalizations per day in the week ending July 27, nearly double the number a month earlier. The latest figure is about two-thirds of last summer's peak and one-third of the peak in summer 2022.

“Outpatient visits are high, in fact, significantly up from last week,” Hudson said Friday.

The week ended on Saturday, CDC estimate KP.3.1.1 now accounts for 27.8% of coronavirus samples nationwide, a staggering increase from 7.2% a month ago.

Because the FLiRT variants are related, infection with one may provide some protection against the other variants, at least for a while.

However, moving away from contact with COVID-19 increases the risk of infection with the emergence of KP.3.1.1, which is more contagious, Chin-Hong said.

As the virus becomes more infectious than ever, the number of people who have never had COVID-19 – so-called “novids” – is declining.

“The percentage of novids is getting smaller and smaller,” Chin Hong said. “In the last few weeks, we've heard a lot of stories of people not getting the vaccine. [COVID illness] Now in its fifth year Since COVID emerged.

The new variant spreads more easily, but generally speaking there is no indication that it is more likely to hospitalize people.

But some people have expressed surprise at how severe the symptoms of the latest COVID-19 outbreak have been, describing excruciating throat pain that feels like they've swallowed razors or broken glass, and violent coughing fits that leave them short of breath.

Doctors say some people may feel especially sick this summer because it has been years since their last infection or vaccination.

“As many of the remaining protections weaken and we add in new variants that are able to overcome whatever remaining immunity people have, we are starting to see an increase in cases,” Hudson said.

Certain risk factors, such as age, underlying medical conditions and how long it has been since your last vaccination, can also affect the severity of COVID-19 symptoms.

The scale of this latest surge in cases is difficult to quantify because many people are testing at home or not testing at all, but the number of cases is clearly on the rise.

Los Angeles County reported an average of 452 new cases per day in the week ending July 28, up from 413 the previous week, and a peak of 571 cases last summer. The case count is an undercount because it only includes tests done in health care facilities.

In Los Angeles County, Coronavirus concentrations in wastewater In the 10 days leading up to July 20, it had risen to 44% of last winter's peak, more than double the level a month earlier.

Coronavirus levels in Los Angeles County sewage are 82% of last summer's peak in early September.

In Santa Clara County, the San Francisco Bay Area's most populous county, all of its sewer districts, including San Jose and Palo Alto, have high levels of coronavirus infection.

The resurgence in infections is happening because many people are not up to date on their vaccinations. Health officials say everyone over 6 months old should have received at least one dose of the vaccine since September, but few have. Thirty-seven percent of California residents over 65 have received at least one dose of the vaccine in that time frame, compared with 18.7% of those 50-64 and just 10.1% of the youngest adults.

On top of that, many people are abandoning COVID-19 safety precautions, staying indoors in muggy conditions or interacting with sick people, not wearing masks or washing their hands properly.

More people are visiting emergency departments with coronavirus-related illnesses. In the seven days ending July 28, 3.7% of all emergency department visits in Los Angeles County were coronavirus-related. That's up from 2.3% a month earlier. The metric peaked at 5.1% last summer.

Chin Hong said the number of COVID-19 hospitalizations at the University of California, San Francisco, rose gradually over the summer but has stabilized in recent weeks, a sign that COVID-19 patients are not becoming so sick that they need to stay in the hospital for long periods or be transferred to intensive care after being admitted, he said.

The CDC and other health experts have made several recommendations. strategy People who want to avoid contracting COVID and other respiratory viruses are encouraged to get up to date on vaccinations, stay away from sick people, wash or sanitize their hands frequently, gather outdoors, and do what they can to keep indoor air clean, such as opening windows to let in fresh air and filter indoor air.

According to the CDC, additional measures include asking people to wear masks and get tested before gathering at events. These measures are especially helpful at a time when COVID-19 is causing a lot of illness in the community.

Since most people no longer wear masks on a daily basis, Chin Hong said it's not a bad idea to have one on hand in case, say, the person next to you on a plane starts coughing.

The Los Angeles County Department of Public Health said in a statement that current data is not useful for predicting what will happen over the remainder of the summer.

The 2022 summer wave lasted for 16 weeks, during which time California had “high” or “very high” virus levels. Last summer's wave in California lasted for eight weeks.

But at some point, cases will peak. When that will be isn't immediately clear. In one positive sign, the CDC said Friday that California's COVID situation is stable or uncertain, an improvement from last week's estimate that COVID-19 was still spreading.

But simply entering the “stable or uncertain” state doesn't necessarily mean COVID will begin to trend downwards: Scientists will need several more weeks of data to determine whether the epidemic has peaked or is just hitting a temporary lull.

The CDC estimated that COVID-19 is likely decreasing in only two states: Hawaii and Nevada. Outside of California, Arizona, Connecticut, Florida, Idaho, Maine, and Pennsylvania were classified as having stable or uncertain COVID-19 trajectories. Thirty-four states and the District of Columbia were estimated to have COVID-19 increasing or likely increasing. Seven states had no estimates.

and Improved COVID Vaccine Vaccinations are likely to begin next month, but doctors have mixed advice on whether people should wait amid the latest surge in infections or get the shot now.

Hudson suggested they wait. “September is a month away,” she said.

Chin Hong suggested that older people and those with weakened immune systems, who are most at risk of severe illness, should consider getting the current formulation. If it's not up to date.

Chin-Hong said demand for existing COVID-19 vaccines has increased so much in Northern California that some people may have trouble getting them, but he said individual drug stores should still have them available.

People who have the current vaccine may not have to wait as long to get the updated version this fall. The U.S. Food and Drug Administration said last year approved People will be able to receive the updated 2023-24 vaccine within two months of their last dose.

Chin Hong said if the same timeline were to be applied to the 2024-25 vaccines, it would mean people could receive the current vaccine in August and the updated one in October.