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COVID-19 cases are surging again in Bexar County and nationwide as a new Omicron subvariant takes hold.
The EG.5 variant, also known as Eris, is likely a key driver behind a 270% increase in San Antonio COVID cases since early July.
Waning immunity is also leaving people vulnerable. It's been months or longer since many people have received a booster or been infected with the virus — at a time when health care experts have typically seen a surge in COVID infections, annually.
San Antonio's Metropolitan Health District said COVID numbers have steadily risen over the last few weeks, with a jump of more than 1,000 cases reported the week ending on Aug. 7.
The Centers for Disease Control and Prevention reported a 12.5% increase in COVID hospitalizations, nationally, in the last week of July.
Dr. Jason Bowling, a UT Health San Antonio professor of medicine and infectious diseases and an epidemiologist at University Health System, confirmed the surge but offered some context.
"Over the first three years of the pandemic, in the summer, we'd see a big bump in activity,” he said. “What we're seeing is this is the same time of year and there is a bump, but it's much less.”
Bowling said the nationwide spike in COVID-related hospital admissions at the end of July represented about 9,000 people. During the same week in 2022, about 45,000 patients were admitted with COVID. About one fifth of the number of patients were admitted this year, Bowling said.
He conceded, however, that it's difficult to know with any accuracy how much virus is currently circulating in the community. Since the national public health emergency ended in May, there are far fewer tools to keep track of cases.
“In the past, we would have all sorts of different data metrics, including test positivity, and we were testing people that were symptomatic and even people who are asymptomatic” he said. “A lot of that has gone away with the end of the public health emergency."
The CDC is now only counting COVID-related hospitalizations and COVID-related deaths, Bowling said. This leaves experts with a delayed and unclear picture of how much COVID is in the community because hospitalizations begin to rise after the virus has been infecting people for a period of time.
Bowling also pointed out that individuals who aren’t sick enough to go to the hospital are less likely to know they've been infected because fewer people are testing themselves.
“Now it's harder for people to get free tests, so even when people are sick, they're probably less inclined or motivated to test because they don't have as much access as they used to. So all of that means we have less information about how much COVID activity is really out there right now," he said.
Bowling said if a Bexar County resident falls into a high-risk category, they should dust off their mask supply, even if no one else with whom they interact is wearing a mask.
“There's good data that show that one-way masking — which means if you're wearing a mask but other people aren't — can still reduce your risk," Bowling said. "If it's a high quality mask, it can reduce your risk of getting infected, which is important for people that are at high risk.”
People who are not necessarily at high risk for hospitalization or death are still at risk for developing long COVID, a cluster of sometimes disabling symptoms that can impact a person for months or even years after infection.
“What we know about long COVID is there are a lot of people that have mild to moderate cases of COVID that end up with long COVID. So, you don't have to have severe COVID or be at high risk for severe COVID to end up with long COVID," Bowling said.
"So there are still risks for having any type of COVID infection,” Bowling added.
According to this week's Morbidity and Mortality Weekly Report from the CDC, 6% of all adults in the United States reported experiencing symptoms of long COVID in mid-June of this year. Among adults reporting previous COVID infections, long COVID prevalence increased to 11%.
“That's where I think it comes down to an individual decision, right? You do your risk analysis for what you think you're willing to tolerate, and you decide,” Bowling said.
Once that decision is made?
“I think the important part is for everybody to be accepting. If someone wants to wear a mask, we don't need to question that. We should be allowed to do that," Bowling said. "People need to do their own analysis, decide what they want to do, and then they should be allowed to do what they want to do without critique.”
Additional factors to consider in these cost-benefit analyses were provided in 2022 with an early surge in respiratory syncytial virus — RSV — that started in August, followed by a particularly rough flu season. Bowling said to keep these things in mind, particularly as kids go back to school.
"Yes, there was a big surge of RSV early [in 2022]. That took people a little bit by surprise," he said. "I think at this point, we need to realize that we need to monitor and you can kind of gauge and predict, but realize predictions are going to go awry."
An updated COVID booster that targets the Omicron XBB.1.5 variant should be available in October. Bowling said getting that vaccine, getting a flu shot, and — for those who are eligible — getting an RSV vaccine will increase everyone's chances of getting through this winter without a serious viral infection.
