California could be headed for an earlier-than-normal start to the summer COVID-19 season, with concentrations of coronavirus in wastewater increasing in some areas as well as the rate of positive tests statewide .
The trend comes as the latest family of coronavirus subvariants, collectively dubbed FLiRT, have made significant gains nationwide.
The FLiRT subvariants – officially known as KP.2, KP.3 and KP.1.1 – have overtaken the dominant winter strain, JN.1. For the two-week period that ended Saturday, they are estimated to account for a total of 50.4% of the country’s coronavirus infections, up from 20% a month earlier.
Instead of California experiencing a reduction in COVID-19 circulation, as happened earlier this spring, state health officials said they believe the spread is now either stable, or slowly increasing.
“Concentrations of COVID-19 in wastewater suggest an increase in several areas of California since early May. Test positivity for COVID-19 has been slowly increasing since May,” the state Department of Public Health said in a statement to The Times on Friday.
During the seven-day period that ended Monday, about 3.8% of COVID-19 tests came back positive; at the end of April, this share was 1.9%. (Last summer’s peak positive test rate was 12.8%, as of late August.)
Doctors at hospitals in Southern California and the San Francisco Bay Area are also seeing an uptick in the spread of the coronavirus.
“We’re definitely seeing an uptick. And this is all due to the so-called FLiRT variants,” said Dr. Elizabeth Hudson, regional chief of infectious diseases at Kaiser Permanente Southern California.
So far, the increase has been seen mainly in outpatient cases at the Kaiser.
“Every time there is a new variant, then, unfortunately, the new variants will have the ability to (overcome immunity resulting from previous infection), and if it has been a while since a person has hasn’t been vaccinated, she’s obviously not going to have the same level of protection as someone who was vaccinated more recently,” Hudson said.
In San Francisco, infectious disease doctors are noticing more people hospitalized with pneumonia caused by COVID.
“I saw more than I expected, sick people in the hospital” for COVID, said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco. The number was only a handful, “but it’s definitely noticeable.”
Based on his reading of wastewater data, “we know it’s up, and it’s up earlier,” Chin-Hong said of coronavirus activity.
“Last year I think it was the end of June when it started to increase, and this year it’s like now it’s the end of May. So it’s a little bit earlier, but we’re starting from a very low point,” Chin-Hong said.
And anecdotally, people in the Bay Area are talking more about COVID, it seems, Chin-Hong said. He remembers hearing about the class of someone’s child dealing with a case of COVID a few days ago.
“It’s not necessarily an alarming number now, but it’s … early summer, so that’s what we expect,” Chin-Hong said.
The Los Angeles County Department of Public Health has also started to see a very slight increase in cases in recent days.
From May 10 to 15, the most recent data available, there were an average of 82 to 92 COVID-19 cases per day, an increase from early spring. There were an average of 60 to 80 new cases per day between March 25 and May 9, Los Angeles County health officials said in a statement to the Times. Case counts generally reflect testing done at medical facilities and do not include at-home testing — nor do they account for infections among people who do not get tested.
“It is too early to say whether this very slight increase in recent days will turn into a lasting increase. This number of cases is low, making it difficult to assess true trends at this time,” the Los Angeles County Department of Public Health said.
Coronavirus levels in Los Angeles County wastewater remain relatively stable, at 9% of last winter’s peak. But the data in these results has a significant lag, with the most recent data available covering the 10-day period ending May 11.
Elsewhere in the state, virus levels in wastewater are rising, including in Santa Clara County, Northern California’s most populous and home to Silicon Valley. In recent weeks, coronavirus levels have reached the “high” threshold in the Palo Alto sewer basin.
With the summer travel season set to begin in earnest this Memorial Day weekend, doctors urged people to consider getting up to date on their vaccinations — especially if they are at higher risk of serious complications from COVID -19.
In California, only 36% of people ages 65 and older have received the updated COVID-19 vaccine, first available in September. The U.S. Centers for Disease Control and Prevention has urged everyone 6 months and older to receive a dose of the updated vaccine. A second dose is also recommended for people aged 65 and over, provided at least four months have passed since their last injection.
It is especially important that older people receive at least one updated dose. Of the patients he saw recently who had severe COVID, Chin-Hong said, all had not received an updated vaccine since September and were older or immunocompromised.
“We are still seeing people hospitalized, and based on CDC data presented in February, more than 95% of people hospitalized had not received the updated vaccine for 2023-2024,” the public health department said of Los Angeles County. CDC data showed that getting the updated vaccine provided 54% increased protection against COVID-19 disease compared to those who did not receive the vaccine.
For seniors now considering an updated second COVID-19 vaccination, factors to consider include travel plans or whether they have a job in which they interact with many people, say doctors. We have plenty of time to get this vaccine now, as well as get the new formulation expected in the fall.
“By getting your booster now, you’re really going to protect yourself to get through this likely summer surge,” Hudson said.
Although for many people, COVID no longer means a hospital visit, “for some people it’s a big deal,” Chin-Hong said. “And these are the people I saw in the hospital – they were very, very sick and they were there for a while.”
Nationally, since the beginning of October, more than 43,000 people have died from COVID, according to the CDC, including more than 3,400 in California. In contrast, the flu probably caused fewer deaths nationally – about 25,000 over the same period.
The risk of death among people hospitalized is higher for people with COVID than for those with the flu, especially among older adults, according to the Los Angeles County Department of Public Health.
“When you’re in the hospital, a lot of other things can happen. … You can get nosocomial infections. So you always want to avoid hospitalization,” Chin-Hong said.
California recently reached a COVID milestone: zero deaths on a single calendar day, April 2, a feat not achieved since the early days of the pandemic. Los Angeles County also saw a new record for deaths – an average of 0.14 deaths per day over a weekly period, recorded for the seven-day period ending April 2.
“It’s really a triumph of science that we’ve gotten to a point where we’re getting to a day where there will be no deaths from COVID,” Hudson said, giving credit to factors such as development vaccines and anti-Covid drugs, as well as the improvement of anti-Covid drugs. techniques used to treat patients.
Still, “COVID is not just a flu or a cold,” Hudson said. “COVID can potentially have very long-term impacts on some people. …Long COVID really makes things different.”
There is growing evidence that the more you get COVID, the more likely it is that long COVID will develop, Hudson said. And “it appears that people in their 30s and 40s are the ones most likely to get long COVID.”
Some patients have been permanently disabled by long COVID, but, Hudson said, “for most people it seems — maybe after 12 months, sometimes 18 months — that all the symptoms go away.” But it’s been a long time not feeling good.
There has been much discussion that long-term COVID prevalence is lower than at the start of the pandemic. But even now, whenever a person contracts COVID, there is always a chance that long COVID will develop.
Some patients “have breathing problems,” Hudson said. Others may develop something called POTS, which stands for Postural Orthostatic Tachycardia Syndrome, and can cause sudden spikes in heart rate and dizziness.
“Long COVID can affect the autonomic nervous system in ways that we don’t 100% understand yet,” Hudson said. “But we know that people end up suffering from this particular syndrome and it can be life-changing.”
In addition to staying up to date on vaccinations, doctors offered the following tips to prepare for an expected increase in COVID circulation:
• Avoid sick people. Some sick people may pass off their symptoms as a “cold” when it could be the start of a COVID-19 illness.
• Test if you are sick and take a test daily. It may take longer after the onset of illness for a rapid COVID-19 test to come back positive. Consider taking a rapid COVID test once a day for three to five consecutive days after cough and cold symptoms appear, Hudson said. This can help the sick person take steps to self-isolate later and limit the spread of the illness to others.
• Plan to ask for Paxlovid if you become ill. Paxlovid is an antiviral medicine that, when taken by people at risk of severe COVID-19 with mild to moderate illness, reduces the risk of hospitalization and death.
• Masks are much less common these days, but can still be a handy tool to prevent infections. Wearing a mask on a crowded flight where people are coughing in close proximity can help reduce the risk of infection.