Covid cases are rising again. Why hospitalizations may not be.

Covid-19 cases are rising again in the United States, but unlike previous waves, a substantial increase in hospitalizations and deaths is yet to follow.

The United States reported nearly 140,000 Covid-19 cases on Wednesday, marking the third day in a row that daily cases have topped 100,000, according to an NBC News tally.

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Nationwide, cases have increased by about 58% in the past two weeks as the omicron coronavirus subvariant BA.2 and an offshoot of this strain, called BA.2.12.1, continue to rise. propagate.

The last time confirmed cases topped 100,000 was in mid-February when the winter surge, fueled by the original omicron variant, BA.1, began to subside.

However, in the northeast, where the vast majority of cases are reported, the rate of hospitalizations and deaths is not as high as expected, a senior administration official told NBC News earlier this week. .

And with large numbers of underreported Covid infections due to the use of rapid home tests, the rate of severe cases looks even more promising, experts say.

Usually, when infections start to increase, “we see an increase in hospitalizations about 10 days later and an increase in deaths about 22 days later,” the official said.

In fact, hospitalizations are reaching nearly 20,000 a day, up 20% over the past two weeks, according to an NBC News analysis of health and human services data — but officials say that metric is getting worse. less and less of a reliable indicator.

In Massachusetts, for example, as Covid hospitalizations have increased, two-thirds of those hospitalized are so-called incident Covid cases, meaning they were hospitalized for other ailments but also tested positive for the virus, according to the state Department of Health. .

Meanwhile, deaths across the country have fallen to an average of 301 deaths per day, down about 17% in the past two weeks, according to an NBC News tally, and down from more than 2,600 per day during the omicron winter surge.

The lower rate of serious illness in the northeast may reflect the region’s high vaccination rate, prevalence of testing and the use of antiviral drugs, such as Paxlovid, which clinical trials have shown to reduce 89 the risk of hospitalization and death of a patient. percent, the official said.

Dr Isaac Bogoch, an infectious disease physician at the University of Toronto, said that as communities continue to build their immunity to the virus, people should expect new variants to have less d ‘impact.

The United States has acquired a high level of immunity to Covid through a combination of vaccinations, boosters and previous infections. Nearly 60% of people in the country had been infected by February, including about 75% of children and adolescents, the Centers for Disease Control and Prevention recently reported.

The wave of Covid could last until July

Bill Hanage, associate professor of epidemiology at Harvard’s TH Chan School of Public Health, said while the lower rate of serious illness is “comforting”, the high rate of infection is still something that cannot be ignored. .

Indeed, he said, people hospitalized with Covid but who do not have severe symptoms are still at risk of transmitting the virus to others, including patients at risk as well as hospital staff, who may be forced to miss work if they become infected.

“It’s something that is not trivial,” he said.

Bogoch, of the University of Toronto, agreed, adding that people cannot ignore the impact of long Covid, which can cause a series of health problems that can last for weeks or even months.

Hanage also said the low hospitalization rate seen in the northeast may not be replicated in other parts of the country, especially in places where testing is not as readily available, mitigation measures have disappeared and vaccination rates are not as high.

According to a model from the Institute for Health Metrics and Evaluation, which has predicted the trajectory of Covid throughout the pandemic, nationwide Covid cases could remain high through July, particularly in places where mask use and vaccinations are low. In parts of the country, hospitalizations and deaths could also increase, Hanage said.

“We saw very different epidemiological dynamics in the South, i.e. Florida, Texas, Sun Belt, etc.,” Hanage said. Whether other parts of the country will see an increase in hospitalizations and deaths “will depend on how many people are properly vaccinated,” he said.

Bogoch added that just because much of the north hasn’t seen a huge impact from the virus doesn’t mean there will be “no impact” in the United States.

And the virus will continue to affect some more than others — like the elderly, immunocompromised people and people with underlying health conditions that put them at risk for serious illness, Bogoch said.

Hanage said the best step people can take is to make sure they are up to date on their Covid vaccinations.

The government should also focus on getting resources to the most vulnerable who may not have access to preventative treatments, like Evusheld, and antivirals, like Paxlovid.

“If you’re poor and have health problems, you’re less likely to get Evusheld and you’re less likely to get Paxlovid and you’re less likely to get boosted,” he said.

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