By Donald Gilpin

COVID-19 case numbers and hospitalizations are up, and the new subvariant EG.5 now accounts for the largest proportion of COVID-19 cases in the country, but the experts are not expecting the kind of surges that Princeton and the rest of the world have experienced in recent years.

“Living with COVID-19 means getting used to the highs and lows of its viral activity,” wrote Dr. Syra Madad, infectious disease epidemiologist in the New York City Hospital system and at Harvard’s Belfer Center for Science and International Affairs in an August 8 email. “While we are seeing an uptick in COVID activity detected in wastewater and people seeking care for COVID-19 at emergency rooms, numbers are still the lowest we’ve seen in the last three summers. It’s all about shifting baselines — meaning despite its relative perception of seeing a 10 percent increase in hospitalizations, which may seem like a lot, it’s still a small increase in numbers.”

In Mercer County, according to the Centers for Disease Control and Prevention (CDC), the last week of July saw seven new hospital admissions of confirmed COVID-19, a 75 percent increase, but still considered a “low” level of admissions. Nationwide the CDC reported a 12.5 percent increase in COVID-19 hospital admissions.

An article in the August 8 Washington Post noted that EG.5, unofficially nicknamed “Eris,” is a bit more infectious than other Omicron variants but not more virulent. The article also stated that the response to EG.5 is the same as for other variants, and its impact on those infected is similar.

Penn Medicine Princeton Health (PMPH) reported Monday that “the number of  COVID-related hospitalizations remains low” at PMPH, but went on to recommend vaccinations and testing.

“Adhering to vaccination recommendations and getting tested following symptoms or exposures remain important strategies to help prevent spread of the virus in our communities,” according to the PMPH statement. “If you have COVID-19 symptoms — such as fever, congestion, sore throat, or a cough — please get tested. We also recommend testing if a member of your household is COVID-positive or if you or a household member was exposed to someone with COVID-19, especially in an indoor setting.”

Princeton Deputy Administrator and Director of Health Jeff Grosser also pointed out that despite reports of an uptick, COVID-related hospitalizations, which have replaced case counts as primary indicators, remain near all-time lows. He also noted the “good news” that the Omicron subvariants “tend to behave similarly to one another.”

He went on, “Now that we are in more of a ‘holding pattern’ with COVID-19, and our public health response is similar to our response to some of our other communicable diseases like flu, it’s vital that disease surveillance continues to be our metric on public health preventative measures, and, of course, that public health resources continue to be supported so increased mobilization and response does not lag behind.”

Madad also urged vigilance, noting, “While there’s no set seasonality associated with COVID-19 yet (like when we have a flu season), it’s important to be cognizant of your local community transmission levels, especially if you are at high risk for severe illness associated with COVID-19 infection, and take extra precautions like wearing a high-quality mask and ensuring you’re up to date with your booster.”

Madad went on to express optimism about levels of immunity, with most Americans having immunizations or repeated infections or both, but she urged wariness as the fall season approaches.

“It’s hard to tell what the fall will bring,” she said. “Luckily, we are still dealing with the Omicron family of COVID-19 and all its offshoots, so there is already built-up immunity. However we should continue to stay vigilant about this upcoming viral respiratory season, including COVID and flu activity.”

She continued, “It’s important once the updated COVID monovalent booster doses are available later this fall, those eligible should get vaccinated. And make sure to get your flu shot by Halloween! Masks are a great tool to wear when transmission levels of any of these respiratory viruses are circulating.”

Grosser explained that Pfizer and Moderna are working to get FDA approval on new boosters, expected this fall, and that these boosters will adapt to newer strains of COVID-19 to provide additional protection. “Individuals should consult their primary care physician about whether they should wait for the updated booster to come this fall or receive the bivalent booster now,” he added.

At some point this fall, the federal COVID-19 vaccination program will end, but remaining doses that have been purchased by the federal government will remain free until they run out, and Medicare Advantage plans will continue to cover COVID-19 vaccinations in-network, Grosser said. 

“Medicaid will continue to cover COVID-19 vaccinations through September 30, 2024 and will generally cover ACIP-recommended vaccines for most beneficiaries thereafter,” he added.  “Once the federal vaccine program ends, anyone uninsured will need to pay out of pocket.”