COVID-19 indicators are creeping back up this summer.

In Utah, the amount of virus detected in wastewater for the week ending Thursday is increasing at nearly 29% of the sewage treatment plants monitored statewide compared to 20% last week.

The seven-day average case count — which does not include the results of home testing — jumped more than 20% in the past seven days, to just over 57 cases, after going up more than 15% in the previous week.

Other indicators are dropping a bit after big leaps over the previous week. A COVID-19 diagnosis now accounts for 0.63% of Utah’s emergency room visits, down from a nearly 32% increase to 0.71% for the week ending July 27.

The seven-day average of people hospitalized with COVID-19 in Utah dipped to 26.3, after climbing nearly 23% last week. There were two COVID-19 deaths in Utah over the past week, a Grand County woman over 85 and a Salt Lake County man, 65-84 years old.

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Nationwide, the Centers for Disease Control and Prevention reported some indicators have been increasing since early July, after some six months of steady declines. By late July, the federal agency saw more than a 12% weekly increase in hospitalizations.

“We’ve seen the early indicators go up for the past several weeks, and just this week for the first time in a long time we’ve seen hospitalizations tick up as well,” Dr. Brendan Jackson, the CDC’s COVID-19 incident manager, told NPR last week.

“This could be the start of a late summer wave,” Jackson warned.

What Utah public health experts are seeing

“It’s just a little blip so far,” Dr. Leisha Nolen, state epidemiologist with the Utah Department of Health and Human Services, told the Deseret News.

“Here in Utah, we’re just starting to see a small increase in our number of cases and a few more people going into the emergency room, more places having more COVID in the wastewater. But it’s just the beginning, small bits,” she said.

Han Kim, a professor of public health at Westminster University in Salt Lake City, agreed there’s not much more COVID-19 to worry about, at least not yet.

“Yes, we are seeing increases, but from a fairly low number,” Kim said.

Other parts of the country, especially the West and East coasts, are seeing more of an increase, Nolen said, adding that doesn’t necessarily mean Utah will catch up to those numbers.

“It’s not always predictive, that what happens in one place is going to hit us,” she said. “But certainly it does make us take notice.”

Even so, Nolen said the state is not stepping up any COVID-19 measures at this point.

“This is going to be something that we probably are all going to see the rest of our lives, where we’re going to have COVID come thorough, increase, decrease. There’s going to be bad years. There’s going to be good years,” she said, comparing it to the flu.

Why this is different from past surges

“One thing that’s different is that we’re not seeing a different variant,” Nolen said. “When we’ve seen surges before, it’s been because there’s a new variant coming through. But right now there doesn’t seem to be many new variants.”

That new versions of the virus haven’t emerged recently, she said, “is reassuring.”

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Kim noted the slight hike in COVID-19 is “nothing like the previous summers, where we had fairly sizable surges.” Two summers ago, the much more contagious and virulent delta variant of the virus hit Utah hard, just as many people thought the worst may be over.

By January 2022, it was the highly transmissible omicron variant that was driving up Utah’s case count to record-breaking levels and straining health care resources. Mass COVID-19 testing sites were so overwhelmed, sick Utahns were told to just stay home.

This time around, Kim, too, said there’s no new version of COVID-19 driving up cases.

“We’re not seeing some crazy variant from left field, so that’s good news,” the professor said, adding “for most people it will be just maybe a mild cold. In fact, a lot of people who did have mild colds may have had COVID, quite honestly.”

Still, he said, there’s the risk of developing what’s known as long COVID-19, a little-understood series of symptoms occurring post infection that can include a wide range of symptoms, such as extreme fatigue and brain fog as well as heart and lung issues.

Plus, COVID-19 remains deadly, Kim said, especially among the elderly. Nationwide, nearly 1.14 million people have died from the virus. In Utah, the COVID-19 death toll has reached 5,406 with the two lives lost over the past week.

“We need to stay vigilant,” he said. “We don’t want to get surprised by a new variant or a sudden spike. We still need to remember this is a serious disease that has killed and caused so much suffering. ... We have to balance that.”

What every Utahn should be doing

The single most important advice about COVID-19 right now? Stay home and away from others when you’re sick, the state epidemiologist said, even if it’s just the sniffles and a home test for the coronavirus comes up negative.

“No matter what, I don’t care if it’s COVID or anything (else), if you’re sick, please don’t go out. We don’t want to spread any kind of infections,” she said. “I think we should all go back to that pattern and stay in that pattern forever.”

Kim agreed that should be the routine for every airborne disease.

“That should just be common sense,” he said. “If you are sick, stay at home.”

For anyone “feeling a little nervous,” wearing a mask when traveling or attending large, indoor gatherings is “not a bad idea. Overall, I think these are things that we should be kind of normalizing regardless of whether there’s a surge or not,” he said.

But for most Utahns, Kim doesn’t think that’s necessary yet, adding whether or not to take additional precautions comes down to a personal assessment of risks for severe illness, such as age or health concerns.

Nolen said she sees no need yet for most Utahns to mask or avoid crowds.

“I wouldn’t be that concerned about it right now. Certainly, people who are very immunosuppressed, I think they should talk to their doctors about it,” she said. “They probably already have a plan and maybe this is the time they ramp up that plan.”

For most Utahns, though, “it’s reasonable at this time to recognize it still is quite low numbers and therefore not a very large threat,” Nolen said.

Masking is “a personal choice,” she said. “Masks can help with all sorts of different infections. I don’t think this is the time I’m going to encourage the general population to wear a mask. I’m certainly not wearing a mask.”

Her advice on masking may change this winter, should there be a significant surge in COVID-19, Nolen said. “That’s when I would be strongly encouraging it. But at this time, I think it’s very reasonable not to, unless you are concerned.”

Paxlovid, a COVID-19 treatment that must start soon after an infection is an option some people may want to consider, she said. “If you’re older, it certainly can make a huge difference.”

Those 65 and older are most at risk for severe COVID-19 and may want to be prepared with home tests to confirm the virus, Nolen said, adding they should talk with their doctors about the antiviral treatment.

“Right now, I’m not overly concerned. I do think we’ll just have to see how the year goes,” she said. “We know that we have different ways to protect ourselves and (will) keep those in mind in case things do get more extreme.”

What’s happening with the COVID-19 vaccine?

Nolen said the “real respiratory season” is coming this fall, along with updated vaccines for COVID-19 and influenza as well as a new adult shot to protect against RSV or respiratory syncytial virus.

There are no specifics on when the latest COVID-19 shot will be available, she said. It’s a monovalent shot targeted solely at a version of the coronavirus that’s dominated cases most of the year and intended to be an annual dose for most Americans.

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Don’t expect mass vaccination sites to return, however. The updated COVID-19 shots will be available at doctor’s offices, pharmacies and public health clinics, likely at the same time as this year’s flu shot.

But the state plans to roll out a separate promotional campaign for COVID-19 shots.

“We don’t want to get people tied up and make conflict between all the different vaccines. We know some people are very concerned about the COVID vaccines.” Nolen said, acknowledging they’ve been politicized.

Nationwide, only 17% of the population has gotten the first updated COVID-19 booster dose since it was first offered last fall, according to the CDC. An additional shot was made available to older and medically vulnerable Americans this spring.

In Utah, the state reports that number is even lower, just 15.7%.

Kim said when the new COVID-19 vaccine comes out, he’s “going to be one of the first in line to get that, just to prepare myself for next winter.” He said it’s no different than getting a once-a-year flu shot, “just to minimize your risks.”

Will there be a surge this winter?

“Don’t we all wish we knew,” Nolen said. “I definitely expect we will have more cases in the winter, just because of the way we transmit viruses and how we respond to viruses in the winter. So I expect there will be an increase as the weather gets colder.”

She’ll be watching to see if hospitalizations climb for the virus. Along with monitoring wastewater for the presence of COVID-19, that’s been the most accurate way to track the spread of the virus since the state ended mass testing early last year.

The current upward trend probably does not mark the start of a potential winter surge, Nolen said, suggesting it could be related to people spending more time together indoors to avoid this summer’s extreme heat.

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Kim added travel to the list of potential causes. Everything from passport offices to airports to popular destinations are getting “hammered,” he said, thanks to a huge jump this summer in what’s been dubbed “revenge travel.”

And waning immunity from previous infections as well as vaccinations might also be sending case counts up, Nolen said, since it’s likely “a lot of people now are far enough out from when they got their last infection that they’re susceptible again.”

Or COVID-19 could just be acting like other infectious diseases where “we go through these little waves. Heck, do we monitor anything else quite as well as this? No. So it might not be all that different,” Nolen said.

“Maybe it is some sort of behavior changes, where we are now all back to our normal lives,” she said, “so people aren’t being as good about staying home from work when they’re sick and that’s causing more and more transmissions.”

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