Concerns are circulating that the United States may be in the midst of a “fifth wave” of COVID-19 as the latest Omicron variant causes increases in cases from the relatively low levels of disease spread seen earlier this spring.
The 7-day average of COVID-19 cases has risen to more than 80,000. Two months ago, the average was less than 30,000 per day.
Hospitalizations have ticked up to 18,000, a 50 percent increase from the 12,000 reported a month ago but still well below the 130,000 level seen in mid-January.
The 7-day average for deaths related to COVID-19 remains at about 300, significantly less than the 2,700 reported in early February.
Summer, however, is quickly approaching with most regions of the country lifting mask mandates and other restrictions as people prepare their vacation plans for the upcoming warm months.
What can we expect in terms of COVID-19 this summer?
Healthline asked Dr. Monica Ghandi, a professor of medicine at the University of California San Francisco, and Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Tennessee, for their thoughts.
Healthline: What do you think will happen this summer in terms of COVID-19 cases, hospitalizations and deaths?
Gandhi: “The trajectory of the pandemic in the U.S. has often been weeks behind that in the U.K. and Europe, where variants seem to arrive first, so we can look to those areas to try to predict what will happen in the U.S. this summer. Cases have been rising in the U.S. due to the BA.2.12.1 subvariant, but deaths have continued to decrease.
“Cases rose in the U.K. considerably about 6 weeks ago, driven by BA2 and its subvariants (including BA.2.12.1), with declines reported over the past two weeks. Although COVID-19 hospitalizations rose in the U.K. during their BA.2 and subvariant surge, hospitalizations, ICU admissions, and deaths remained relatively low compared to previous surges in cases, thought to be a result of high population immunity in the region.
“With the U.S. about four weeks behind the U.K., our surge in cases will hopefully start coming down at the end of the month. With almost 60 percent of adults in the U.S. and 75 percent of children having been exposed to the virus according to a CDC seroprevalence study on April 26, 2022 [and] with 82 of our population over 5 having received at least one dose of the vaccine; and with a trajectory that is likely to follow the U.K.’s, I think that COVID-19 cases, hospitalizations, and deaths this summer will hopefully remain low.”
Schaffner: “The most recent variant of Omicron, BA2.12.1, is even more contagious than its parent, so it will continue to spread widely, soon becoming the dominant variant in the United States.
“Omicron and its variants have the capacity to infect even those who have an up-to-date vaccination status and those who previously were infected by one of the COVID viruses. This, along with the relaxation of social distancing and mask-wearing, contributes to the brisk transmission of the virus in our population. Fortunately, most of the resulting cases are mild, not requiring hospitalization.
“As a consequence of this contagiousness, cases will continue to occur throughout the summer. Most will be mild, but there could well be local increases in hospitalizations as this contagious virus finds those who are unvaccinated or partially vaccinated.”
Healthline: What will be the main factors in determining how if there will be a significant COVID-19 wave this summer?
Gandhi: “The most significant factor associated with COVID cases and hospitalizations in U.S. counties during the Delta surge was vaccination coverage. During the Omicron BA.1 surge over the winter, vaccination rates in a region also were strongly associated with COVID hospitalizations, although incidental COVID hospitalizations (swabbing positive on a test but being admitted for another non-COVID indication) comprised over 50 percent of the hospitalizations in highly vaccinated regions.
“Each COVID-19 wave triggers mucosal immunity in the population and transmission predictably slows so the main factor of whether cases will increase or not this summer will be if a new subvariant arises with greater transmissibility.
“Of note, the number of COVID-19 deaths worldwide (and in the U.S.) are at their lowest point since the recording of COVID-19 deaths started in March 2020, likely due to increased immunity globally from both vaccination and the Omicron BA.1 wave.
“The Institute of Health Metrics and Evaluation in Seattle predicts that cases in the U.S. will peak in early June and that deaths will continue to decline to their lowest levels yet globally and in the U.S. by July 2022.
Schaffner: “Thinking ahead, there is an even larger concern of what might happen this fall/winter when more activities occur indoors and as immunity from vaccination begins to wane, providing more opportunities for the highly contagious variants to spread even more readily and to produce disease.”
Healthline: Are you concerned about “COVID-19 fatigue” and how people seem to be less concerned about a surge in cases?
Schaffner: “I am very concerned about both ‘COVID fatigue’ and ‘vaccine fatigue.’
“Vaccines will continue to be fundamental to mitigating the personal, healthcare, and community impact of COVID as we transition into an endemic phase. Indeed, as is likely, another round of vaccination with an updated COVID vaccine will be recommended this fall (along with the usual annual recommendation for influenza vaccine). It will require a substantial effort to stimulate turnout at that time.
“Consider, as of this writing, only about half the eligible population has taken advantage of receiving the third vaccine dose. That dose is necessary to secure the protection against severe disease and is widely and easily available and is free.”
Gandhi: “I think that people are rightly responding to the lowest rates of COVID-19 deaths worldwide and in the U.S. since the start of the pandemic due to rising immunity in the population. The U.S. population has made a number of sacrifices over the past two years and has recognized that COVID-19 is not eradicable by its viral features.
“We have the tools to combat COVID-19, mainly vaccines and therapeutics, taking us from the pandemic to the endemic phase.
“Therefore, I don’t call this COVID-19 fatigue but a recognition that the U.S. has the tools to control COVID-19 in terms of severe disease with our vaccines, oral antivirals, pre-exposure prophylaxis with monoclonal antibodies (Evusheld) for severely immunocompromised populations, and surveillance.”
