Is a Fall/Winter COVID-19 surge coming to the U.S.?

Our administration has warned that 100 million COVID-19 infections could occur in the U.S. in the fall and winter, despite many Americans believing the pandemic to be over.

A “likely” fall/winter Coronavirus surge in the United States was predicted by leading infectious disease expert Anthony Fauci as early as April.

About a month later, the Biden administration put a number to the prediction: 100 million Americans – about one-third of the population – could contract COVID-19 during the fall and winter months. A new variant could result in significantly more cases if the median estimate is wrong.

Now, in September, Coronavirus cases are actually decreasing after plateauing during the summer months at over 100,000 new cases each day, which was likely a massive underestimate as many relied on at-home tests that aren’t reported to health departments.

But the decline might not last long.

The combination of waning COVID-19 immunity and colder weather on the horizon that will see more people heading indoors could send infections right back up, with the current trend reversing as soon as next month.

“We are expecting a rise,” says Ali Mokdad, an epidemiologist with the Institute for Health Metrics and Evaluation at the University of Washington. “The rise will be in reported cases. There’ll be a rise in hospitalization and mortality but not as high proportionally to the rise in cases simply because many of us – the majority of Americans right now – have been either infected or vaccinated or both, so we have some immunity.”

As the country enters its third fall/winter with COVID-19, infections and deaths remain elevated, but society has returned to a “semi-normal” state. Many offices are bustling with workers while children are heading to school. Federal agencies have significantly reduced COVID-19 recommendations, citing a desire to “limit social and economic impacts.”

While the number of Americans who believe the pandemic is getting better has starkly dropped since spring, the country is also reporting a record-low rate of mask-wearing, highlighting a growing divide between the pandemic’s status on the ground and what actions Americans are willing to take to combat it.

With many mitigation measures gone out the window, the question remains as to how significant fall and winter surges will be. Could the U.S. really see 100 million more infections like the Biden administration predicted?

Such a number is “very possible” according to Mokdad. The projection remains feasible even if another variant doesn’t come in to replace the current dominant subvariant, BA.5, because the Omicron Subvariant is just that contagious.

Others agree that it’s possible the U.S. saw a similar number over the past three months, considering the latest surge in the U.S. was drastically undercounted.

Unclear if updated boosters will be a ‘game changer’

What’s different about the next surge? There will be new COVID-19 shots that specifically target circulating variants. This will be the first time the U.S. has updated its Coronavirus vaccine, and the Biden administration hopes that it will reduce transmission.

Leaders remain hopeful that updated shots will bring us the protection we need through October, November, December to prevent yet another wave that shut downs. 

But data on how effective the updated shots are in humans is not yet available, so it remains unclear what effect the shots could have on the course of the pandemic.

New variant threat lingers

There is a possibility that the predicted 100 million number could increase if a new variant takes over. Experts are optimistic that another variant won’t appear anytime soon.

It is not necessary for the virus to mutate in a way that will escape our defense mechanism since our defense mechanisms against infection are very weak.

There is little chance that a new variant will both be more transmissible than BA.5 and cause more severe disease, experts say.

We’ve had about 100 million infections the past three months, so why couldn’t that happen again in the fall and winter months?

Viruses don’t care if they make people sick – all they care about is getting to transmit from one individual to another. So what’s driving the virus is transmission, not severity.

That’s not to say that BA.5 is harmless beyond infections. The Coronavirus is still killing on average close to 400 Americans each day. Continuing at such a rate would mean about 145,000 deaths in a year. The figure would be well below the 2021 COVID-19 death toll of 415,000 but much greater than the number of Americans who die of the flu each year, which ranged from 12,000 to 52,000 deaths annually between 2010 and 2020.

And of course, it’s still possible a new variant arises that is more transmissible and more severe, but the variants that we have right now are already so transmissible that it is tough for new variants to out-compete.

Without a variant showing up out of left field, the fall and winter surge appears likely to be fueled by BA.5. But experts are also keeping an eye on BA.4.6 and BA.2.75.

BA.2.75 has yet to show up on CDC’s variant tracker, but it has nine more mutations on the spike protein than BA.2, or “stealth omicron.” BA.2.75 still shows a relatively low prevalence globally, but a number of countries have observed recent increasing trends,” according to the World Health Organization.

Is the U.S. prepared for a surge?

In June, Congress signaled that it would be going all-in on Coronavirus vaccines and treatments, with its remaining funds. Until then, the administration will reserve the remaining tests for distribution later this year. This has increased worries over a testing shortage once the next surge hits – an issue that the U.S. has run into before. 

Our pandemic preparedness infrastructure should be strengthened because we have no idea what to expect from this – or other pandemics, not just because of future projections.

COVID-19 testing, vaccinations, and treatment 

As we await the potential for a COVID surge to develop across the United States, let’s not forget to take care of ourselves and those we love.

A simple way to achieve this would be to get tested! Stay mindful of following the standard recommended precautions when interacting with the public.

Tested positive for COVID-19? We’re here to help you get the COVID treatment that is right for you.

Is a Fall/Winter COVID-19 surge coming to the U.S.?

As we await the potential for a COVID surge to develop across the United States, let’s not forget to take care of ourselves and those we love. A simple way to achieve this would be to get tested! Stay mindful of following the standard recommended precautions when interacting with the public. Tested positive for COVID-19? We’re here to help you get the COVID treatment that is right for you.