What to know about this summer's major surge in COVID infections

As summer winds down, much of the U.S. is seeing the biggest COVID wave in at least two years, and hundreds of people are still being killed by the virus every week. According to a CDC analysis of hospitalizations, 25 states have or likely have rising numbers of COVID infections. William Brangham speaks with Dr. Eric Topol about what’s behind the uptick and how people can protect themselves.

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William Brangham: As summer winds down, much of the U.S. is experiencing another COVID surge. It’s the biggest wave we have seen in at least two years, and hundreds of people are still being killed every single week by this virus.

According to the CDC’s analysis of hospitalizations, 25 states in the U.S. have or likely have rising numbers of COVID infections. And the spread is nationwide, in the West, the south, the Midwest, and the Northeast.

I recently spoke with Dr. Eric Topol. He’s the founder and director of the Scripps Research Translational Institute. And I asked him, what was behind this uptick?

Dr. Eric Topol, Scripps Research Translational Institute: Right, William.

Well, there’s a significant rate of infections, perhaps around a million people infected, Americans, per day. There are three factors that are contributing. One is that there’s a variant which is distinctly more challenging to our immune system.

And that’s the so-called KP.3.1.1. Second is that we have immunity waning, because, more than six months from a booster shot or an infection, we have a hard time to recognize and deal with the virus. And third, of course, is that we have largely abandoned any mitigation measures.

So these three things together are causing the biggest summer wave of infections, not necessarily hospitalizations, than we have seen over the past couple years.

William Brangham: Well, on that point, apart from the concerns over long COVID, as you’re saying, hospitalizations and deaths are the things that we really do worry about, what does the data indicate is going on in that regard?

Dr. Eric Topol: Fortunately, there hasn’t been a big spike in hospitalizations or deaths.

So we do have that immunity that’s been built over the last three to four years that’s helping to prevent severe disease. It’s still occurring. We’re still having some increases in hospitalizations, but not nearly as high as we have seen when this level of infections were manifest.

But as you mentioned and you touched on, we’re going to see more long COVID, unfortunately, because that can happen even after a mild infection.

William Brangham: So let’s talk about protective measures. Are we back to the point where people like yourself would be recommending masking in crowded places? I mean, do you wear a mask if you go into a crowded place or travel on an airplane?

Dr. Eric Topol: Well, I sure would recommend that, yes, because we have a lot of circulating virus right now, and it’s a challenging one.

And we’re awaiting a new booster, but we’re somewhat vulnerable more than we have been. Using a high-quality mask like a KN95, N95 is really going to help reduce the likelihood of getting an infection, as you mentioned, William, particularly when you have got crowds, public transportation, places where you just don’t know and there’s a lot of people out there that could be carrying the virus.

William Brangham: And what about that issue about the booster? Should people who are concerned get the current one? Should they wait for the next one? When will the next one be? Will it be more targeted?

Dr. Eric Topol: Yes, it’ll be more targeted. It’s directed towards a variant called KP.2, which is pretty darn close to what we’re dealing with right now. It’s going to be available in the first week of September.

The problem is, here and now, we have still got a few weeks to go to get to that point. And so, if you got the old booster, it’ll provide some protection, but it’s not nearly as well aligned with the new one. So it would have been great if that new one had been ready much earlier when this wave got its roots many weeks ago, but we still have a few weeks to go.

And, certainly, for high-risk people, 65 and older, immunocompromised, it’s going to be really important to get the new booster and possibly even a booster now if someone is anticipating a significant risk that they’re being confronted with.

William Brangham: And I understand you think there’s some promise with nasal vaccines. What’s happening on that front?

Dr. Eric Topol: The U.S. has invested, but not enough, in a couple of nasal vaccine programs.

But this is what we need, William, to get us out of the woods, because our biggest problem right now is we’re not able, really, in any significant way, to stop the infection and the risk of long COVID and the small, but persistent risk of severe COVID hospitalizations and fatalities.

So we have got to double down, triple down on the nasal vaccines because there’s been so much recent work to show that this is feasible. It’s just a matter of getting the clinical trials done and scaling up manufacturing.

But I’m quite confident that we will have a nasal vaccine. We should have had it by now, in fact, even more than one. But we’re moving in slow-mo. We’re not putting in the resources like we did for the initial shots back in 2020. So we got to take that more seriously. This is our big vulnerability right now, is infections.

William Brangham: And is it your sense that the nasal vaccine in and of itself is more effective or simply because of ease of delivery more people would take it?

Dr. Eric Topol: Well, both. I mean, taking a spray, even if it’s every three or four months, that would be great.

Because it’s basically creating this nasal mucosal immunity, it shouldn’t be at all variant sensitive. That is, as we keep seeing more virus evolution and tougher variants, the nasal spray should provide higher efficacy against infections. So, for many reasons, the ease of use and the protection it will afford, this should be a very high priority, which it’s not getting right now, unfortunately.

William Brangham: As you have well seen, and given the number of infections we’re seeing around the country, the urgency amongst the general public does not seem that strong. It seems like people are treating this like a cold, the flu, kind of just this seasonal thing that’s an irritant.

Do you think that that’s progress that we are starting to see it as a nuisance, as opposed to something much more grave?

Dr. Eric Topol: Well, here’s the problem is, for many people, it is like a cold. It is — it’s in the same family of coronaviruses that cause common cold.

The problem is, it’s a much tougher virus for some people. And it’s like a lottery, where it could then weeks later lead to long COVID. And we’re still seeing that even with the current virus in people who were previously very healthy. So we can’t predict who’s going to have the serious sequela of a mild infection of COVID.

And that’s really why we have to prevent infections. And, of course, even though some people are not winding up in the hospital, they’re getting pretty sick. They’re having to be out of work or missing out on the vacation or whatever. We have really got to get our arms around this infection problem. And we haven’t done it yet.

William Brangham: All right, Dr. Eric Topol, always great to speak with you. Thank you so much.

Dr. Eric Topol: Thank you, William.