What to expect from COVID this Summer/Fall
When will this wave be over and when's the next one?
Summary
The Omicron subvariant Summer wave is almost over in the N.E. US and the rest of the country will follow. We can expect the next wave to peak in November/December in the US. For people who are planning travel and/or want to take minimal risks of being infected due to concerns for long COVID or being in a high risk category, I would learn to “ride the waves”. This means planning higher risk activities for times when the waves are at lower points and avoiding higher risk activities when they are higher. We should (hopefully) have a new Omicron-specific vaccine before then. Vaccine timing will be crucial to minimize cases and hospital overwhelm with the next wave.
Current state of COVID in the US
The US has the appearance of having a flattened peak Summer wave but this is actually the combination of slightly out of sink timing of waves across the US.
Due to timing of variant spread and differences in timing of previous waves, which in turn puts people in different regions on different levels of waning immunity, the US is not totally in sink with its waves. I predict that our waves will converge in timing more going forward as we mix hybrid immunity types and sink up with vaccination schedules. You can see that the N.E. is largely through its Summer wave while other regions are peaking.
The death rate is at an all time low currently. You can see this by comparing the cases to deaths in the below figure. The cases are also very underreported currently because of rapid tests, which you can see by comparing the test positivity rate to the cases in the below figure. The hospitalization rate is also very low. Encouragingly, more people are now hospitalized with COVID than for COVID.
This suggests to me that COVID is following a best case scenario trajectory and becoming less lethal over time. This is both due to Omicron being milder and people building up immunity from vaccination and previous infection.
The Future of COVID in the US
We can look to places where mitigation from masks and lock downs have been minimal to understand what will happen in the US going forward. This is because the US also has had (and I believe will have going forward) minimal mitigation compared to Europe, Canada, and many Asian countries.
Waves are consistently coming every 5-6 months in places where mitigation efforts are absent or minimal (see S. Africa below).
The N.E. US last peaked on May 19, 2022. So based on history of peaks every five to six months, I would expect that this would put the next peak in the N.E. somewhere in October or November 2022. The rest of the country may follow a month or so later in November/December 2022.
For people who are planning travel and/or want to take minimal risks of being infected due to concerns for long COVID or being in a high risk category, I would learn to “ride the waves”. This means planning higher risk activities for times when the waves are at lower points and avoiding higher risk activities when they are higher. Around peak wave times you may also get stuck in countries due to travel restrictions, which is another reason to pay attention to peak and troughs of waves. Since waves are coming at times that disrupt our Summer and Winter holiday plans (sadly), it may also make sense to plan vacation in off peak times for travel.
If the US can do this in time, I think we could disrupt the next wave by timing boosters or the new vaccines for late Summer/early Fall. A big part of why the waves are coming every 5 to 6 months is waning immunity. Antibody levels from previous infection or from vaccination fall steadily and hit a critical low point around 5 to 6 months out. If we could vaccinate/boost 1-2 months before next wave we would drop hospitalizations and deaths a lot and may even flatten infections considerably. The US FDA has recommended Omicron specific boosters for the Fall. The timing and execution of this will be critical.
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