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Dr. Leana Wen: The summer covid wave is here. It won’t be the last.

Commuter wearing a mask NYC
Thought Leader: Leana Wen
July 18, 2024
Written by: Leana Wen

This piece is by Dr. Leana Wen.

More than half of states are registering “high” or “very high” levels of the coronavirus in wastewater testing, the Centers for Disease Control and Prevention reports. Nationally, emergency department visits due to covid are increasing. On Wednesday, the White House announced that President Biden tested positive with his second coronavirus infection. As with his first bout, he is experiencing mild symptoms and has started Paxlovid treatment.

If this feels like déjà vu, that’s because it is. Covid-19 has not settled into the annual pattern favored by other respiratory viruses. If anything, it seems coronavirus waves are occurring at least twice a year, with an uptick in the summer followed by another rise in the winter coinciding with the flu and other viruses.

The current covid wave is cause for caution, not alarm. Thanks to readily available vaccines and treatments, most people do not need to alter their summer plans.

This advice applies to Mary from California. She and her friend, both in their 60s and recently retired, have been planning “for ages” to go to Paris for the Olympics to watch the gymnastics competition. “We are vaccinated and got all our boosters, the last one in April,” she wrote. “Now we’re worried about covid again. Any advice? Please don’t tell us we have to cancel our trip!”

Mary shouldn’t cancel her long-awaited travels. If she and her friend are in generally good health, their chances of developing severe illness is low, especially if they promptly take antiviral treatment after contracting the coronavirus.

That said, they should be aware that if they attend large events in crowded indoor spaces, they could easily be exposed. The ongoing Tour de France has been plagued with coronavirus cases, with multiple cyclists forfeiting midway through the three-week race because they became ill. It’s possible the coronavirus will also disrupt the Olympics, if not among the athletes then surely among the millions of spectators descending on Paris.

I advise Mary and her friend to bring several well-fitting N95 masks or something equivalent with them. They can don them while traveling and in crowds. They can also reduce their risk of infection by opting for outdoor dining whenever possible. And they should bring plenty of rapid tests and have a plan for accessing antivirals.

Many readers want to know if they should try to get another dose of the existing coronavirus vaccine now instead of waiting for the newly formulated booster. Mark from D.C., 73, asks, “If cases are rising now, why isn’t the CDC recommending that everyone get the covid vaccine now?”

I think there are at least four reasons it made sense for the CDC to recommend that people receive the updated booster in the fall rather than get the 2023 version at this time:

  • As I wrote in a previous newsletter, that recommendation aligns the covid-and-flu-shot timing and therefore is more likely to increase uptake.
  • The new version will be better matched to currently dominant variants compared with a vaccine developed last year.
  • It is only a short matter of time before the new vaccine is made available. Older individuals who followed the CDC recommendation to receive a spring covid booster would have had a recent shot and still be well-protected.
  • And, finally, there are logistical challenges. Many pharmacies have stopped supplying the 2023 vaccine, and it might be hard for people to find the shot.

There may be a small subset of individuals who could benefit from an additional vaccine sooner. These are older people with multiple underlying medical conditions who were eligible for the spring vaccine but delayed getting it. If they are able to find the booster now, they could get it right away. Then, four months later, they could receive the updated formulation.

What about people who already received the spring booster, like Denise from New Hampshire, who asked if she should get another dose before her travels next month? In that case, I’d advise her to hold off until the new shot is released, which could be as early as late August. She and others seeking optimal protection should use all the other tools at their disposal, including masks and ventilation to prevent infection, tests for early detection, and antiviral treatment to reduce the chance of severe disease.

This pattern of multiple covid spikes a year will almost certainly continue for the foreseeable future. If so, the same questions will keep popping up, including how well vaccines protect against emerging variants. Scientists should continue developing better vaccines with longer durability and broader coverage. In the meantime, those striving to avoid infection should be aware of virus levels in their community, but most no longer need to upend their plans as a result.

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