COVID-19 cases are rising again in Maryland and around the country, a smallish wave so far but a reminder that the virus is sticking around and could cause trouble in the fall and winter when flu and respiratory syncytial virus could also make another significant comeback.

A new COVID variant has emerged that is better at circumventing people’s immune defenses and spreading faster, prompting a rise in hospitalizations and a continued small number of daily deaths. How many cases there are is unknown with fewer tests performed and reported.

It’s not what the pandemic-weary public wants to hear, but public health officials are urging people to consider another COVID-19 booster when the vaccine is updated, expected in September, as well as an annual flu shot.

This wave is “a reminder that COVID is still around and still dangerous for parts of the population,” said Andy Pekosz, professor and vice chair of the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health.

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How bad is the new wave?

The Maryland Department of Health is monitoring the spread of COVID-19, said David McCallister, a department spokesman.

“It is not unusual to see upticks during the summertime as individuals travel and take vacations,” he said. “The department encourages all Marylanders to stay up to date on their vaccines, follow [Centers for Disease Control and Prevention] guidance and to test when appropriate.”

For now, hospitals are handling the increase in cases, which remain at pandemic lows. About 150 people remain hospitalized in Maryland this week from COVD-19, up from about 50 last month, far below the peaks in the last two Januarys in the thousands. Hospitals, however, have stopped testing visitors without significant symptoms.

The CDC reports more than 10,000 people were admitted to a U.S. hospital in the past week, up more than 14% from the previous week. Deaths jumped 10%.

Officials say cases of respiratory viruses could still swamp them.

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“Even during the summer months and with school starting soon, viruses like COVID-19, flu and RSV are currently spreading across Maryland and the nation,” said Meghan McClelland, the Maryland Hospital Association’s chief operating officer, in a statement.

“A rise in illnesses associated with these viruses could stretch hospitals’ capacity and resources over the fall and winter,” McClelland said.

She said hospitals are prepared, but she encouraged the public to take preventive steps, specifically through vaccinations and staying away from others when you’re sick.

“It’s critical for adults and children to stay up to date on their shots,” Pekosz said.

Will a booster protect you from the new variant?

Pekosz said the variant that recently began dominating COVID-19 infections, EG.5, is similar to the most recent XXB variant that is the basis for the next booster. The new shot should provide most people ample defenses against severe cases.

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That is, if people get the booster. Most people didn’t get the last one and people’s immunity has waned, increasing their vulnerability, Pekosz said. For now, seniors and those with serious underlying health conditions continue to bear the brunt of COVID-19. They should plan to get the antiviral treatment Paxlovid quickly if they are infected, he said.

Everyone should also stock home test kits, he said, though they may be harder to find for free now that the federal public health emergency has ended and health departments and libraries may have run out. Some insurers are likely still covering them, and some schools plan to hand them out. Older boxes may still be good. Updated expiration dates are available on manufacturers’ websites.

Many adults and children who opt for a booster will likely have them covered by insurance or government programs at their doctor’s office or pharmacy. Some schools and most county health departments also continue to offer some COVID-19 vaccines and plan to offer flu shots.

The state has launched a website to find local health department vaccination clinics, which will be updated to add flu shot availability in the fall. There’s also information on vaccine requirements for students. Another website called MyIR Mobile allows families to track and print immunization records.

The school year is about to start. How disruptive will this new wave be?

Few children get terribly sick from COVID-19, though, like adults, some develop so-called long COVID, in which symptoms persist or new ones emerge. Experts such as Pekosz say it’s better to avoid infection to protect yourself and prevent transmission to vulnerable people.

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In a letter to schools and day care centers, Maryland health and education officials recommended “routine prevention” and “layering” measures during an outbreak at school or a wave in the community. Those include masking, testing and increased ventilation. It said test kits will be given to school-based health centers and provided upon request for students to take home. The schools must report COVID-19 outbreaks to local health departments, which will make specific recommendations.

The response to outbreaks likely means sick students and staff go home but also could mean masking those infected or their contacts, increased hygiene practices and cleaning, canceling activities or moving them outside, and even suspension of in-person learning.

“These decisions will be made on a case by case basis in coordination with the local health department, the local education agency and child care licensing specialist as applicable,” says the letter, sent last month by Mohammed Choudhury, state superintendent of schools, and Dr. Nilesh Kalyanaraman, deputy secretary for public health services.

Specific policies have largely been left to local school systems, and it appears there will be something of an honor system for families — keep sick students home and test them for COVID-19 yourself.

No system is requiring anyone to mask, and none plans to routinely test students or staff, though some will stock tests for those who want them. Some plan to send home kits.

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The systems aren’t saying at what point in an outbreak they’d send anyone home for COVID-19 or any condition, or when they’d let them back. Most pre-COVID policies ask students to remain home until their fever has been gone for a day and symptoms are resolving. Post COVID-19, the advice has been stay home for five days past the onset of symptoms and mask for 10 days.

Baltimore City school officials, for example, said they will address COVID-19 and other outbreaks on a case-by-case basis. They plan to quickly deploy advice from health officials and other experts, including those from the Johns Hopkins University, said André Riley, a schools spokesman.

Most counties and Baltimore also are holding COVID-19 and back-to-school clinics at schools or through their health departments, and flu clinics are expected in the fall.

meredith@thebaltimorebanner.com

Meredith Cohn is a health and medicine reporter for The Baltimore Banner, covering the latest research, public health developments and other news. She has been covering the beat in Baltimore for more than two decades.

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