Dear Doctors: I just got the new COVID-19 booster, and the nurse said hardly anyone is getting the updated shot this year. I’m not surprised because after years of headlines, COVID-19 is gone from the news. I’m also hearing it’s getting harder to track. Do you know why? Are people still getting sick?
Dear Reader: It was just after the new year in 2020 that COVID-19 first entered the general conversation. A new respiratory illness, similar in many ways to pneumonia, was causing concern. Highly contagious, and with no effective treatments or vaccine, it soon expanded into a global pandemic. In the United States, we have had more than 99 million confirmed cases of COVID-19 to date, and the disease has caused more than 1 million deaths.
Today, thanks to vaccines, growing herd immunity and the emergence of effective drugs and treatments, the COVID-19 emergency has ended. No longer a pandemic, it is now considered to be endemic. That means a disease is embedded in the population, but it occurs at predictable and manageable levels. And, interestingly, as you have heard, this transition is also making COVID-19 data more difficult to track. Thanks to accurate home tests and milder illness, not all cases get reported. Hospitalizations, which do get reported, have also dropped significantly. In an effort to predict and prepare for local surges of illness, many communities are now tracking the ebb and flow of the COVID-19 virus in wastewater.
At this time, the Centers for Disease Control and Prevention reports that viral activity in wastewater for COVID-19, which has been low nationwide, is beginning to surge. The same goes for ER visits and hospitalizations. A handful of states -- including New Mexico, Arizona, Massachusetts and Minnesota -- are now reporting high viral activity in wastewater. A new variant, known as XEC, has recently emerged as the leading cause of disease, accounting for 45% of new cases. The good news is that a nationwide surge in COVID-19 activity has not been detected. This may be due to the summer surge, which left many people with short-term immunity.
The nurse you spoke with is correct about the low rate of vaccination with the updated COVID-19 shot. Information collected by the CDC shows just 20% of adults older than 18 have received the updated COVID-19 vaccine. That number improves to 44% when narrowed down to adults 65 and older. This is unfortunate because, although not nearly as deadly as at the height of the pandemic, COVID-19 can still cause serious illness and lead to hospitalization.
People who become infected also run the risk of developing long COVID. That’s the collection of symptoms that linger for months, and sometimes years, after initial infection. Long COVID affects between 10% and 30% of people who have had COVID-19, including those with mild illness. The cause is still not understood, and there is no targeted treatment. The good news is, being vaccinated not only helps protect against infection and serious illness, it also reduces the risk of long COVID. Anyone who hasn’t gotten the updated COVID-19 vaccine should please consider doing so.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
