The number of COVID-19 cases is rising again in North Carolina, data from the state Department of Health and Human Services shows. 

The number of COVID patients in the hospital dropped this summer to the lowest level since the pandemic began. But that number has been ticking back up since the beginning of July.

The latest data from the state showed a daily average of 501 patients hospitalized with the virus as of Sept. 2. 

The amount of virus found in wastewater monitoring has been climbing since late June, according to DHHS, which tends to be a good predictor of how many people actually have COVID in the community.

Wastewater monitoring sites around the biggest cities in North Carolina, including the Triangle, Wilmington, Charlotte, Winston-Salem, Greensboro and Asheville, reported an increase of 80% to 100% in the amount of COVID-19 being detected.

“This virus isn’t a seasonable virus, like the flu is, it’s with us constantly,” said David Montefiori, who studies COVID-19 vaccines at Duke University. He said the waves of cases come and go with immunity, either through vaccines or natural immunity from catching the virus. 

Boosters

“As immunity wanes in the population, we’re going to continue to see increased numbers of infections and associated increases in hospitalizations and deaths,” Montefiore said. 

About 17% of eligible people in the United States got the latest bivalent booster shot, Montefiore said. That means most people have not had a booster shot in over a year, he said. 

“The best thing that people can do to maintain a normal way of life is to get their booster shots,” he said. Updates to the booster shots have been working to keep people protected, he said. “If you haven’t been boosted or infected in the past year, that immunity isn’t very good anymore.”

“The vaccines have been holding up very well” to the latest variants, Montefiore said.

The latest booster shot, which has been updated as the virus changes, should be available later this month or in early October, said Dr. Cameron Wolfe, an infectious disease specialist at Duke University. 

Montefiore and Wolfe spoke with reporters Wednesday about the latest on COVID-19.

Wolfe said a late summer spike, like North Carolina and the rest of the country is seeing now, is typically followed by a bigger winter surge in COVID cases.

In May or June, Wolfe said, Duke had its lowest number of COVID patients with 10 or 15 in the hospital. But that number is now up to about 55. The number of COVID patients who do not need to be hospitalized is also up.

He said the patients are different this time around. Most have not been so sick as to need intensive care as they were seeing early in the pandemic, Wolfe said. 

Many of the COVID patients who end up in the hospital or intensive care have some other health problems, he said. That includes people who may already have emphysema or heart disease, and the virus has made their existing conditions worse.

For people with suppressed immune systems, like people going through chemotherapy or who have had transplants, the situation is different. 

“They’re not able to respond to the vaccine or develop immunity from previous infections as efficiently,” Wolfe said. 

He said one issue with the new booster shots is that the federal government will not be subsidizing the vaccines like it had earlier in the pandemic. That means underserved communities and people without health insurance may be less likely to get the new shot. 

Duke and other health systems, along with drug makers and the federal government, are trying to figure out how to make sure that everyone who needs a new booster can get one, Wolfe said. 

New variants

The latest variants found in North Carolina are not causing patients any more problems than other variants, Wolfe said. 

An emerging variant, called BA.2.86, has public health officials paying attention. It’s not been detected yet in North Carolina, according to DHHS data.

“It’s been found in multiple countries, and it’s been found in multiple locations in the United States,” said Montefiore. But because fewer people are getting tested, it’s hard to know exactly where it is and how common it is,” he said. 

The concern, he said, is how different this new variant is compared to earlier variants. Montefiore compared it to the emergence of omicron, which sent case numbers skyrocketing in late 2021.

“It’s a major leap,” he said. But the good news, Montefiore said, is it looks like the latest vaccine boosters will be effective against the new variant.

People have been living with the COVID-19 pandemic since 2020 and most people know what to do. Wolfe and Montefiore said it’s important to continue to test for the virus if someone doesn’t feel well. They also said people should wear a mask and avoid crowds if people don’t feel comfortable. 

“It’s also interesting that we continue to have this evolution of the virus, and the virus acquiring mutations in regions that could be very critical for how long the vaccines will continue to work,” Montefiori said. “And yet the vaccines are continuing to work, and the updated vaccines are very important in that regard to assure people do have adequate immunity.”

“I’m optimistic right now about the vaccines that are available in the future, of being able to keep up with variants that arise later on,” he said.  

'Still on people’s mind'

Dr. Kristin Black, a family physician with two clinics in North and South Carolina, said patients are starting to ask about it more.

“COVID is still on people’s mind, I think when we think about COVID, we need to realize that it’s never really left,” Black said Thursday.

In recent months, Black said roughly 10% of patients brought up COVID-19 concerns. But now, Black said the number is increasing, as kids head back to school and coverage of new strains dominates headlines.

But, with a smaller societal emphasis on testing, Black said it is hard to know how much the disease is circulating.

“You know, not ignoring certain symptoms that we may think or allergies or just sinuses. We need to assume we may have COVID, and we don’t want to spread it to other people. And, we want to be cognizant and just be good neighbors, be good people and act accordingly!” Black suggested.

As a mother to two teenagers, Black said she understands parent concerns, as thousands of North Carolinians return to classrooms.

“If your kid does seem a little run-down, does have a stuffy nose, coughing, eyes red, whatever, pay attention to that! Let them stay home a day or two,” Black recommended.

Additionally, Black said she is still giving her patients advice they’ve heard for years now. Wash hands, exercise, eat well, and if you’re concerned, wear a mask.

“If there is concern you or your family members have been sick,” Black said, “Or, will get sick or are going to events with large amounts of people, I would recommend wearing a mask just to be on the safe side.”

Thankfully, she said most patients who reach out to her about having COVID describe mild symptoms and recover. However, Black said patients with diabetes, asthma, COPD or cancer should continue to exercise extra caution.