These new shots — which the Center for Disease Control and Prevention are calling “new” or “updated” COVID vaccines rather than “boosters” — will be distributed through health care providers and county public health departments, as well as at health centers and pharmacies like CVS, Walgreens, Rite Aid and Safeway.
Safeway pharmacist Ashley McGee fills a syringe with the Pfizer COVID-19 booster vaccination at a vaccination booster shot clinic on Oct. 1, 2021 in San Rafael, Marin County. (Justin Sullivan/Getty Images)
COVID numbers are on the rise once more in the Bay Area, around California and nationwide in what’s being called a “summer surge” by many. And it’s fueled, at least in part, by the new omicron subvariant EG.5 — unofficially named “Eris” — that’s risen to become the dominant strain nationwide, and here in California.
So what do you need to know about spotting symptoms of the new EG.5 variant? What’s this new “Pirola” variant in the mix too? When should you take a COVID test, and where can you even find a free COVID test now? When will the new COVID vaccine be available? If you do test positive, who can get Paxlovid — and can you take this antiviral drug again if you already took it for a previous COVID infection?
EG.5 is the name of the newest subvariant of the omicron variant of COVID. Even though the World Health Organization (WHO) has revised its naming conventions to reserve “Greek labels” only for “variants of concern,” some online have unofficially named this new EG.5 variant “Eris” — like XBB.1.16 was nicknamed “Arcturus.”
What are the current COVID cases in the Bay Area right now?
In the absence of widespread data on positive COVID test results (more on that below), watching for the presence of the coronavirus in human sewage has become increasingly important for gauging the levels of COVID spread in a particular area.
When it comes to COVID in Bay Area sewage, WastewaterSCAN’s Ali Boehm told KQED in an email on Sept. 6 that the trend is “significantly upward” — and that the new Eris variant is definitely visible.
A great deal of people who suspect they have COVID will test themselves at home with an antigen test kit, not a PCR test — but the California Department of Public Health still tracks only the people who do get a diagnostic test result from a lab after taking a PCR test. The state’s 7-day COVID test positivity rate — that is, the percentage of people who take a PCR test that is then found to be positive, tracked over the week prior — has been rising since late June, and is currently the highest it’s been throughout 2023.
That 7-day positivity rate currently stands at 14% as of data from Aug. 28 — up from 8.4% back on Aug. 1. This mean’s the state’s 7-day positivity rate is currently even higher that it was back at its high point in December 2022, when it was 12.4% on Dec. 29.
In California, the number of people hospitalized with COVID fell greatly throughout the year after this winter’s surge, from a high of 4,616 people on Dec. 30, 2022. But those numbers are rising again.
Why don’t we have firmer numbers on how many people are actually testing positive for COVID right now? Earlier on in the pandemic most people were getting diagnostic PCR tests through official sites, which were then tracked through their laboratory processing and had their numbers reported — the way that the state’s official test positivity rate is still tracked.
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However, the arrival of widespread antigen tests has now given more people a way to test themselves for COVID at home without having to find a PCR test (albeit in a way that’s different from how a PCR test “detects” the virus.) But while public officials have urged at-home testers to report positive results to their local health authority, very few people still do so.
All of this goes some way to explain why the “true” number of people who currently have COVID in 2023 is a very difficult number to report — and why any official number from PCR testing almost certainly represents a big undercount.
Isn’t there another new variant too, on top of Eris?
Yes, and it’s called BA.2.86 — dubbed “Pirola” by some. In mid-August, the CDC announced that this new variant had been detected in Denmark and Israel, and that “at least two cases” had been identified in the U.S.
“BA.2.86 actually poses either similar or less of an immune escape risk compared with currently circulating variants, not more,” said Dr. Dan Barouch, who conducted one of the studies at Boston’s Beth Israel Deaconess Medical Center. Barouch called this “good news” that “does bode well for the vaccine.”
WastewaterSCAN’s Boehm says that her team has not detected Pirola yet in the Bay Area’s wastewater samples, but also that the most recent samples are from Aug 24. “That variant should be very easy to see in our sequencing data and we do expect that if it is there, we will see it,” she said.
Is this ‘summer surge’ of COVID a surprise?
Dr. Peter Chin-Hong, infectious disease expert at UCSF says that in the context of previous rises in COVID cases over summer — and winter — he “kind of expected” this latest surge for several reasons.
The first, he said, is the amount of summer travel people have done — and are still doing: “More people moving around, record number of travelers, mixing people from more risky with less risky areas.”
The second is the presence of recent heat waves around the U.S. — and to some extent, within the Bay Area — and how they’ve driven people to seek shelter and moderate temperatures indoors: “Just like winter drives people indoors,” Chin-Hong noted.
Thirdly, there’s the fact of waning immunity. Whether people gained immunity from getting a COVID infection back in the winter or by getting their vaccine booster in the late fall of 2022, that’s about “six months and change” ago, said Chin-Hong, “so people are losing immunity.”
“And we know that immunity wanes the fastest, from CDC data, in those who are over 65,” he said. “So that is all contributing to just a lot of more susceptible hosts.”
What are the symptoms of this new EG.5 ‘Eris’ COVID variant?
This latest variant doesn’t have any surprising wild card symptoms, confirms Chin-Hong — they’re the same COVID symptoms you’re used to hearing about from previous variants, or at least that’s how it looks right now.
He advises you to particularly look out for a runny, stuffy nose, headache, fatigue, sneezing, sore throat, cough and smell changes. According to the Centers for Disease Control and Prevention (CDC), this is the full list of the possible symptoms of COVID:
Remember, you might have a combination of these symptoms, or just one. They might be mild, or feel more severe. But if you’re experiencing any of these, take a COVID test (more on this below).
How different is EG.5 to previous omicron subvariants?
A good way to think about EG.5 and omicron subvariants like it, Chin-Hong says, is “instead of thinking of how different they are from the last thing, you think about how similar they are.” The most recent COVID variants, he says, are “all kind of flavors of XBB.”
“The interesting thing is: COVID hasn’t really changed too much … since winter to now,” said Ching-Hong. “It’s just been variations on the theme.”
“Of course, every time you see a successive generation, they are just a little slipperier than the rest,” he acknowledged — but right now, he’s seen “no evidence” that EC.5 is more virulent or causes more serious disease. The main thing to know about EG.5, said Chin-Hong, is that “it’s slightly more immune evasive,” meaning that we’re simply seeing more people getting infected.
The upside of EG.5’s similarity to previous subvariants? The new COVID booster that’s coming some time in the fall — with latest predictions for a widespread rollout by October — is formulated to target XBB, which means that this vaccine “is going to be pretty decent at targeting these variants,” like EG.5, says Chin-Hong.
So when will the new COVID boosters be available?
On Aug. 31, CDC Director Dr. Mandy Cohen confirmed that the new updated COVID vaccines — as they’re now being referred to, rather than “boosters” — will be available later this month, in just a few weeks.
The vaccines are “going through FDA regulatory review right now,” said Cohen at CDC conference. “And then they will go immediately to CDC for recommendation. and then they’ll be available in mid-September.” That meeting for the CDC’s Advisory Committee on Immunization Practices (ACIP) to discuss the recommended rollout of these updated vaccines is scheduled for Sept. 12.
If you haven’t got your latest COVID vaccine and were debating getting it in the next few days, should you wait for this new updated vaccine that targets the most commonly circulating strains of COVID? Yes, said Cohen: “For most folks, it is likely the right place to wait those two weeks for the updated version.”
The exception to this, she said, would be the older people or those with “more underlying conditions.” If those groups are behind on their COVID vaccines, said Cohen, “they should talk with their doctor about whether or not they should get the current version of the vaccine now.”
As for who will be able to get the updated COVID vaccine starting mid September, Cohen said that while she didn’t want to pre-empt the FDA and CDC recommendations, “we likely will expect that this will be something we recommend for all ages above six months.”
When COVID cases rise, strongly consider rising up — and testing if you feel symptoms. (Photo Illustration by Michael Ho Wai Lee/SOPA Images/LightRocket via Getty Images)
Should I be altering my behavior with this rise in COVID cases?
Everyone should consider taking extra or new steps to protect themselves from COVID infection during a rise in cases — even if it feels like “a step backward” for you, at this stage of the pandemic.
This might include bringing a well-fitting N95 mask along to indoor spaces that you know could be crowded, like the grocery store. Or if you’re hosting people indoors in your home, ensure the space has good ventilation by taking measures like opening windows.
You might also consider favoring outdoor hangouts and meetups with friends and family at this current time, to help reduce the potential risks of COVID transmission. The chances are good that the folks you’re meeting up with could also be feeling a little anxious right now about the recent rise in cases, but might not feel able to articulate it for fear of killing the social vibe. Consider doing the quieter folks in your circle a favor and be the person that raises the issue first, to keep everyone safer. Remember: It’s not weird to not want to get COVID.
If you’re at higher risk for serious illness or hospitalization from COVID, it’s an especially good idea to take extra precautions against the virus right now. These groups can include older people, immunocompromised and disabled folks, and people who “haven’t been recently vaccinated, in the last six months or so,” advises Chin-Hong.
Another reason you might consider being extra cautious about COVID right now: if you’ve got summer travel plans. Even if your symptoms are mild, a COVID infection can require isolation from other people for well over a week — and you can double that timeline if you get a rebound (i.e., second) infection, which are surprisingly common even in people who don’t take the antiviral treatment, Paxlovid.
I think I was exposed to COVID. When should I take a COVID test?
If you’ve heard that incubation times for the virus are getting shorter — that is, the amount of time between getting exposed to COVID and testing positive for COVID — it’s true. People are testing positive for COVID more quickly than they were in 2020 when the average incubation period was five days, because the incubation period has changed with each new variant, confirms Chin-Hong.
While “we don’t have a ton” of up-to-date information on incubation times at this stage of the pandemic, notes Chin-Hong, given this general trend, it makes sense to take a COVID test as early as two days after exposure if you’re already having symptoms. And if you test negative at that time, test again the next day if symptoms persists.
Where can I still find a free COVID test?
Good question. Finding a quick, free COVID test — whether an at-home antigen test or a PCR test — has gotten progressively harder at this stage of the pandemic, as more sites and services have been shuttered. The federal government has also ended its free at-home COVID-test-ordering service through USPS back in June.
An at-home COVID test. (Beth LaBerge/KQED)
So what do you do now if you don’t already have a supply of antigen tests for COVID at home? Try the following:
Purchase a COVID at-home antigen test at a pharmacy near you
The quickest option will also be one of the most expensive up-front: Purchasing an at-home antigen test at a nearby pharmacy. (Ideally, ask someone to purchase one for you, so you don’t potentially expose other people at the pharmacy — and if you really have to go yourself, wear a well-fitted N95 mask to help lower the risk you pose to others.) These at-home test kits are usually around $20 for a pack of two antigen tests.
PCR testing is more accurate than an antigen test — because it’s more sensitive at picking up traces of the coronavirus in your body — but it may take longer to get your results than with an at-home test.
Currently, there are still some sites offering free COVID testing around the state. Try using:
If you have health insurance, you may be able to get a PCR test ordered by your health care provider with the costs covered. Having a test ordered by a provider is — usually — the only way to get your testing costs covered if you have Medicare, too.
If you have health insurance, contact your provider
If you are insured with major Bay Area providers, such as Kaiser Permanente or Sutter Health, the easiest option to secure a COVID test may be to make an appointment through your particular provider. Most providers offer sign-ups online through a member’s login and appointments can also be made by phone.
Because of good supply, the drug is no longer reserved for people most at risk of severe illness from COVID, and everyone is encouraged to contact a health care provider to see whether they qualify.
As of February 2023, you no longer need proof of a positive COVID test to get a prescription for Paxlovid either. But for it to be effective, health officials recommend starting a course of Paxlovid within five days of a positive test. This means that taking a test as soon as you suspect you have COVID is still very important.
If you took Paxlovid for a previous COVID infection, can you take it again for a new infection? Yes, it’s “definitely ok” to do so says UCSF’s Chin-Hong if it’s a new, “distinct episode of COVID”. The only time it wouldn’t make sense to take Paxlovid a second time, says Chin-Hong, is for the same infection — because you “will likely not benefit in taking another course even if you still test positive”.
If your first initial COVID test is negative, remember that because incubation periods can vary, it can take a little while longer to get a positive COVID test — even if you have symptoms already. Keep re-testing as much as you’re able to, to be sure it’s not COVID.
What if you’re still feeling sick and it’s not COVID? Whether you’re suffering from a bad cold instead, it’s still a very good idea to stay home as much as you possibly can, to avoid infecting other people.
So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.
An earlier version of this story was published on August 29.
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