COVID-19 cases are on the rise in the United States as children return to school and the colder months approach. For the week ending August 9, the hospitalization rate for COVID-19 was 1.7 per 100,000 people, which is double the rate from two months prior, according to the Centers for Disease Control and Prevention (CDC). Additionally, for the week ending August 23, 11.2% of COVID tests returned positive, a significant increase from 3.3% two months earlier.

Despite these increases, current metrics remain significantly lower than in previous years. Hospitalization rates are approximately three times lower than at the same time last year, and the percentage of positive tests is about half of what it was during the same period last year. Over the past two months, around 200 Americans have been dying from COVID-19 each week, CDC data indicates.

Confusion has arisen regarding COVID-19 vaccinations following the Food and Drug Administration's (FDA) approval of updated vaccine versions for individuals over 65 and younger people at high risk for severe disease. Federal health officials have stated that anyone who wishes to receive the vaccine can do so. The CDC reports that test positivity rates have surpassed 10% in many areas of the Southwest and Western U.S. as students return to classrooms.

Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, commented, "When the dust settles, I expect it to not be as bad as last year … but that still means that some people are getting sick. Fewer people are getting hospitalized, proportionately speaking, but some people are still being hospitalized." He noted that the increase in cases is due to several factors, including the time elapsed since many people last contracted COVID-19 and the emergence of new variants.

As of the week ending August 30, the XFG variant, an offshoot of the omicron variant, is the dominant strain in the U.S., accounting for an estimated 78% of new COVID-19 cases. Other omicron offshoots, NB.1.8.1 and LP.8.1, represent 14% and 3% of new cases, respectively.

Dr. William Schaffner, a professor at Vanderbilt University School of Medicine, explained that the currently circulating variants are all part of the omicron family and do not exhibit major mutations that would increase transmissibility. "You can think of them all as cousins," he said. "These cousins do share a couple of characteristics, one is that they appear to be fairly contagious and are quite capable of producing a great deal of mild disease. By mild, I mean not serious enough to get you into the hospital."

Schaffner added that the vaccines expected to be available this fall should provide reasonable protection against severe disease caused by these variants. Pfizer-BioNTech announced that its 2025-2026 COVID vaccine will target the LP.8.1 sublineage to better align with circulating strains.

The rollout of COVID vaccinations in the U.S. remains uncertain. CVS has indicated that the availability of vaccines will vary by state due to the current regulatory environment. In 34 states, individuals can receive the COVID vaccine at CVS pharmacies. In 13 states and Washington, D.C., vaccinations are available depending on age and may require a prescription. However, in Massachusetts, Nevada, and New Mexico, the COVID vaccine is not being offered.

Chin-Hong expressed concern over declining vaccination rates as the country enters the respiratory virus season. He stated, "As vaccination rates decline, from both people’s desire as well as structural barriers that are being put up by the federal government, it means that fewer people are going to get vaccines, even if people wanted to. I’m worried that … it may mean that we would have some hospitalizations and deaths that we wouldn’t have seen normally if there was a simpler rule around vaccines."

Schaffner advised that those eligible for the COVID vaccine should get vaccinated, along with the annual flu shot. He also recommended that individuals with risk factors for severe disease take extra precautions, such as wearing masks in crowded indoor settings and practicing social distancing.