Western Pennsylvania is seeing an uptick in covid-19 cases just as the new school year is about to start.

Dr. Carol Fox, chief medical officer for Independence Health System, said the system’s five hospitals have seen a slightly higher number of patients who are being hospitalized because of covid compared with earlier this summer.

“It’s not a large number, but it’s certainly more than it had been in awhile,” she said. “It’s something that we take notice of.”

During covid’s worst point around two years ago, Fox said, Independence Health System had about 180 to 200 patients hospitalized. Now, the number has held at around 10 patients, she said, but, about a month ago, there was just one person hospitalized.

“It’s certainly an increase, but it’s nothing significant comparatively,” Fox said.

A high or very high level of covid-19 virus is being detected in wastewater in almost every state, according to the Centers for Disease Control and Prevention. Wastewater analysis has become the preferred method of measuring infection rates as many people no longer test for covid.

Covid symptoms can include a fever, body aches, a cough and a sore throat, Fox said.

“We’re not seeing any increased number of people who are catastrophically ill,” she said.

Dr. Amesh Adalja, a Pittsburgh-based infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security, said covid cases have been increasing across the United States.

“This increase in cases, which is predictable and expected as people move indoors to avoid the heat, leads to increased spread,” he said. “That, coupled with more evolution of the virus … causes the summer increase we’ve seen multiple times already.”

Why an uptick?

At Allegheny Health Network, Dr. Joseph Aracri, system chair of pediatrics, said there’s been a small increase as well.

But covid now should be considered similar to other respiratory viruses rather than as a pandemic, Aracri said.

“Now, we treat it as just a virus,” Aracri said. “The reason is that covid has gone around so much that it is not as dangerous as it used to be; the population now has some natural immunity to it.”

Since it’s been over four years since the pandemic’s onset in 2020, pretty much everyone has been exposed in the United States, Aracri said.

“With any virus — even the common cold — you can have some significantly serious cases,” he said. “These viruses can make people seriously sick, but it’s not impacting the majority of the population like it was several years ago.”

Aracri said there is no worry about hospitals being overwhelmed or people becoming extremely sick.

“It’s a lot milder than we’ve seen in the past,” he said.

The recent increase in covid cases appears to be fairly consistent with outbreaks of influenza, according to Fox.

“I can’t really pinpoint it,” she said of a main reason behind the uptick.

Adalja said the increase is consistent with previous summers since 2020. However, it’s been manageable due to the increased immunity and new tools to combat covid such as vaccines and antiviral drugs.

“While it might not be protective against cases going up, it is very protective against severe disease, hospitalization and death,” he said of increased immunity.

Health departments are able to complete wastewater testing, which provides a look into the increased amounts of covid detected in wastewater, Fox said.

According to Adalja, wastewater testing means monitoring sewage for levels of covid, and the numbers have been higher than in previous years.

“When people get covid, when they defecate, the virus is in their feces, and you can measure those levels in the sewer,” he said.

The majority of the United States has some sort of wastewater monitoring for all kinds of viruses, Adalja said, and he said he believes it’s a much better indicator of infection within communities compared to tracking case numbers.

“Cases have always been an underrepresentation of the actual burden of illness because they’ve always been underestimating the number of actual cases,” he said. “It’s not very reliable because most people are using home tests, which are not reported.”

Looking at case numbers could even be misleading, according to Adalja.

“Those are not really useful numbers,” he said. “You can look at trends in them, but I don’t think they’re very valuable at this stage.”

Mitigating infections

A new covid vaccine is on its way and should be ready in the next several weeks, according to health care professionals, and Fox said she is advocating for people to get it.

As with flu, the Centers for Disease Control and Prevention attempts to match new vaccines to the circulating strain, Fox said.

“Viruses are … notorious for changing their characteristics in order to survive — that’s how nature works,” she said. “That’s why we’ve seen all these different strains of covid.”

And those who are most at risk, such as elderly people or those with medical conditions, will continue to be at risk of having the most serious symptoms and difficult outcomes from covid, Fox said.

When school starts, it’s imperative that students stay home if they catch the virus, she said.

Often, local hospitals see a spike in upper respiratory infections in general around the start of school in the fall, in September and October, according to Fox.

As of now, the CDC advises those infected to stay home and away from others for at least 24 hours after symptoms are getting better or until there is no fever without using fever-reducing medicine.

Future of covid

Mask mandates will remain a requirement of the past, health care professionals agreed.

“I know there was an awful lot of controversy related to masking — feelings on both sides on the fence,” Fox said. “Personally, I do think the fact that people were masking more significantly helped.”

Aracri said he doesn’t believe mask mandates will ever be reinstated for covid, but certain places, such as individual shops or hospitals, might retain mask requirement policies.

“You shouldn’t have a mask mandate for this, let’s just say that,” he said. “It’s been in the community; it’s been circulating.”

However, masking could have helped with mitigating influenza cases, as there were fewer during the pandemic, Fox noted, which may or may not be a byproduct of people wearing masks during flu season.

“There was less transmission,” Fox said.

Much about covid and its long-term effects will remain unknown for years to come, according to Fox.

“I don’t think we understand the depths and breadth of the impacts of covid-19,” she said. “I think it’s going to take a number of years before we have a really good insight.”

Clinicians in Western Pennsylvania’s leading hospital systems have reported an increased flow of patients with long covid ailments — from never-ending headaches to depression and sleep problems — with many people unable to shake off the symptoms.

Though there are some studies that have been completed on long covid, Aracri said a lot more research is being completed on the condition.

“I think we’re going to be studying this virus for a very long time,” he said.

Long covid will always be a risk, especially for populations that aren’t as immune, Adalja said, but it’s less of a risk with current strains of the virus.

Compared to other respiratory viruses, there are more tools for covid-19 because it was such a priority during the height of the pandemic.

“There was a concerted effort … because we went through a worldwide pandemic in which 1.1 million Americans died,” Adalja said. “That galvanized people to develop tools for a virus that wasn’t even known to the human species before 2019.”

Though people should be prepared for covid when going back to school this fall, Adalja stressed that covid will always be a concern during back-to-school season from now on, and people should take advantage of the tools available to mitigate it.

“This virus is not going anywhere — it’s part of the human condition,” he said.

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